Countering the Healthcare Shortage - The Human Elements

[HighSpeed]

Healthcare faces a major challenge in the form of healthcare shortage: the number of healthcare professionals versus patient load and healthcare services suffers an imbalance because the former is significantly lower than the latter.

The approach which has been taken for years to counter this imbalance has been to create various incentives to boost the number of healthcare workers. We can see this if we look in our local employment section. Ads that read "$10,000 sign on bonus" are doing exactly that. They are offering economic incentives to trade for a boost in the number of healthcare staffers. This strategy has been ongoing for years without change.
A reasonable inference can be made that it is not working, or if it is, it certainly has not caused a measurable impact in the healthcare crisis, specifically the shortage of healthcare workers.

Many approaches can be suggested to repair the healthcare crisis. Some of the most recent strategies have been in the area of reforming the financial structure of the current system. This includes changes made in insurance,
billing, subsidies, and so on. The major challenge with this system is that the people, or the government end up bearing the burden one way or the other. It is unavoidable as the scarcity principle of economics supports the notion
that resources (finances in this case) are limited.

A new approach can be considered in checking the healthcare crisis. This strategy, which has been tried and proved for generations does not cost the government significantly relative to the other methods. This strategy is that of harnessing the human element. Elements such as morale, motivation, discipline, carmaraderie, and esprit de corps.

Before we go into the details of implementing such a system lets ask ourselves what the healthcare shortage is? It is simply the situation where the number of healthcare workers does not meet the demand of healthcare services. To the reader. Know that this "number" is an average taken from the various healthcare establishments in the nation. Some establishments are below the average while some are above the average. Why? What is the
common denominator in place inside those healthcare establishments that exhibit "above average" numbers disrespecting the shortage. It is the human element. In such organizations there exists a higher measure of morale, motivation, discipline, carmaraderie, and esprit de corps.

To implement this system we simply need to create light programs that improve employee morale. A healtchare facility can for instance have "recreation days" where they pit their nurses, doctors, e.t.c in friendly competition against other neighborhood facilities. It would ideally be "infotainment" oriented games where the contestants are tested on
"finding patient information", jeopardy (with health oriented themes), Who Wants to be a Millionaire (with questions specific to whatever genre of healthcare the competing facilities are in). These micro exercises in "having fun while earning makes great strides in boosting the general morale inside the healthcare facilities involved. The morale building process would not be in who wins, but in the preparation of such exercises.

How do we know such a strategy would work? Ask our military community that expends significant effort in such programs (on the unit level), ask our local law enforcement agencies, ask our fire departments in our various cities. This strategy has worked for them for decades, and it will no doubt work for the healthcare industry where such an effort in boosting the human element is mostly non existent.


When we then have a healthcare facility where the morale, motivation, e.t.c has increased. It causes the workers to make a better effort to provide healthcare absent of any artificial incentive. We can then visualize the effect it would have if hundreds, perhaps thousands of healthcare facilities adopt such programs, and imagine the possibilities it presents in significantly challenging the "shortage" category of the nations healthcare crisis.

In the interest of maintaining a short article I would like to stop here but please feel free to email me, PM me, or simply post clarification by posting replys. Certainly enjoy the forum and SDN.

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[MagicalTrevor]

I'd say that increasing medical school enrollment is a way to get around lack of staff. I can't see how popular this sort of thing would be.

 

[HighSpeed]

I'd say that increasing medical school enrollment is a way to get around lack of staff. I can't see how popular this sort of thing would be.

The crux of the article is that increasing the number of staff, say, by increasing medical school enrollment, is not the issue, but rather powering up the human elements (e.g. moral, motivation, dedication to goal) among existing medical/clinical staff.

If you compare a medical facility where the staffers have average morale versus medical facilities where the staffers have above average morale, you'll discover that the those with boosted morale tend to provide better healthcare.

Please also know that in many healthcare facilities there is no concrete effort to initiate programs that improve such features. Are there professions where such programs have been initiated? Yes. (law enforcement, military, firefighters). Is it working for them? Yes.

