Clinical turnover has been on the rise since the pandemic’s onset, leading hospices to raise the bar on their recruitment and retention efforts. But a disconnect may exist between health care leaders and the underlying issues affecting frontline staff.
Rising turnover during the pandemic has heightened workforce challenges for hospices and other providers throughout the continuum, including worsened turnover, according to the 2022 study from BerryDunn. Home health and hospice agencies saw clinician turnover rise an average of 16% to 20% in 2020 compared to previous years, the study found.
Health care leaders have a learning curve when it comes to understanding the needs and experiences of frontline staff, according to Dr. Sachin Jain, president and CEO of SCAN Health Plan.
“We have a leadership crisis in U.S. health care where we’ve kind of lost touch with the frontlines,” Jain said at the HLTH conference in Las Vegas. “We’ve asked people to do more and more in less time, and we’ve created so many additional burdens on the health care workforce without necessarily taking away from them.”
It’s no secret that staffing shortages are among the most pervasive challenges impacting hospice care delivery. Clinical workforce shortages have caused some hospices to shutter or temporarily halt their programs, while others have turned away referrals because they lacked the staff to meet demand.
Nearly 334,000 health care workers in the United States left the industry last year, according to recent Definitive Healthcare data. More than 117,000 physicians exited the medical field in Q4 of 2021 alone, with roughly 53,000 nurse practitioners who also left during that period, the data showed.
Burnout, insufficient staffing and stressful working environments are common reasons that registered nurses in particular are leaving the workforce, according to providers who participated in the BerryDunn study.
High turnover volumes affect clinicians at the bedside as well as the wider organizations, particularly when it comes to managing caseloads and the amount of time they can spend with patients and families, according to Jain.
“We’ve created this very tangled web of health care delivery, and the job of being a frontline clinician is no longer what many of us imagined it to be in medical school, which is building meaningful relationships with patients that produce good outcomes,” Jain said. “We have to work to get back to some version of that, while also broadening our view of what clinical care is.”
Hospices nationwide have ramped up recruitment and retention efforts, employing various tactics aimed at growing and sustaining their clinical ranks.
Strategies have included augmenting compensation, improving caseload management, implementing flexible scheduling options and expanding educational and training opportunities. A focus on workplace culture has also been key.
Anecdotally, these efforts are fueling improvement in recruitment and retention for some hospices, but the staffing crisis is far from over as demand continues to rise.
More innovation and educational solutions are necessary to address clinical turnover issues in the future, according to Dr. Cheryl Pegus, executive vice president of health and wellness at Walmart (NYSE: WMT).
Currently, medical students gain little hands-on exposure to the nuances of community health care needs. Many also lack an understanding of pharmaceutical and insurance regulations that can influence their own work , she said.
“Health care is broken … and something has to give,” Pegus said during the HLTH conference. “We have to change that model [when] we’re educating medical students. We have no one to blame for what came before, if we’re not focused on how we’re making it better than it is.”
Health care providers need to work more closely with educators to better prepare medical students to enter the workforce, Pegus explained. This includes expanding the scope of information health care providers learn during medical training, she added.
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