The Association of Schools Advancing Health Professions is working with member institutions to ensure a diverse pipeline of healthcare workers.
Disparities in healthcare have been aggravated throughout the duration of the pandemic.
Whether they stem from socioeconomic factors or lack of awareness when it comes to diversity, equity, and inclusion (DEI), if not addressed they can negatively affect the quality of care and service patients receive. Research has shown that disparities ins relationships between patients and their healthcare providers can make the process of offering care or treatment difficult.
The Association for Schools Advancing Health Professions (ASAHP) is actively working to ensure a diverse pipeline of future health professionals beginning at the undergraduate level.
In addition to institutions recruiting students from underrepresented backgrounds, ASAHP president, Deb Larsen PhD, FAPTA, FASAHP, explained the importance of making sure those students are supported once they're enrolled.
"It's not just getting them on campus, it's making sure they're successful once they get there," she said. "That's navigating the complexities of admission, registration, and housing; but also helping them feel like they belong at the university and in the program."
As director of the School of Health and Rehabilitation Services at The Ohio State University, Larsen has begun implementing several "best practices" to better serve underrepresented students. These include changes to the admissions process, for example, lessening the emphasis on standardized test scores and grades, and instead emphasizing the experiences and attributes of the applicant.
"Those kinds of things, we think, make for good health professionals. I think changing the way we admit students is a key part of this, and I think the same happens at the faculty level," Larsen said. "We need to make sure we're hiring faculty that represent diversity of experience and ideas, and not just [because they] come from the top PhD programs or have the strongest research program."
Having recently established a DEI committee within the organization, ASAHP is facilitating other schools, such as Florida A&M University, a historically black university, with implementing similar changes.
Understanding a patient's background and experiences can affect the conversations and relationships they have with healthcare workers, says Cynthia Hughes Harris, PhD, dean of Florida A&M's School of Allied Health Sciences.
"First, we have to help our students realize that diversity is a piece of the health puzzle that we are putting together as we work with patients and clients and how it influences statistics," she explained.
While diversity usually is perceived to be a "black and white" issue, Hughes Harris said it's really what makes an individual unique from other individuals.
As the healthcare industry makes progress with diversity and inclusivity, the disparities will improve, Larsen said.
"I think there's enough research to say that people tend to seek out healthcare providers that look like them and understand them, and they are more apt to follow directions and be compliant in their plan of care if they have a connection with their healthcare provider," Larsen said.
"You want diversity of thought, you want a diversity of experience of experience, you want a diversity of personal characteristics," she said. "You just want to embrace that whole plethora of characteristics."
Lori Herndon MBA, BSN, RN, was installed as the chair of NJHA in late January.
Lori Herndon, MBA, BSN, RN, president and CEO of AtlantiCare, has been appointed as chair of the New Jersey Hospital Association.
Herndon was officially installed as chair during NJHA's annual meeting, which took place virtually in late January.
Her work with NJHA began in 2014, working on some of the organization's committees.
Over the course of the COVID-19 pandemic, she has been a voice of leadership and guidance for the healthcare industry, the state of New Jersey, and the state department of health "making sure that our workforce is safe," Herndon said in a recent interview with HealthLeaders. "And making sure that we are advocating for things that they need to do their important work has been critical."
As chair of NJHA, Herndon hopes to continue working to protect healthcare workers, redesign how they deliver care, and continue efforts to develop the workforce. In her installation speech, she also emphasized the need to treat one another with kindness.
"I think that civility and the need for people to step back and recognize that we're all human and we're not all perfect and this a tough, terribly challenging time," she said. "We need to remind ourselves to be kind to one another."
Throughout the industry, women are continuing to step into more leadership and stakeholder positions. According to Herndon, not only is there room for this to continue, but it's also needed.
"Women in all stages of their healthcare careers can and should advocate for those who need care and those who provide it. Every woman – every individual – has a voice," she said. "Whether we are at the bedside, in the board room, or working in the community, the solutions, strategies, and skills we offer are critical to enhancing and saving lives. Helping each other to grow professionally and personally is important."
While she has served in a number of roles in the healthcare industry with varying responsibilities, she sees herself as a nurse first.
"The clinical skills that I was able to learn over those years gave me the confidence to always advocate for patients [and] be engaged with the plan," she said. "The role of the professional nurse is so intricate and accountable for outcomes, and that I really embraced."
Through her work as a nurse came opportunities to assist and offer her opinion on improvements, which she said was a natural progression to getting in front of leaders early on in her career. At 35 she was hired as a hospital administrator for one of AtlantiCare's hospitals.
