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All
the King’s Horses And All the King’s Men
By
James R. Teeter, President and CEO, Arkansas Hospital Association
We’re
not into reading tea leaves, but we did predict ¾
what, about three years
ago? ¾ that yet another hospital calamity would one day emerge from the haze. Not
a crisis of the more common sort ¾ financial, legislative, or regulatory
¾ but a nightmare of workforce shortages.
Those
shortages are quickly becoming a reality. The percentage of hospital
executives who cited labor/staffing as one of their “key worries”
nearly doubled in 2000. HSM Group Ltd. interviews of 948 hospital
administrators found 58% mentioning labor/staffing concerns last
year compared to 34% who mentioned them in 1999.
While the shortage of nurses has received the most public attention,
hospitals are also experiencing thinning ranks of pharmacists (off
to Wal-Mart for $30K a year more!), technicians and technologists
of almost every kind (better work hours at clinics!), and medical
record coders, housekeepers, and food service workers, some of whom
are paid $5.54 to $6.97 an hour (Burger King pays eight).
Hospitals in Arkansas and throughout America cannot possibly meet
the healthcare needs of a growing and aging population without sufficient
number and quality of caregivers and support staff, a fact of which
the public and the politicians are becoming increasingly aware.
With labor and patient safety concerns as a backdrop, the U.S. Senate’s
Health, Education, Labor and Pensions Committee’s Subcommittee on
Aging, chaired by Senator Tim Hutchinson of Arkansas, held a hearing
in Washington February 13 to talk about the dwindling numbers of
nurses and other caregivers and the effects of this on the nation’s
health. The hearing room was jam-packed. In fact, people stood in
the corridors.
Among those testifying was Linda Hodges, dean of the College of
Nursing at UAMS. She said what she’s been saying for months: The
labor shortage, particularly in nursing, grows worse every day;
the image of professional nursing has changed from one that offered
job security to one that is uncertain, sometimes dangerous; nursing
is viewed as “low tech” and salaries as low compared to other professions;
the number of nurses under age 30 has declined by 41% since 1983;
the average age of the nursing workforce is increasing at twice
the rate of other professions; and Arkansas schools will graduate
fewer nurses in 2001 than in 1990.
Another individual testified that we must identify strategies to
bolster recruitment, retention, and development of caregivers and
support staff. But he said the problem cannot be solved by hospitals
alone, it demands a collaborative approach among all affected parties.
He and Hodges and others testifying recommended nurse recruiting
programs for young people, higher wages, and more flexible hours.
Later Sen. Hutchinson said he plans to introduce legislation focusing
on some of those recommendations. He announced his intent after
subcommittee members unanimously agreed on the need for immediate
action to address the country’s nursing shortage.
Closer to home, the Arkansas State Board of Workforce Education
and Career Opportunities met February 8. It approved three high-demand
fields for which the state will, during the 2001-2002 school year,
continue helping college students repay up to $10,000 in school
loans. Those programs are computer/information technology, advanced
manufacturing, and biomedical/biotechnology.
The best news, however, was that in April the board will consider
adding nursing to the list of high-demand fields in which students
can qualify for the Arkansas Technical Career Student Loan Forgiveness
Program.
All of this is well and good. But government efforts to expand and
strengthen the labor supply will be wasted time and money if hospitals don’t alter their
ways. Some ideas to consider:
- Despite all the financial reverses and pressures, hospitals
simply must find a way
to increase employee compensation. If money can be found for other
hospital improvements, it must be found for workers. Hospitals
have no greater assets than their human resources. Hospital careers
are demanding and often require advanced education and continuing
training. Until hospital pay is comparable to what other employers
pay workers with similar credentials, our workers will continue
gravitating to alternative workplaces. This is not textbook theory,
it is labor market reality.
- Workplace satisfaction among hospital caregivers and
support personnel is essential if a hospital is to be successful.
Human resource issues are today, were yesterday, and tomorrow
will be, issues that should be heard and considered by a sensitive
hospital executive team rather than matters routinely delegated
to supervisors. Ask any union organizer.
