9 minute read
Worker Shortages
PRE SENT CHALLENGES FOR LANCASTER COUNTY HEALTH SYSTEMS, BUT OFFICIALS HAVE OPTIMISM
BY SUSAN SHELLY
Statistics released during the past year concerning nationwide health care staffing shortages are discouraging, to say the least.
The American Hospital Association in February 2022 submitted a statement to the Senate Health, Education, Labor & Pension Committee, describing the issue as “critical,” while U.S. Surgeon General Vivek Murthy, MD, issued an advisory in May that called on the country to address the growing threats of staffing shortages and health worker burnout.
Data released in June by the Association of American Medical Colleges indicated that the U.S. could face a shortage of between 37,800 and 124,000 physicians by 2034, and the U.S. Bureau of Labor Statistics projected the need for 1.1 million additional registered nurses by 2030 in order to meet demand.
There is little dispute that staffing shortages continue to plague health care systems across the country, as well as in other parts of the world, and that the situation is likely to remain a problem for the foreseeable future.
While Lancaster County health care systems are not immune to these shortages and are working aggressively to address them, representatives of some of the systems serving the county reported their situations seem to be improving, and they’re hopeful the worst may be behind them.
They spoke of workers who had left the systems and then returned to their jobs, reframing the “Great Resignation” as the “Great Regret,” and said they are working hard to assure that benefits and working conditions are in line to attract other workers.
Lancaster Physician reached out to the health systems serving Lancaster County to learn more about their current situations and what they’re doing to address shortages of staff. Penn State Health, Penn Medicine Lancaster General Health, UPMC, and WellSpan Health responded.
Penn Medicine Lancaster General Health
Pandemic-related resignations and other factors have contributed to staffing shortages in some areas within Penn Medicine Lancaster General Health, said Kay Brady, interim chief human resources officer. Staffing issues are especially affecting the areas of nursing, respiratory therapy, and surgical technology.
But on a positive note, Brady said, the rate of employee turnover appears to have leveled off since peaking last September.
“We’re not back to pre-pandemic numbers yet, but it’s getting better,” she said. “Our turnover rate has decreased in the past year.”
Like other health care systems, LG Health has had to make changes in its efforts to attract, hire, and retain employees.
Where it once employed a more generalized approach to finding people to fill open positions, it now focuses on more proactive “sourcing” of potential employees, including some who had previously left positions within LG Health.
“We spend a significant amount of time sourcing for our jobs,” noted Brady. “We’ve found we really need to get out there and identify candidates for open positions.”
Recruiting through social media has increased significantly, and “Talk to Us Tuesday” events held on-site enable potential employees for entry-level jobs to get on-the-spot-interviews at specific locations.
LG Health also uses an internal pipeline system to advance employees, offering scholarships to qualified workers who wish to continue their educations. And staff members work with area school systems to bring 16- and17-year-old students into the hospital to introduce them to health care jobs.
“We want students to be aware of the variety of opportunities available to them,” Brady said.
In addition to altering its recruitment and hiring efforts, the system has stepped up its efforts to address the health and well-being of current employees.
An on-site resilience coach counsels workers on issues related to stress and burnout, and regular surveys are conducted to determine employee well-being needs. Management continually monitors compensation rates to make sure the system remains competitive.
“It’s important to make sure we know how employees are feeling and what they’re looking for within their work environments,” Brady said. “We want them to know that they’re valued.”
While LG Health’s staffing situation has improved, there’s still work to be done.
Certified medical assistants who work in doctors’ offices are in short supply, and varying recruitment and hiring practices must be engaged to attract employees to different parts of LG Health’s coverage area.
The health care system serves patients in Lancaster City, as well as suburban and rural areas, Brady noted, requiring different strategies to attract employees to varying types of work environments.
“We touch 300,000 people a year,” Brady said. “That’s a lot of area to cover.”
She’s hopeful that attitudes toward working in health care will improve and more people will begin to pursue careers in the field.