"That lead to the confidence and willingness to raise my hand and be involved in things that were at times very high profile, [having a] high degree of risk," Herndon said. " I always encourage people if you want to build a career, chase and volunteer for the work that's complicated, the work that's difficult, and has a high reward but also a high risk. If you're successful, it will lead to another door eventually."
The survey reemphasizes the importance of internal communication and employee feedback.
With ongoing staffing shortages and workers concerned for their own health, employers are forced to reevaluate their relationship with their employees.
In its recent 2021/2022 State of the Sector report, insurance, risk management, and consulting firm Gallagher found that 53% of employers reengaging with their employees as a priority. In reengaging with employees, organizations will be better able to rally them around its purpose, strategy, and values.
Communication
Internal communications will rise in importance, but what is being communicated must also be easily comprehended, the report says.
"As we move through 2022, to really nail that crucial clarity and alignment factor, the organizational narrative will need to be holistic and to cover 'how' we do it as much as 'why' and 'what' when it comes to communicating change," the report stated. "And that will certainly need some clear direction from the top."
Asking employers about changes they'll be making this year, the survey found that process and ways of working, culture change, and system and technology change to be the top three challenges employers were facing. "Lack of clarity from the top" was also a notable challenge.
Regarding organizational well-being, purpose, strategy, and values, only 34% of participants said they were firmly, actively involved in the way they're communicated, the survey found. Overall, only 63% of respondents were involved with internal communication.
Improvements in D&I and ESG
The importance and benefits of a diverse and inclusive organization, as well as environmental, social, and governance (ESG) awareness, regardless of industry, has increased in recent years. So how is this awareness reflected within the organization's culture?
According to the survey, 77% of participants said their employees "care about their organization's commitment to reduce it's impact on the environment," yet only 50% have a "compelling ESG narrative in place."
Results with diversity and inclusion (D&I) efforts were more favorable, with 61% of participants' organizations having a narrative in place that is shared internally. It was noted that larger organizations approached efforts to improve D&I and ESG in a more structured manner than smaller organizations.
Employee critiques
Whether maintaining social distance in the workplace or working from home, general interactions with employees are difficult to manage.
Some 88% of survey participants agreed that their organization values employee feedback, which was a consistent answer regardless of the organization's size. However, 64% believed their organizations learn from the feedback they receive.
"The information you share has to resonate, it has to be clear and it has to drive action," the report said. "If your employees don't understand what you're saying, they won't waste their time trying to work it out."
While the CDC recommends returning to work after five days, the study claims that's when the virus is at its peak.
New data from a study by the University of Chicago Medicine is showing that 40% of vaccinated healthcare workers are still testing positive for COVID-19 up to 10 days after their symptoms began.
The study, which has not yet been peer reviewed, followed the U.S. Centers for Disease Control and Prevention's (CDC) isolation recommendations from January, saying individuals with COVID-19 could end their isolation after five days if they were fever free, their symptoms were beginning to go away, or if they were no longer experiencing symptoms.
Even more individuals with COVID-19 may still be contagious after the first few days, including those who feel like they've recovered, the study said.
While the CDC didn't recommend getting tested again after the fifth day of isolation, having individuals return to work before 10 days of isolation or receiving a negative rapid antigen test to be certain they're no longer sick could increase the likelihood of others getting sick.
The CDC's isolation recommendations were based on studies done prior to the omicron variant, as well as before people got vaccinated or infected, according to Emily Landon, MD, executive medical director of Infection Prevention and Control at the University of Chicago who co-authored the study.
"In those situations, symptoms generally didn't start until a person had already reached their peak virus load," she said. "In those cases, ending isolation after five days might be reasonable, since earlier data showed few people still had live virus at that point."
With the omicron variant, Landon added, symptoms are showing up before the peak virus load, so an individual's isolation period begins earlier. However, those individuals are more contagious after the sixth day, she said.
After discussions with public health and infectious disease experts, UChicago Medicine developed a policy that would allow fully vaccinated healthcare workers with mild symptoms to return to work after five days of isolation. However, the employees would be required to take a rapid antigen test as a precaution.
Those able to return early had to follow strict masking and distancing guidelines. Employees with negative results wouldn't be able to return to work until either testing negative or after day 11 of isolation.
The study has implications for the CDC's recent return-to-work recommendations, the research team said. One hypothesis that came from the study is that individuals who'd been vaccinated and gotten a booster shot were more likely to have a positive rapid antigen test on their first attempt to return to work. The same individuals may also get better before the virus is out of their system.
While the health system encouraged the use of rapid antigen testing before ending isolation and returning to work, it emphasized that preventive measures like masking are also important.
