Health Care

Q&A: ‘You can’t run a marathon every day’

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How are you managing and how is it varying in the states where you operate in terms of the volume of COVID-19 patients? 

Brian Smith: Timing is everything. If we’re having this conversation (in mid-August), it’s a little bit different answer than where we’re at today. So as we operate in multiple states across the East … it’s really a tale of two countries. … Our organizations in Ohio and Virginia are starting to see an uptick. So as we take a look, particularly over a stretch in mid-August, we start to see more hospitalizations, more calls coming in for transfers and starting to put more and more stress on the global healthcare system, not simply Bon Secours Mercy Health. 

What are your greatest needs and challenges right now? 

Smith: Supply availability is in really good shape right now, as it relates to (personal protective equipment), which early in the pandemic was a big issue. We’re starting to see some stress on testing availability, particularly with this variant and the sensitivity of some of the acute instant tests. So we’re working through that. But more importantly, for everyone it’s staffing. We continued to run full-service healthcare operations, both acute and ambulatory, throughout the last six months as we went through the third surge and we head into the fourth surge. We still have a lot of that same business, as well as now the surge coming on top of us. So balancing staff and balancing resources is a daily occurrence now, as we work, not only in the communities we serve with other health partners, but also within our own system. 

Have you been forced at any of your hospitals to scale back on normal operations because of the volume of COVID-19 patients and/or staffing shortages? 

Smith: At this point, we’ve not had to face that. All of us have learned a great lesson over the last year about business continuity and the necessity of being prepared. We’ve obviously run some tabletop exercises about what that might look like, what those triggers are within our markets. At this point, we’ve been fortunate enough that we haven’t had to implement any of those. … But we certainly are wary and have plans in place if we need to react.

In terms of staffing, pretty much everybody in the business is having the same problems. What are you finding is effective at retaining critical staff and bringing in people either for short terms or to fill staff vacancies? 

Smith: I would say flexibility, flexibility, flexibility. This is 18 months in, and we talk about this a lot among our team and with our caregivers. You get tired legs, right? You can’t run a marathon every day. So it’s really trying to make sure we’re cycling in and out and looking for creative ways to staff. Over the last 90 days, we’ve had a huge emphasis on hiring and had a really intentional hiring surge to bring more folks in and now bringing clinical nurse specialists in to help onboard those. We’ve seen across the industry, first-year turnover has been quite high. … We’ve had to change the way we onboard folks so they have the best opportunity to succeed. 

If you think ahead to a time when we’re not in the middle of a constant crisis, what do you think can be done to address the lingering effects of the trauma healthcare workers have endured that may make people want to leave the field or find easier work within it? 

Smith: I had a chance to sit with 13 of my colleagues across the state of Ohio (recently), and this was a topic of conversation over a course of a long afternoon. I think it has to change, right? It starts with the care model. And if we think back to the last year and a half, you’ve seen this explosion in the adoption of technology that already existed around virtual care and video visits. So in our system, as an example, we’ve done over 900,000 video visits, virtual visits and e-visits over the last 12 months. … As we get into the acute-care space, we really have to harness the potential of automation. We really have to look at using big data to help drive and help us shape our response.

I also think we have to bring other team members back into the environment. We talk a lot about how do you bring social work and community social determinants and needs to the bedside, at the same time you deal with the current social needs that an individual has that resides in that population. … We have to find a way to make the job more fulfilling. 

A growing number of employers have imposed COVID-19 vaccine mandates or something similar to them, including a lot of healthcare companies. To date, Bon Secours Mercy Health has chosen not to do that. What other strategies have you found work at persuading employees who might be reluctant to get vaccinated? 

Smith: It’s a question I get often and from our community and volunteer boards. The first step in this is listening. We have to not get so polarized that we take one side or another. We have to be able to understand both sides and figure out what the best option and opportunities are because there are legitimate questions. We firmly believe in vaccines, we strongly encourage our staff members to be vaccinated. That being said, we looked at community situations and local markets to see how we can best lean in. We’ve seen our vaccination rates slowly climb. But we also want to understand why. We’re investing significant time into going out and asking and listening and trying to understand if there are things that we can do differently, whether it’s messaging, whether it’s opportunities to understand, to ask different questions. 

Are you seeing any differences at individual hospitals or in certain states or parts of states where the vaccine uptake rate is higher or lower? 

Smith: It’s different across the board. We’ll have areas that we have very, very high uptake that is very similar to the community. I’ll be honest, in most communities, our vaccine uptake mirrors the community. … Typically we measure and monitor and track against the community itself. As you look in some parts of the country where we operate, we have slower uptake than some of our bigger metro areas. … We’re seeing the same trends as everyone else. 

This year, not only did you participate in the co-founding of Truveta, but also you made an investment in Trilliant Health. How do you see the use of data and analytics tools shaping the way you operate in the future, not just inside your own buildings, but in a bigger sense, how that could transform healthcare across the board? 

Smith: We’ve been interested in this work over the last five years, and we’ve had a variety of partnerships and working with different folks. We believe that data analytics can make healthcare easier because we can help understand the trends within specific business lines or service lines, as well as in specific disease states. … If we can marry up a person’s shopping habits and exercise habits with their consumption habits, along with their health state and allow them to have that data, and we can make healthcare easier to make the right default choices, we think that’s huge. That could be a potential game changer.

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