“I think it’s a cyclical thing, and I think the situation will improve,” Brady said. “But I’m also realistic about where we are right now and the need to keep working to make sure we have sufficient levels of staffing to care for our patients.”
Penn State Health
With two new hospitals that opened just about a year apart in 2021 and 2022, Penn State Health remains under pressure to attract additional employees to staff the new facilities.
“We were really needing to staff up so we could continue to serve our communities and deliver what we’d promised we would,” explained Jennifer Sarff, vice president of human resources.
While there have been some challenges in getting the hospitals — the newest of which is a $375 million facility that opened in October in East Hempfield Township — sufficiently staffed, Sarff said a shortage of workers appears to have abated somewhat over the past several months.
“I would say that it (understaffing) definitely continues to be a problem, but we are seeing some improvement as the months go by,” she said.
Peak shortages occurred in April, May, and June of this past year, but Sarff said the system was able to meet its recruiting goals for the opening of Penn State Health Lancaster Medical Center.
Perspectives
The hospital has continued to serve its patients, supplementing with agency nurses when necessary to meet patient needs.
Hired to her current position during the height of the pandemic, Sarff said Penn State Health has had to shift its hiring focus and pivot to doing things differently.
“We’re doing things we haven’t previously done,” she noted.
Those things include careful monitoring of market reviews, making salary adjustments, and keeping a close watch on market data.
New technology is being employed for recruiting employees, and jobs fairs — which were completely virtual during the pandemic — are now a combination of virtual and in-person. Penn State Health also is moving toward a regional recruitment method and has enhanced communications with potential employees.
“We’re hoping all of these things will make it easier to identify, hire, and onboard employees,” Sarff said.
The health system also is looking internally to better understand what employees are looking for in an attempt to boost employee retention.
“We’re using internal data like we never have before,” Sarff shared.
While there are openings at nearly every job level, nursing positions remain the hardest hit by shortages. Forty percent of all job openings across the Penn State system are within the category of nursing jobs, including bedside nurses, licensed practical nurses, and nursing educators.
There are numerous reasons why so many nursing positions remain unfilled, Sarff said, but a major contributor is a low proportion of nursing students graduating within Pennsylvania. If more people can be persuaded to pursue nursing as a career, the problem will improve.
Penn State Health officials are encouraged that some employees who gave up their jobs during the pandemic have come back, a move that is evidence of wider-spread Great Regret.
“We are definitely seeing that play out here,” she said.
While she expects it will take time for the worker shortage to resolve, Sarff said Penn State Health continues to move forward with hiring and retaining employees.
“I’m encouraged by the positive trend we’re seeing, and from what we’re hearing from our employees,” she said. “We’re really excited about the opening of our newest hospital here and we’re looking forward to serving the people of Lancaster County.”
WellSpan Health
WellSpan Health is addressing the widespread worker shortage by employing innovative incentives for hiring and retaining workers, reported Dr. Ericka Powell, vice president of medical affairs at WellSpan Ephrata Community Hospital and an emergency department physician.
Those efforts include working to rehire employees who left their jobs during the pandemic — an endeavor that has been successful. More than 1,000 workers have returned to WellSpan during the past two years, according to Powell.
“It’s a pretty significant number,” she said. “We’re proud of that.”
Powell said WellSpan Health continually promotes a culture of excellence, an effort that resulted in the system being recognized last year by Becker’s Healthcare as a top destination for employment on its 150 Top Places to Work in Healthcare 2022 list.
Factors contributing to that designation included workforce diversity, employee benefits, and opportunities for professional growth for employees.
Powell noted that WellSpan has been reaching out to the LGBTQ community and other groups in its efforts to promote employee diversity, and it offers excellent salaries along with extensive benefits packages that are tailored to meet employee needs.
“Those distinctions and recognitions have made us stand out in the community,” she explained. “We’re just known as a great place to work.”
WellSpan partners with high schools and community colleges to introduce students to health care jobs and offers an advancement program for employees who are looking to advance in their careers.