"Without checking a rapid test to be sure your viral load is past its peak, ending isolation early may increase the risk of infecting others," Rachel Marrs, DNP, RN, and director of Infection Control and Prevention at UChicago Medicine said. "That would counteract the hope that ending isolation early would reduce the staffing issues plaguing nearly every industry."
Michelle Gaskill-Hames assumed her new role on February 7.
Kaiser Permanente recently announced that Michelle Gaskill-Hames has been promoted to senior vice president, chief operating officer, and chief strategy, growth, and experience officer for its Southern California and Hawaii region.
In her new role, Gaskill-Hames will oversee eight medical service areas in the region, as well as lead the organization's growth strategy and efforts to improve consumer experience to bring the system's healthcare to more individuals in the region.
"We are fortunate to have someone with Michelle's caliber and high level of experience assume this critically important role at a time when the healthcare industry is being pushed to its limit amidst a global pandemic," Julie Miller-Phipps, president of Kaiser Permanente Southern California and Hawaii health plan and hospitals, said in a press release statement. "Michelle will partner with the Permanente physicians and local teams to ensure our Kern, Ventura, and LA County healthcare delivery systems continue to provide excellent service and quality care."
Miller-Phipps added that Gaskill-Hames will also play a role in expanding access to the system's leading model of integrated care to more businesses and individuals in their communities.
Gaskill-Hames has worked in healthcare for over two decades and began her career as a neonatal intensive care registered nurse. She has served in served in numerous leadership roles, including serving as a chief nurse executive and hospital president for Advocate Health Care.
Joining Kaiser Permanente's Northern California region in 2016, she served as senior vice president of hospital and health plan operations and played a pivotal role in the region's response to the pandemic as lead Incident Commander, according to the press release.
"I look forward to being a part of the most accessible, innovative, and highly desired health care system in Southern California and Hawaii," she said in a statement. "I am even more honored to work alongside a diverse group of talented physicians, dedicated staff, loyal members, and wonderful community leaders. Together we will continue Kaiser Permanente's mission to deliver exceptional experiences while improving the health of the communities we serve."
Student loan repayment and tuition reimbursement are the most common options.
Education benefits have risen in popularity among healthcare organizations in recent years, with organizations such as Blue Cross Blue Shield and Aetna offering options like student loan repayment and tuition reimbursement for employees.
Benefits such as tuition reimbursement is common in markets like healthcare where employees need a certain degree to do a role, said Gwen Cymerman, a benefits manager with Orlando Health. While Orlando Health offers student loan repayment and tuition reimbursement, in December 2020 it launched its preferred education program.
"The idea behind preferred education was to offer high-quality education at local schools at low cost to the organization, and what we've done is made it very easy for our team members to participate in it," Cymerman said. "We remove any financial barrier that the team member may have had in order to participate in these programs."
Orlando Health has partnered with four schools local to the system—Valencia College, Seminole State College, St. Petersburg College, and Lake-Sumter State College—where it covers 100% of the books and tuition for its employees.
The preferred education program helps Orlando Health differentiate itself from other healthcare systems, Cymerman said.
"It's easy to sell Orlando Health and the growth and the path you can create here with these programs," she said. "So, our talent acquisition team, whenever we're rolling out new benefits or expanding it, I definitely made sure we got in front of them to explain things."
While employees can continue their education via the preferred education program, the health system is able to grow its own pipeline of potential talent.
"They really do show that if you come here to work, we believe in you, we believe in you obtaining an education," she said. "Wherever you might want to go with that we can map it out for you."
The program allows nonclinical team members to take on everyday tasks so their frontline colleagues can focus on patient care.
On any given day at one of Sentara Healthcare's hospitals, you might find Jillian Ouyang, a corporate strategic planner, stocking equipment shelves or Tasha Ringo, an Optima Health claims processor, cleaning rooms.
The unique teamwork is part of Sentara's efforts to quell pandemic-caused stress and strain for healthcare workers via the new Nonclinical Resource Pool program in which nonclinical employees can volunteer their time to help clinical colleagues.
The program was created to support healthcare workers on the frontline amid the current omicron variant surge.
Volunteers handle such tasks as fetching materials, distributing meal trays, and any other jobs that allow the clinical staff to focus on patient care.
The health system has had a COVID task force in place for about two years, along with a clinical resource pool with staff that rotate to different areas of need across the system, says Terrie Edwards, Sentara's corporate vice president.
"We have about 20,000 [full-time employees] across our system, and there are about 6,000 that are in corporate services or health plans or finance and other areas, and they want to help," she says. "They're highly engaged, motivated employees. What would be the best ways to engage them and what roles could they play in the hospital?"
