You've probably heard that "riz" -- a Gen Z deconstruction of the word "charisma" -- is the Oxford Dictionary word of the year for 2023. For the record, my almost perfect and consistently effervescent wife, Ellen, has "riz". By contrast, your faithful blogger, a tightly wound former hospital CEO born of old New England stock, does not. But "riz" is not the only nifty neologism now in circulation. How about "labordemic"?
The bond rating agency, Fitch, earlier this year coined the term, "labordemic", to describe the current state of the staffing-retention-turnover gestalt bedeviling the hospital industry. Unlike "riz", labordemic" is not just passing through the lexicon. With so many nurses and physicians leaving the field -- adding to already ominous projected shortages -- healthcare leaders will need to re-examine past assumptions and future actions.
Recruiting and Retaining Healthcare Staff
In the December 5 Becker's Review, staff writer Alan Condon interviewed Fitch's Kevin Holloran regarding Fitch's outlook for the hospital industry in 2024. Holloran, Fitch's senior director and health sector head, posits "(m)uch of a hospital's ability to be successful, will depend on their ability to recruit and retain staff in the currently hyper-competitive landscape for personnel". [emphasis added] Fitch/Holloran goes on to predict that there will be a trifurcation among hospitals in 2024. Those hospitals that have figured out the recipe to recruit and retain clinician staff will be in the top tier; most will find themselves in the middle tier ("mixed results", "lower margins", "still-heavy reliance on external contract labor") with the bottom tier of hospitals "vulnerable to downgrades".
Successfully navigating the "labordemic" requires a change both in thinking and in practice by the executive suite.
Do Patients Really Come First?
The conventional wisdom in healthcare -- probably one of the few things that physicians, nurses, therapists, EVS personnel, dietary staff, and managers at all levels will consistently, universally cite as a hospital's #1 priority: "patients come first". I disagree -- although in the interest of full disclosure I, too, used to repeat consistently that chestnut throughout my 40 year career in healthcare administration. I was wrong. True, patients and patient care are the reasons hospitals exist. But the first priority of the CEO and their senior team needs to be "people". Without people, there is no ability to serve patients. Without enough people with the right training, skills, team alignment, appropriate technology, and effective processes, there will not be safe, high quality patient care. Front-line staff deliver the care to patients, not executives. Executives need to care for the people who deliver the care. Making this mindshift is the first step in systematically slaying the "labordemic" dragon. The second step is to follow on with changes in the workplace and in work practices to make it easier for staff to care for patients.
Hospital Executives
If you're a hospital executive and want to move your organization to Fitch's top tier -- or even just want to find a way to survive the labordemic -- consider these actions:
expect all leaders, but especially senior executives, to do periodic job shadowing of front-line staff (where observing and deep listening are emphasized)
create and require leader standard work (LSW)
develop and deploy a sophisticated, deeply ingrained, and rigorous daily management system (DMS)
consistently apply one or more of the improvement sciences (Lean, six sigma, operations research, agile, design thinking) in consultation with front-line staff to improve workflow and reduce delays, waste, inefficiency, and job skill mismatches
invest in AI/ML solutions -- selected, tested, and endorsed by front-line staff -- that eliminate or at least markedly reduce data entry, administrative requirements, and/or repetitive tasks that are non-value add
regard clinicians as knowledge workers who are given significant latitude to make clinical decisions without unnecessary administrative encumbrances or delays
get rid of superfluous or outdated policies, procedures, redundant approvals and other stupid stuff (GROSS)
Ready to transform your hospital or workplace?
Are you frustrated by adversarial relationships between front-line clinicians and senior leadership? Organizational Wellbeing Solutions was formed to enable senior leaders to identify the specific drivers of clinician burnout in their organization; and to support leaders in designing and executing a comprehensive plan to stop clinician burnout, increase retention, and improve operating results. A hallmark of our consultancy is correcting the all-too-frequent distrust and alienation clinicians feel toward the c-suite generally and the CEO in particular. Let us help you help your organization and its clinicians develop a more trusting, aligned, and productive working relationship.