UnityPoint VP Agnew: Educate Patients, Clinicians to Expand Hospice

Katrina Agnew joined UnityPoint Health in December 2021 as vice president of hospice. Though professionally she has cared for terminally ill patients for more than 30 years, her personal experience after her mother’s diagnosis with Stage 4 pancreatic cancer underscored the critical importance of her work.

This drives her commitment to expand access to hospice care, particularly among underserved populations. Hand in hand with that goal is her mission to ensure that UnityPoint has the clinical staff it needs to care for the patients and families she is working to reach.

UnityPoint is an integrated health system with sites in Iowa, Illinois and Wisconsin. The nonprofit offers hospice and other community-based services through its UnityPoint at Home segment, which serves both metropolitan and rural communities.

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Agnew recently sat down with Hospice News to discuss her community education and outreach efforts and the ways UnityPoint is engaging with the health care workforce amid industry-wide staffing shortages.

As a leader at UnityPoint, what are your priorities for 2022?

Our programs are growing, and so with that I have to be focused on recruiting and retaining our staff, but the communities also need to know who we are. Being able to strengthen our outreach into the communities that we serve is really important to me and to our leaders.

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End-of-life care is very personal, and it’s emotional. People are often fearful of hospice, because of myths and misconceptions that surround it. So the goal is to continue to educate our communities, and especially our underserved communities who need to know about this service.

In November 2020, I lost my mom to pancreatic cancer. She was diagnosed on Oct. 31, and she literally died two weeks later.

We were able to bring her home. She wanted to come home with me, and I was able to get hospice started for her right away. They were able to get her pain under control. They were able to make sure that my family understood what hospice is and what was going to happen.

This is so important for our communities to understand what hospice is, so that they can have a positive experience. I have seen it, and I truly believe that hospice is one of the best things that can happen for those that are suffering with a terminal illness.

I know that diversity, equity and inclusion is a topic dear to your heart. What are some of the barriers that contribute to these longstanding disparities that we’re seeing in hospice and throughout health care?

There is just the lack of knowledge about hospice and what it can provide for the patient and family. It’s one of the main barriers. There’s so many misconceptions about hospice, among so many cultures. I really do believe if people fully understand the comfort and the support that hospice could provide their loved one — as well as the caregivers — I know that more people would utilize it if they just knew about it.

In addition to that I think there’s misconceptions about the costs. When you talk about an interdisciplinary team coming into your home — nurses, a social worker, chaplain, having access to the physician, volunteers — people are automatically going to think that there’s a cost associated with that. That makes people hesitate to use our services when they don’t understand that hospice is funded through Medicare and Medicaid.

The [U.S. Department of Veterans Affairs] has a hospice program, and then also many other types of private insurance.

One of the things that I love is that at UnityPoint Hospice, we care for everyone, including those without insurance. We’re able to do that through the support of community contributions and memorials, because we’re a nonprofit organization.

How are you approaching these issues at UnityPoint?

Education, education, education. We have to dispel the myths that create the obstacles and deter people from accessing hospice. Once we explain the comfort that we’re able to provide their loved one, it helps them to make more informed decisions.

People don’t want to be in pain, and they don’t want to be alone. That’s what they fear most. We’re able to get their pain and their symptoms under control and give them that extra layer of support.

A lot of our programs operate in rural communities. Sometimes in those communities, there are health deserts where they have to go miles and miles to get to a clinic or hospital.

A lot of our staff also live in those communities. These are the same people that are caring for their neighbors and their fellow church members. It takes a grassroots approach to educate by partnering with community-based organizations and faith organizations to raise awareness. I think it fosters trust, when you work for an organization and you’re caring for the community.

We’ve found that when you partner with trusted organizations that can help provide people with the knowledge and confidence as they navigate the end of life, it will afford them the opportunity to make better choices.

As you work to increase access to the benefit, there’s simultaneously the staffing shortage. Are you concerned that providers may lack the capacity to meet the rising demand as more people learn about the benefit?

At the end of the day, our mission is to provide our patients and families with quality, coordinated and compassionate care that allows them to live their life to its fullest capacity.

At UnityPoint Hospice, we are focusing on unique ways to recruit and retain so that we continue to have the resources that we need to provide that exceptional care.

I know that UnityPoint has established a nurse residency program. Can you give me some details about that initiative?

Our UnityPoint At Home Nurse Residency Program helps attract newly licensed registered nurses and prepare them for careers in home health care or hospice. It’s accredited by the American Nurses Credentialing Center, and it focuses on easing the transition to the workforce and then fosters a relationship with the regional nursing education programs. It also helps them get an understanding of what it’s like to work in the health system.

All of the participating nurses have a hospice rotation, which of course is very valuable. We find that a lot of nurses say they never would have even known that they would love [hospice] so much. That’s wonderful to hear, because we do need those nurses that really have a passion for hospice and really have that hospice heart.

We’ve been really successful with recruiting nurses to our program. I’ve witnessed a couple that have matriculated from being in the nursing residency program to RN case manager or a clinical supervisor, a really positive career track for them.

What are some of the other strategies that you’re using in regards to recruitment and retention?

We use some of the same traditional methods, such as LinkedIn or other online platforms. But the big difference for us I think is word of mouth. We have colleagues with a lot of tenure, and that is a direct result of our culture and our focus on values and accountability.

I believe that our staff, our colleagues, value being a part of this amazing team. We’re just getting back to being in the offices in-person. You could even see that people on the teams like being here.

Our colleagues are our best recruiters. They believe in the organization. They promote job opportunities, and they encourage people to work for UnityPoint.

We continue to advance our leaders and team members, always looking for internal promotion, and we build very flexible work and reward options to meet the needs of our workers.

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