John Michael Eargle, division vice president for system service lines, designed and developed the program for nonclinical employees.
"From a design perspective, the way that it really worked was we created a standard survey and it was distributed out to those 6,000 employees, and it asked them to sign up for shifts," Eargle says.
"We created seven positions of need that were identified within our acute care hospital settings and those nonclinical employees had the opportunity to volunteer at their home hospital or their regional based hospital in those positions," he says.
The hospitals within the system sent a list of things that needed to be done at their facility. Using the answers from the initial survey, Eargle and his team matched those individuals up with the positions they favored in a way that supply and demand would be balanced.
In two weeks, program volunteers completed more than 3,000 hours—an average of 228 hours per day—with nearly 500 nonclinical team members having expressed interest.
"The volunteers were incredibly grateful as well to be able to help out their hospital and clinical-based teams in the acute care setting," Eargle says.
Initially, the program was to be used throughout the system until February 12, after which the need for volunteers will be evaluated on a weekly basis. However, because of such positive reception to the program, Edwards says the health system is looking into ways to make it permanent.
Bridget Frazier's job is usually to process claims, but volunteering through the program has been an eye-opening experience, she says.
"For us that work from home, I think it's a great opportunity to break us from the routine and to come out and help," she says.
"It feels good to give back to my workplace," Ouyang says. "I feel like everyone who has been working in the hospitals are superheroes. We can't thank them enough for their hard work and truly they are the backbone to keep us going."
Dr. Margaret Larkins-Pettigrew of Allegheny shares her expertise as a Chief Clinical Diversity, Equity, and Inclusion Officer.
While the pandemic has aggravated many issues in the healthcare industry, disparities driven by lack of diversity, equity, and inclusivity have been the most persistent.
In a report on the importance of diversity in the healthcare workforce published in 2021, Fatima Cody Stanford, MD, MPH, FAAP, FACP, FTOS, expressed the experiences of racial and ethnic minorities when pursuing their medical degrees compared to those from majority groups. In a survey of about 3,500 healthcare professionals, the findings showed that minorities and women were less likely to rank their organization as "culturally competent."
Margaret Larkins-Pettigrew, MD, Med, MPPM, is the senior vice president and Chief Clinical Diversity, Equity, and Inclusion Officer for Allegheny Health Network, a nonprofit health system headquartered in Pittsburgh, Pennsylvania.
In a recent interview with HealthLeaders, Larkins-Pettigrew said that as the leaders of their respective organizations, C-suite executives must be the "diversity champions" of their institution.
"They have to really want to acknowledge and embrace the historical events that have brought us to this place where we are recognizing that we have such disparate care and medical disparities," Larkins-Pettigrew said.
She explained that healthcare is not only what patients receive at the hospital, but the way healthcare professionals take care of people—how they ensure they are providing services patients may need, and how they make the best decisions for each patient.
"[Healthcare is] how we treat people who come to our system and who rely on us as experts, and what services we offer them to give the comprehensive care that allows us to decrease the disparity in the health gap that we see across the world," Larkins-Pettigrew said.
The first step for many organizations seeking to improve their DEI is to hire someone at the executive level who can recognize, acknowledge, and engage the necessary methods or initiatives to begin improving.
"C-suite leaders understand that we, ourselves, are biased. We need to make sure that we understand what it will take to make sure that we are checking our biases," Larkins-Pettigrew said. "That the trickle-down effect in our decision-making are those not based on biases, but based on scientific literature, is evidence-based, and that we're giving everybody the same [quality of care]."
Additionally, organizations must be mindful of the trust patients give their hospitals, healthcare facilities, and healthcare workers, and strive to keep it.
"Patients and healthcare workers should be able to show up as their authentic selves, with workers being mindful to meet the patient where they are in the moment regarding their care to continue that trust," Larkins-Pettigrew said.
In hiring, she added, the importance isn't as much in recruiting diverse individuals as it is retaining them.
"Retaining them means that they have to feel that they belong, that they're included, and that they are part of that big picture." Larkins-Pettigrew explained. "That their expertise matters."
From a socioeconomic perspective, the need for DEI increases when it comes to healthcare organizations and systems serving patients in rural communities. The current rural healthcare crisis is a result of several factors including the closing of numerous rural hospitals and healthcare facilities, staffing shortages, and the lack of expert or specialist care.
"[Healthcare systems] have to be connected to all of the folks we need to take care of. That means we need to understand what the needs are of people who live in rural communities," Larkins-Pettigrew said. "We need to pay attention to educate more primary care physicians who will be dedicated to these rural areas."