All we in the healthcare sector need do is copy.

 

[kronickm]

I absolutely agree with the point you are making here. The vast, vast majority of hospital staff are usually cranky, overworked and complain about their jobs endlessly, I would know as I often catch myself doing this. There are numerous problems with your plan though. First of all, this stuff costs time and money which ultimately effects the bottom line which is what management really cares about. A larger problem, however, is that hospitals and such I think benefit somewhat from a work shortage. Along the same line, boosting staff morale will certainly provide benefits in many aspects of the business, including patient care, what it will not provide, however, is more dollars in your pocket. Also, your plan does not really help with the issue at hand. Sure happier workers will, perhaps, be more obliged to go the extra mile, and, perhaps again, work that much more, but it won't really increase the raw number of healthcare employees.

The one aspect of this plan that seems feasable is that if you have happier healthcare workers they may incourage others to enter the industry as opposed to the usual, "I hate my job" "healthcare sucks" and so on. Perhaps people will see that it is a worthwhile field to go into, which is not usually the opinion one gets from speaking with healthcare employees.

All that being said, I do feel that the happiness of one's employees should be of the utmost importance to an employer. I think it would be wonderful if places would do as you suggested. Would it likely make for a better healthcare experience for the patient, absolutely. Would it lead to more people wanting to go in to health care employment, not likely.

 

[kronickm]

On a slightly seperate note.

I never could really grasp how management is sometimes so out of tune with their employees. I will give a personal example.

At my hospital they have initiated a program with the goal of increasing patient satisfaction scores. Basically they spend a ton of money to hire an outside firm to come in force all employees to sit through this ridiculous 2 hour power point presentation on smiling, and greeting people and other stupid crap like that, with a stupid anagram for a name. It was hilarious that afterwards everyone I did it with was just bitching and moaning twice as much as they were before they went in.

Won't they ever realize that forcing people to spend two hours watching a presentation by some perma-grinning idiot telling you how to smile is not the way to increase patient satisfaction. If only they would do something like you suggested above, and increase the staff's happiness and morale, they would get genuinely happy staff members, and a better healthcare experience for their patients.

 

[HighSpeed]

Along the same line, boosting staff morale will certainly provide benefits in many aspects of the business, including patient care, what it will not provide, however, is more dollars in your pocket. Also, your plan does not really help with the issue at hand. Sure happier workers will, perhaps, be more obliged to go the extra mile, and, perhaps again, work that much more, but it won't really increase the raw number of healthcare employees.

It's good that you touched on those two points--on elevated staff morale boosting dollars in the pocket (We'll assume you mean the dollars coming into the healthcare establishment), and the raw number of healthcare employees.

Boosting the raw number of healthcare workers is precisely what the approach suggested should not go after primarily. That strategy has been tried numerous times. It has not proven effective so we can conclude that playing "the numbers game" by directly attempting to boost the number of healthcare employees will not check the state of healthcare as intended. Numbers will change soon enough if the plan is effectively implemented.

To touch on your first point on dollars in pockets you would need to ask yourself as you read this how dollars come into service organizations. It is primarily through advertising. Word of mouth advertising being the more effective. Now if patients (or their family members) end their experience with a healthcare establishment with a favorable opinion they become walking commercials for that particular establishment sending back referrals with smalltalk conversations such as "...well, if little Jamie is sick you ought to take him to the oncology ward at [insert your hospital here]. They have a heck of a team there".

The only way to get that type of end effect would be if a happily employed healthcare staffer provided them with good customer service. The "happily employed worker" of course has been through the various morale programs put in place by his/her place of employment.

Now visualize another scenario where the healthcare worker is employed in an organization without such a program. Ideally he would not have whole heartedly provided the same type of satisfactory service that the former has consequently effecting end conversations such as "...are you taking Jamie to [insert your hospital here]? Good luck with them. You're going to need it".