- Hospitals must invest in those things that will help
establish a competitive, if not preferred, work environment, including
(a) work schedules that provide more worker flexibility; (b) work
assignments and roles that emphasize a profession’s competencies
and contributions rather than assignments defined by regulatory
requirements and administrative procedures; and (c) information
technologies that reduce repetitive administrative tasks and manual
documentation.
- Continuing education, which hospitals have always encouraged
for physicians and nurses, must be extended across all occupational
groups. Hospitals must develop effective programs through collaboration
with one another and/or with state hospital associations, colleges,
and universities. Clinical and non-clinical education and career
development programs that upgrade skills and help hospital workers
transition from one career to another are becoming critical success
factors for hospitals.
- Hospitals must broaden their workforce initiatives to
reach populations not traditionally employed by hospitals. Society
is becoming increasingly diverse. Hundreds of Little Rock School
District students, for example, come from homes in which English
is spoken second to 52 different languages from around the globe,
up from 29 such languages five years ago.
Meanwhile,
between 1990 and 2000 Arkansas’ Hispanic population (with its strong
work ethic) mushroomed by 337% to 87,000 while the state’s population
as a whole grew by 14.2%, according to 2000 Census data. As society
becomes more diverse from an increasing number of racial, ethnic,
and national backgrounds, we must
train and recruit a more diverse workforce by tapping into those
populations.
Chances
are that no hospital workforce challenge is more critical than the
need to develop and test new work designs for both caregiver and
support services. Developing, testing, and sharing new work designs
can be achieved sooner and with better results if approached on
a more global basis than by individual hospitals.
The American Hospital Association’s newly appointed Commission on
Workforce for Hospitals and Health Providers is expected to play
a critical role in this endeavor. But the Commission is in need
of and will look to us for our
ideas, for – if I may paraphrase the old nursery rhyme – it’s going
to take all the king’s horses and all the king’s men to put our
workforce back together again.
Arkansas Newsmakers and Newcomers
Tom Siemers, FACHE, CEO of Rebsamen Medical Center
in Jacksonville, was installed as Arkansas’ Regent for the American
College of Healthcare Executives (ACHE) during the organization’s
Annual Congress on Healthcare Management March 25-29 in Chicago.
Siemers succeeds Steve Lampkin, President, Washington Regional
Health System in Fayetteville, who has completed two terms as the
state’s Regent.
Eva Applegate became administrator of Stone County Medical
Center in Mountain View February 5 succeeding Kaye (Korky) Mallory
who has taken on other hospital-related responsibilities. "I
look forward to the continued growth and improvement of Stone County
Medical Center under the direction and capable leadership that Ms.
Applegate will provide," Mallory wrote in a letter to the AHA.
The Mountain View facility is part of the White River Health System
headquartered in nearby Batesville. Gary Bebow, FACHE, is
system CEO.
David G. Blackburn, president of the Arkansas Heart Hospital
since its opening in Little Rock, will retire this spring, but stay
on the job until his successor is named and actually on site.
The success of the hospital, says Blackburn, is an obvious source
of pride to him. "And I have been privileged to serve this
last 5 ½ years in our state with a fine group of hospital executives
as colleagues. Arkansas is very fortunate to have such dedicated
men and women serving their communities. In 35 years in hospital
administration, I’ve never worked with as fine a team as we have
at the Arkansas Hospital Association."
Brian Holt has been named president and chief executive officer
of Northwest Arkansas Radiation Therapy Institute (NARTI) in Springdale.
For the past eight years, Holt was vice president of finance at
NARTI before serving as interim president following former president
Eddie Bradford’s retirement last summer.
Brian J. Hargis has been named executive vice president and
chief financial officer of Wadley Regional Medical Center in Texarkana,
Texas, effective January 22, 2001. He previously served as administrator
of the Prattville Medical Park, a subsidiary of Baptist Health/HCA
Healthcare Corporation in Montgomery, Alabama.
David Cicero, executive vice president and chief financial
officer of Ouachita County Medical Center since 1978, has been named
president of the Camden facility. Former president C. C. McAllister
will take the helm as chief executive officer of Ouachita Valley
Health System, the hospital’s parent corporation.