American Association of Nurse Practitioners president offers actionable suggestions.
As the COVID-19 pandemic enters its third year, protecting the well-being and mental health of nurses and other healthcare workers is more important than ever, says April Kapu, president of the American Association of Nurse Practitioners (AANP). Kapu, based in Nashville, remembers when COVID first began to affect the community in March 2020.
From setting up testing centers to developing COVID ICUs and ensuring they were staffed 24/7, there were a number of steps taken early on to attempt to wrestle control of the virus.
"I think at the beginning it was all-hands-on-deck, thinking that things will maybe wind down in mid-2021 if people got vaccinated," she said.
Kapu admitted that the surge of the Delta variant in the late summer of 2021 was a "huge hit." By that time, the staffing shortage had been aggravated further by the pandemic, including healthcare workers getting sick with COVID themselves.
According to Kapu, Nashville has reached its peak with Omicron variant cases, with children's and adult hospitals treating a high number of cases. She notes that while those being treated are "largely unvaccinated," they have begun to see more breakthrough cases with less severe symptoms.
"Having a staffing shortage, working day in and day out … that is physically exhausting," Kapu said, explaining how the stress and strain leads to burnout.
The long hours and constantly being on the move are physically exhausting for healthcare workers, she explained. Another factor of burnout is the emotional and mental toll the pandemic has taken on healthcare workers.
A number of studies have been conducted on the burnout healthcare workers are experiencing. Leading a group in her own study last year, Kapu found that 26% of nurse practitioners were exhibiting signs and symptoms of burnout. When asking participants what enabled their resilience to continue to push through their burnout, the "overwhelming recurrent" answer was wanting to make a change.
"Nationally, we just need to increase the supply of nurses and to support the education and training of nurses. Allow them to practice to the full extent of their education and training [and] increase autonomy," Kapu said, noting that the lack of the latter is directly related to burnout.
Having mental health services readily available to healthcare workers, in addition to emphasizing and implementing a healthy work environment, are also key to supporting workers. Workers also must not be afraid to seek out those resources if they feel like they need them, or to take days off.
"We cannot continue to run on the empty tank of gas. We need to take the time off now so that we can bring our very best self to our patients," Kapu said. "And when we do take that time off, we need to unplug and really spend that time getting out with nature, spending time with others, thinking about things other than work. That’s how we'll be able to come back and do what we really love."
Editor's note: This story was updated on February 9, 2022.
The tentative name for the new system is BHSH System and is set to launch on February 1.
Beaumont Health and Spectrum Health announced Monday that they will be merging to launch a new, combined health system "For Michigan, By MichiganTM."
The new system, which will temporarily be referred to as BHSH System, is set to launch on February 1. BHSH System will be led by an equal number of board members from both organizations, with the current Beaumont Health board chair, Julie Fream, serving as chair of the new board.
"Now, more than ever, our communities rely on physicians, nurses, and other caregivers for essential and life saving care. As we know, healthcare is personal and local. The ability to make decisions at the local level is crucial," Fream said in a virtual news conference. "We look forward to partnering with our patients, team members, and health plan members as we build a new organization designed to improve the health of the communities we serve."
Tina Freese Decker, president and CEO of Spectrum Health, will lead as president and CEO of BHSH System.
"This latest experience with delta's steady climb, and adding omicron on top of an already exhausted system has been overwhelming and at times heartbreaking," Decker said. "Our team member's never ending passion, grit, courage, and integrity everyday – even in the midst of so much trauma and burnout – demonstrates our determined commitment to providing outstanding care and coverage to all the communities we serve."
Other members of the BHSH leadership team include Jason Joseph as Chief Digital and Information Officer, Matthew Cox as Chief Financial Officer, Pamela Ries as Chief Integration Officer, and David Leonard as Chief Legal Officer.
The organization will be conducting internal and national searches to fill additional C-suite roles including Chief People Officer and Chief Strategy Officer. The organization will also be recruiting a new president of BHSH Beaumont Health, as Beaumont's Health's current president, John Fox, announced his plans to leave the organization last year. His last day will be February 4.
"I am very proud of our Beaumont team members for their many accomplishments, and I'm especially proud of the compassionate, extraordinary care they have provided for our patients throughout this long pandemic," Fox said in a statement. "I'm confident BHSH System will become one of the best health care systems in the nation.
Current Spectrum and Beaumont Health patients and health plan members will continue to have access to their same sites of care, providers, and plans. They are also encouraged to access care just as they would normally as both organizations focus on the creation of BHSH System.