Know that this is not an expensive approach relative to the strategies being tried today in healthcare establishments across the nation. Also know that it is not a "boring" approach like the example you mentioned. Be assured that the "fun factor" is high with the approach I propose. If implemented correctly it will not cost the actual organization much if anything at all. In the interest of shortening my post lets not go into the details of the actual economics involved in this plan. We can certainly discuss that with readers if they are interested.

 

[randomedstudent]

On a slightly seperate note.

I never could really grasp how management is sometimes so out of tune with their employees. I will give a personal example.

At my hospital they have initiated a program with the goal of increasing patient satisfaction scores. Basically they spend a ton of money to hire an outside firm to come in force all employees to sit through this ridiculous 2 hour power point presentation on smiling, and greeting people and other stupid crap like that, with a stupid anagram for a name. It was hilarious that afterwards everyone I did it with was just bitching and moaning twice as much as they were before they went in.

Won't they ever realize that forcing people to spend two hours watching a presentation by some perma-grinning idiot telling you how to smile is not the way to increase patient satisfaction. If only they would do something like you suggested above, and increase the staff's happiness and morale, they would get genuinely happy staff members, and a better healthcare experience for their patients.

It's funny that you use this example, b/c I was just thinking that if someone suggested that I go play games with the employees from another hospital after just working a 15 shift I would be none too pleased and would certainly be doing some bitchin' and moaning myself. Maybe I'm misunderstanding something, but personally, this all sounds very juvenile - I mean I graduated from 3rd grade about 20 years ago. I think the answer to the problems brought up in this thread are simple - more money, fewer hours, more respect and compliance from patients (ie. patients need to realize they are at the hospital, not a 4 star hotel).

 

[Yourmother]

So if a form of national healthcare is implemented, and all of a sudden 40,000,000 new Americans are added to the mix.

Won't we have a massive healthcare shortage? Someone help me understand this?

 

[Soon to be Dr E]

I think the answer to the problems brought up in this thread are simple - more money, fewer hours, more respect and compliance from patients.

You couldn't have hit the nail much harder on the head. Moral is going to be based on whether or not the employees feel respected by the patients and by their management, and they need to feel like they are being compensated for their time and effort.

In my last job, respect within the organization was terrible. And as a result a ton of people left for other organizations. From what I've seen, people tend to show more respect within university hospitals. And the patients have a more willing attitude to let you help them, and to contribute to education. Also the staff and faculty at these types of hospitals seem more willing to contribute to the education of the newer and less skilled employees.

I think if more healthcare institutions could create an atmosphere more similar to a university hospital, it would boost the moral of the newer healthcare workers.

 

[Instatewaiter]

Healthcare faces a major challenge in the form of healthcare shortage:

The approach which has been taken for years to counter this imbalance has been to create various incentives to boost the number of healthcare workers. We can see this if we look in our local employment section. Ads that read "$10,000 sign on bonus" are doing exactly that. They are offering economic incentives to trade for a boost in the number of healthcare staffers.

Some establishments are below the average while some are above the average. [/B] Why? What is the common denominator in place inside those healthcare establishments that exhibit "above average" numbers disrespecting the shortage. It is the human element. In such organizations there exists a higher measure of morale, motivation, discipline, carmaraderie, and esprit de corps.

To implement this system we simply need to create light programs that improve employee morale. It would ideally be "infotainment" oriented games where the contestants are tested on "finding patient information", jeopardy (with health oriented themes), Who Wants to be a Millionaire (with questions specific to whatever genre of healthcare the competing facilities are in).

How do we know such a strategy would work? Ask our military community that expends significant effort in such programs (on the unit level),

This is probably the most asinine idea I have ever heard. How is SUPPLY going to be changed by boosting morale? If you want to boost supply perhaps people should work on enrollment in medical school, nursing school etc. Incentives to sign on only affect those that have already gone through their respective school. Of course they wont work. At best they minimally change the supply.

The article tries to make that argument that increasing the number of staff, by increasing enrollment, is not the issue. Unfortunatley the programs that it is talking about are not targeted toward enrollment but rather at reallocation of the current healthcare worker pool. So in effect its argument is fatally flawed.