Its recruitment efforts are supported by employees, who receive rewards for referrals.
“Everyone at WellSpan helps to recruit,” said Powell.
To address the issue of nurses leaving the health care system for higher paying jobs with agencies, WellSpan initiated a WellStaffed™ program of floating nurses across its regional health system.
The program addresses patient care needs at each of WellSpan’s hospitals, while providing opportunities for nurses and certified nursing assistants who wish to expand their skill sets by supporting various specialties.
“We’re super excited about that program,” Powell said. “It’s done really well.”
The health system also plans to initiate a pharmacy residency program at Ephrata Community Hospital with the intent of increasing its pool of pharmacists. It currently has a pharmacy residency program at WellSpan York Hospital.
And, said Powell, the system is innovatively employing new technologies that enable providers to deliver effective care to patients in less time. With Baby Boomers retiring and staffing levels still below pre-pandemic levels, it’s important to take advantage of resources that enable better patient care.
“Ideally, we could replace every provider who leaves WellSpan,” Powell shared. “But when you can’t do that, you have to look at how you can do things differently and use technology to close the gap.”
Staffing issues are a significant problem for health care systems, Powell acknowledged, and must be addressed on state and national levels. But WellSpan is doing all it can to hire and keep employees who value the organization’s culture and recognize the advantages of working there.
“We want people to know it’s a career they’re coming to, not just a job,” she said. “And that applies to everyone, from those in housekeeping to physicians.”
UPMC
UPMC has expanded its job training and education efforts and created additional opportunities for potential employees with innovate pipeline programs that enable those interested in careers in the medical field to get first-hand experience.
The programs, intended to address worker shortages by connecting individuals with employment opportunities at UPMC, include EMT training, medical and surgical technician training, an urgent care assistant program, and others. UPMC also partners with community colleges and other schools to encourage students to consider health care careers.
“We are looking for creative ways to build pipelines and remove barriers to receiving an education,” said Amanda Paull, a recruitment manager at UPMC.
The urgent care assistant program, which began in 2022, enables someone who is at least 18 years old and has earned a high school diploma to receive training in an urgent care setting while being paid as a UPMC employee. Qualified trainees who successfully obtain required certification can then be considered for permanent hire within the UPMC system.
“It’s a great opportunity for people to come in and get the training they need for employment,” Paull said.
New to the central Pennsylvania region is the UPMC Shadyside School of Nursing at UPMC Harrisburg, which opened to its inaugural class in August. Partnering with Harrisburg University, Shadyside School of Nursing is a 16-month, cost-effective, accelerated diploma program for registered nurses. It, and other UPMC nursing schools, will offer a tuition loan forgiveness program for new enrollees beginning in the fall of 2023.
The school includes non-nursing classes, nursing classes taught by UPMC faculty, and over 900 hours of clinical rotations at regional UPMC facilities.
Shayla Thompson, UPMC’s director of human resources, said the school addresses a need for nurses across the region.
“We know that the need for nurses is expected to increase, and we’re working to help meet the growing health care needs of our region,” Thompson said.
With 127 students in the inaugural class, the school is expected to graduate thousands of nurses over the next decade.
Retention efforts also are in place to address worker shortages, which Paull said are most prevalent in the areas of nursing, respiratory therapy, and imaging.
Thompson said UPMC addresses employee retention by providing pathways for workers to advance in their careers. A care attendant, for instance, potentially can move up to a nursing assistant position, eventually qualifying to be a registered or licensed practical nurse.
“We have career ladders for several roles within our organization that provide staff the opportunity to grow and develop within their careers,” she shared.
In addition, UPMC emphasizes a culture of openness and appreciation of its staff.
While worker shortages remain a concern, Thompson noted that the system is continuing to grow and can staff additional facilities. In addition, some employees who left the health care system have returned.
“We are continuing to grow and add practices to our organization, which is exciting from our perspective,” Thompson said.