‘Don’t beat yourself up with thinking you have to have all the answers’
You plan to go overseas to address your nurse staffing shortage. How is that going?
Our goal is to bring about 100 nurses into Henry Ford’s work environment by Q2 of this year.
We’re in good shape as that process goes. We filed all of our initial applications. Because we border Canada, we have a fairly active process, on a daily basis, of ensuring that we support our team members who may need our resources around immigration. We have between 900 and 1,000 nurses on a day-to-day basis who come across the border from Canada. So dealing with nurses from outside the U.S. is not new for us.
Once we get the first group, we’ll work through that orientation process and then begin simultaneously working on a second group of team members to join us.
‘There are Philippine nurses who joined us in the ’80s and ’90s who have practiced for long period of time in the Henry Ford system. In Southeast Michigan, we have a pretty strong and robust community of Philippine individuals. We have the experience and we know what mistakes we made in the past and how to overcome those.
So cultural competence can be a benefit here?
We’re extremely focused on ensuring that we can reduce health equity gaps. And part of that issue is ensuring you have cultural confidence with the team members who do the work.
We will be very diligent around ensuring that every one of our international nurses goes through the standard orientation process for all of our teammates. We also have additional acculturation processes that help build familiarity with the surroundings, with housing support, those kinds of things.
We have pretty aggressive mandatory diversity, equity and inclusion training for our team members. We won’t require anything new from them. We’ll simply make sure that they have the time and the ability to go through all of that and understand expectations.
And then when you think about quality in this environment, we have to make sure staff members have what they need to be their best self at work. During COVID, we’ve had a 600% increase in team members requesting employee assistance support. We have more than doubled our resources around employee assistance. We have wellness rounds and resilience rounds for our clinical staff to help the blow off steam, to hopefully feel like they’re not alone.
We also have a process in which team members can draft their stories of what they’re experiencing and to share those with their colleagues. I’ve heard that it is one of the most successful efforts that we launched during the COVID crisis.
How have staffing issues affected your growth and service line plans?
When you’re in the middle of a crisis, sometimes it’s difficult to think about tomorrow, next week, next month, next quarter, next year, because you have so many resources that are focusing on putting out the fire. Today, we’re more than 98% full in our general med-surgery areas, with our intensivecare units being more than 90% full.
So we’ve delayed some plans for expansion. The staffing shortages caused us to close some of our clinical activity. We’re in better shape now, but when you have beds that are closed and you also have high COVID volume, it doesn’t give you the slack to spend time on recruiting for a new service line.
But in spite of that challenge, we’ve opened two very large ambulatory multispecialty centers. We’ve opened a $125 million destination cancer center in the heart of Detroit. We kept that investment going because we knew people are still suffering from cancer and they need answers. We also opened two partner hospitals internationally.
So my belief is that while you’re fighting the fire, you still have an ability to expand service lines, to look at growth. And we’re very focused on growth in ways that are responsive to the community’s healthcare needs.
You became AHA board chair this year, how does that help inform your decisions at Henry Ford?
Serving in ’22 as chair of the AHA board is a great privilege. It gives me an opportunity to hear from the industry on a consistent basis around their most critical challenges and what creative solutions many members are employing, and then to be able to bring some of those back to our organization.’
It also gives me the opportunity to share Henry Ford stories like our Philippine nurse process.
And it also allows me to learn about something unique happening in a part of the country that we haven’t heard about and that we can then bring back and I can say to our team, “Hey guys, I heard of something really interesting happening in Texas or happening in Montana or happening in New England, and maybe we ought to think about this and here’s the name of someone. Let’s reach out and get more data so we can understand how we might be able to utilize that.”
What are three pieces of advice on staffing issues?
My first piece of advice is to not presume, and also don’t beat yourself up with thinking you have to have all the answers. We’re in the midst of a very tumultuous time that none of us have faced previously and that our workforce has not faced previously. So we should not presume that what we’ve done in the past will work today.
The second thing I would say is that we’ve got to understand that our workforce is experiencing shifts in their expectations, in their resilience, and in some cases, in their connection to the purpose of work that we do. And so we’ve got to listen very carefully and think about how we can structure, and in some cases, restructure our approach to supporting the work that they do, that still provides a kind of meaning that it has historically.
Lastly, we have to try a lot and be willing to fail fast and try something else. So I think that this isn’t the time for us to study, study, study for long periods of time to find the perfect solution. It’s time for us to do something that we think might have an impact. Let’s put it in place. Let’s see how it works.
If it has the intended consequence, keep going, spread it further. If it doesn’t have the intended outcome, stop doing it, acknowledge that it was a trial and an error and try something else.
“We have to try a lot and be willing to fail fast and try something else. … This isn’t the time for us to study, study, study for long periods of time to find the perfect solution.”