The programs that you site as increasing numbers really are not directed soon enough in the pathway. Those mainly target movement of a portion of the pool (much like changing morale does) to a certain healthcare facility rather than increasing the total pool.

How are you going to change supply w/o increasing enrollment? No seriously. There are X amt of workers. Our heathcare system needs X+10,000. Where are the extra 10K coming from if they dont go through school?

The rate limiting step (the one useful concept from Gen Chem) is medical/nursing/heathcare enrollment not maintaining the current pool.

How is boosting morale in a hospital, with current nurses/doctors going to change the number through school?

Heathcare jeopardy is not going to change supply nor will changing overall morale. The article states that those hospitals with adequate staff did it because of boosting morale. Ok perhaps that is a valid point, health care workers who are happy will stick around. That means that these hospitals are pulling a larger portion out of the available pool, not creating a larger pool. How the author missed this point is beyond me.

Oh and the military is not exactly a good example. They are desperate for recruits.

I really must be missing something here. Can you explain the MECHANISM by which improving morale will do more than just reallocating current healthcare workers to different sites? It seems to me that facilities with high morale will pull nurses from other centers leaving those centers with an even smaller

It almost seems like a teenager wrote this article with all the oversights and confusing correlation with causation.

 

[dandoe123]

It's funny that you use this example, b/c I was just thinking that if someone suggested that I go play games with the employees from another hospital after just working a 15 shift I would be none too pleased and would certainly be doing some bitchin' and moaning myself. Maybe I'm misunderstanding something, but personally, this all sounds very juvenile - I mean I graduated from 3rd grade about 20 years ago. I think the answer to the problems brought up in this thread are simple - more money, fewer hours, more respect and compliance from patients (ie. patients need to realize they are at the hospital, not a 4 star hotel).

I was actually thinking the exact same thing as I was reading the original thread. Playing "Jeopardy" or "Who wants to be a millionaire" type of games in the hopes of improving morale, in my opinion, is a tad bit juvenile. Don't get me wrong. I'm not saying that it'll be completely ineffective and I can't speak on behalf of other individuals, but I know I'll be grumbling and bitchin' that I'm "forced" to take part in such activities.

However, in response to couple other replies, I don't think increasing medical school enrollment or increasing the "supply" in general is the answer either. You are just going to have a larger "supply" of disgruntled workers.

Personally, I think the answer does have to do with more money, fewer hours, more respect, and compliance from patients as stated by someone else... but the more "feasible" solution is to recruit "better" qualified individuals to the medical field. Not so much for nurses (personally, I don't understand why anyone wants to become a nurse), but one of the big factor that attracts people is the prestige, the money, the lifestyle, the respect...

I think medical school should rely less on grades/MCAT, but rather focus more heavily on an applicants medical experience... through shadowing doctors, or volunteering, or whatever. I think a lot of the disgruntled individuals in the medical field are those with stellar grades who really didn't have a full understanding of what it is to be like in the medical profession. I personally think that if more individuals who had a better understanding of what they were getting themselves into were recruited, I think there'd be less disgruntled workers in the field and no real need for these "morale-boosting games".

Just my two cents...

 

[buffdoc]

I think that if you want to improve morale, it's simple:

-- Reform "malpractice" tort law.
-- Reduce monopolistic power of insurance companies over the healthcare industry.

Both of these will lead to an increased sense of respect, increased efficiency, and lower overall cost. Which would lead to an improved morale for both healthcare workers and patients.

 

[Yourmother]

Healthcare faces a major challenge in the form of healthcare shortage: the number of healthcare professionals versus patient load and healthcare services suffers an imbalance because the former is significantly lower than the latter.

The approach which has been taken for years to counter this imbalance has been to create various incentives to boost the number of healthcare workers. We can see this if we look in our local employment section. Ads that read "$10,000 sign on bonus" are doing exactly that. They are offering economic incentives to trade for a boost in the number of healthcare staffers. This strategy has been ongoing for years without change.
A reasonable inference can be made that it is not working, or if it is, it certainly has not caused a measurable impact in the healthcare crisis, specifically the shortage of healthcare workers.

