Most hospital systems have struggled with staffing shortages exacerbated by COVID-19, a desire for remote work, and a very low unemployment rate. Now more than ever, it’s important to ask the questions, “Are the jobs in healthcare good jobs? If not, how can we make them so?” Many organizations are currently in the middle of the worst staffing crisis in memory in which turnover and lack of trust have become contagious. The staffing crisis, combined with increased patient volume, has further decreased well-being, efficiency, and quality, and has increased the cost of care delivery.
Recently, I attended a course by Zeynep Ton, a professor of the practice at the MIT Sloan School of Management and author of The Good Jobs Strategy. While I think almost daily about the work lives of faculty and staff, this course not only highlighted strategies to create good jobs but also emphasized the long-term benefits for companies following these principles. The handful of physicians in the audience found themselves nodding in agreement throughout the course and asking ourselves what we can do to improve the jobs in our organizations.
Fundamental to the creation of good jobs is low turnover. Many of us see daily the impacts of high turnover on patient care, with decreased productivity and staff and faculty well-being—both of which could lead to increased errors. Turnover has many direct costs, including recruiting, onboarding, and training. There are also significant indirect costs because of the loss of productivity of those doing the training and the decrease in scheduling stability when staffing is low. These issues can lead to more turnover, making it a self-reenforcing downward spiral.
Addressing the factors that lead to workplace dissatisfaction, such as pay and benefits, work schedule stability, security, psychological safety, and a career path with a mechanism for promotion can stop that downhill spiral. Without decreasing turnover, it’s almost impossible to develop and execute long-term strategies. We should value, support, and listen to the employees who have the biggest impact on our patients. Obtaining direct input from individuals performing the tasks not only empowers the workforce; the “go and see” approach provides leadership with the needed insights to see process inefficiencies. Listening to our teams not only makes them feel heard and valued, but it also provides needed information about their work and the institution’s culture.
Healthcare needs to catch up. Individuals who go into healthcare do so because they’re passionate about caring for people. We have to learn how to grow this passion and not let it fade under the burden of our current healthcare system. We need to actively work to create a system that understands the long-term benefits of an empowered workforce that feels valued, has opportunities for professional and personal growth, and finds meaning in their roles. Our unifying goal is to provide the highest quality surgical care to our patients. Everything that we do should be directed at achieving this goal.
—Robin