Steven B. Lampkin, president and CEO of Washington Regional
Health System in Fayetteville, has been elected to serve as the
American Hospital Association alternate delegate to the Regional
Policy Board 7, representing the Section for Metropolitan Hospitals.
The three-year term began January 1, 2001.
Doug Luckett, vice president for human resources at Crittenden
Memorial Hospital in West Memphis, has been appointed by Governor
Mike Huckabee to the Arkansas State Board of Nursing. He
will serve until October 1, 2003.
Jon Dixon has been named CEO of Select Specialty Hospital
in Little Rock, succeeding Brian Williams who was interim
CEO. Dixon is a former administrator of Advance Care Hospital in
Hot Springs.
John D. Hoffman, M.D., has been named president/CEO of St.
Edward Mercy Health Network in Fort Smith. He succeeds Michael
Morgan who has accepted the position of president/CEO of St.
John’s Mercy Health Care in St. Louis. Hoffman, board-certified
in obstetrics/gynecology, was chief operating officer of the Rogers
facility for the past three years.
Ray Montgomery, president/CEO of White County Medical Center
in Searcy, has been elected to the governing council of the American
Hospital Association’s Section for Small or Rural Hospitals from
AHA Region 7. His two-year term began January 1, 2001.
In Memoriam
Talmadge Robertson Conway, FACHE, administrator of McGehee
Desha County Hospital for 24 years before retiring in 1990, died
January 24 at UAMS in Little Rock. A former AHA board member and
1987 recipient of the AHA’s A. Allen Weintraub Memorial Award, Conway
served as administrator of Delta Memorial Hospital in Dumas from
1963 until moving to McGehee in 1966.
Rex H. Burton, retired administrator of Carroll Regional
Medical Center in Berryville, died January 25 in Spencerville, Indiana.
George W. Jackson, M.D., former superintendent of the Arkansas
State Hospital and retired commissioner of mental health in Arkansas,
died of cancer January 10 at his home on Lake Hamilton in Hot Springs.
Following his retirement, he practiced psychiatry in Hot Springs
until 1985. Great strides were made in the delivery of mental health
services in Arkansas during Dr. Jackson’s years of service.
AAHT Regional Dinner Meetings
Six years ago, the Arkansas Association of Hospital Trustees
(AAHT) made the decision to offer a biannual series of regional
dinner meetings to be held in several locations across the state.
These meetings offer hospital trustees and CEOs an opportunity to
meet other trustees from the surrounding area, discuss problems
and concerns they experience, and share ideas.
The 2001 AAHT series will focus on the effects of the Balanced Budget
Act (BBA) of 1997 on Arkansas hospitals and how trustees can convey
this information to the community. While it is true that some relief
will be gained from the Medicare, Medicaid, and SCHIP Benefit Improvement
and Protection Act (BIPA) of 2000, most Arkansas hospitals will
never gain what was lost through the severe damage caused by the
BBA. It will take years for many hospitals to recover.
Larry Walker of Lake Oswego, Oregon, will lead the discussion at
each meeting. Now a consultant to trustee organizations and the
American Hospital Association, Walker is a former board chairman
of the 107-bed Mt. Hood Medical Center in Gresham, Oregon, and director
of Legacy Health System, a large Portland, Oregon healthcare system.
He has facilitated many healthcare strategic development processes,
assisting healthcare organizations ranging from small rural hospitals
to metropolitan healthcare systems and physician groups. Prior to
developing The Walker Company, he published weekly newspapers and
business magazines, and served on local city councils and community
boards.
Each of the five regional dinner meetings will begin at 5:30 p.m.
and should adjourn around 8:30. Hospital CEOs and trustees are encouraged
to attend the session nearest their area. Registration and programming
information has been mailed to all CEOs and AAHT members. Call Beth
Ingram at the Arkansas Hospital Association, (501) 224-7878, with
questions. The meeting dates and locations are:
April 3 – Holiday Inn City Center, Fort Smith
April 4 – Fayetteville Hilton
May 15 – Camden Country Club
May 16 – Holiday Inn, Jonesboro
May 17 –
Conway Regional Medical Center
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