Many approaches can be suggested to repair the healthcare crisis. Some of the most recent strategies have been in the area of reforming the financial structure of the current system. This includes changes made in insurance,
billing, subsidies, and so on. The major challenge with this system is that the people, or the government end up bearing the burden one way or the other. It is unavoidable as the scarcity principle of economics supports the notion
that resources (finances in this case) are limited.

A new approach can be considered in checking the healthcare crisis. This strategy, which has been tried and proved for generations does not cost the government significantly relative to the other methods. This strategy is that of harnessing the human element. Elements such as morale, motivation, discipline, carmaraderie, and esprit de corps.

Before we go into the details of implementing such a system lets ask ourselves what the healthcare shortage is? It is simply the situation where the number of healthcare workers does not meet the demand of healthcare services. To the reader. Know that this "number" is an average taken from the various healthcare establishments in the nation. Some establishments are below the average while some are above the average. Why? What is the
common denominator in place inside those healthcare establishments that exhibit "above average" numbers disrespecting the shortage. It is the human element. In such organizations there exists a higher measure of morale, motivation, discipline, carmaraderie, and esprit de corps.

To implement this system we simply need to create light programs that improve employee morale. A healtchare facility can for instance have "recreation days" where they pit their nurses, doctors, e.t.c in friendly competition against other neighborhood facilities. It would ideally be "infotainment" oriented games where the contestants are tested on
"finding patient information", jeopardy (with health oriented themes), Who Wants to be a Millionaire (with questions specific to whatever genre of healthcare the competing facilities are in). These micro exercises in "having fun while earning makes great strides in boosting the general morale inside the healthcare facilities involved. The morale building process would not be in who wins, but in the preparation of such exercises.

How do we know such a strategy would work? Ask our military community that expends significant effort in such programs (on the unit level), ask our local law enforcement agencies, ask our fire departments in our various cities. This strategy has worked for them for decades, and it will no doubt work for the healthcare industry where such an effort in boosting the human element is mostly non existent.


When we then have a healthcare facility where the morale, motivation, e.t.c has increased. It causes the workers to make a better effort to provide healthcare absent of any artificial incentive. We can then visualize the effect it would have if hundreds, perhaps thousands of healthcare facilities adopt such programs, and imagine the possibilities it presents in significantly challenging the "shortage" category of the nations healthcare crisis.

In the interest of maintaining a short article I would like to stop here but please feel free to email me, PM me, or simply post clarification by posting replys. Certainly enjoy the forum and SDN.

Recently I've heard that the problem is not a shortage but a distribution problem. Not sure if it is true or false.

 

[midwesterner]

All that being said, I do feel that the happiness of one's employees should be of the utmost importance to an employer. I think it would be wonderful if places would do as you suggested. Would it likely make for a better healthcare experience for the patient, absolutely. Would it lead to more people wanting to go in to health care employment, not likely.

I think increasing employee happiness *would* have an effect on people wanting to go into healthcare. I know a number of intelligent, motivated, nice people who are a little less type-A than the typical doctor...something I think that might actually make them better doctors in some settings, because I think these people would be more apt to spend time with patients, really listen, coach about lifestyle improvements, etc. The idea of seeing patients for 50 plus hours a week in a stressful environment discourages many of these people from being doctors, when I think they would be excellent ones, especially in primary care.

 

[cpants]

Just wanted to chime in with a couple of points.

Increasing the number of med schools spots will have no effect on supply, as the limiting factor is not med school spots but residency spots.

The shortage is both a distribution and a supply problem. Not only are there not enough physicians, but a disproportionate number of them specialize areas for which there is no shortage. No one wants to go into primary care because you get little pay, work long hours, and generally do not get respect.

Keeping employees happy is definitely the key to getting great performance out of them. Many of the best hospitals employ strategies to boost morale and to keep employees happy. These strategies do not even have to be expensive. A little goes a long way. A few thousand dollars to throw a thank you luncheon for employees or buy everybody T-shirts can have a big impact. It's about showing respect.