Early in the COVID-19 pandemic, Lorna Breen, MD, a New York City emergency room doctor, committed suicide following weeks of incredible stress she endured at work. Nearly two years later, the Dr. Lorna Breen Health Care Provider Protection Act was signed into federal law, providing federal grants to support programs and training on reducing health care worker burnout. While this legislation is an important step forward, it is not enough. Two years into the COVID-19 pandemic, one in five health care workers are quitting their jobs. Hospital employee turnover stands at 19.5 percent compared to 4.2 percent in the general U.S. workforce. Health care worker burnout has led to a workforce exodus. The number of health care workers who made a job transition in 2021 was up 34 percent from 2019. At these alarming rates, Americans will soon face a new public health crisis that there may not be enough health care workers available should they get seriously sick. I am a health care administrator and graduate of the University of Chicago Booth School of Business who leads the Rush University System for Health employee and student wellness program. My job is to address this crisis: I am responsible for encouraging health care workers to preserve their mental health and well-being despite unrelenting pressures from a global pandemic by offering direct clinical support, programming, and other resources. I worked for nearly two years with our frontline clinicians, first rounding on COVID-19 units and managing a behavioral health clinic exclusively for our health care employees and students. If America is going to fix this crisis — to ensure that the best and brightest are attracted to and retained in health care institutions to care for ourselves and our loved ones into the future — it is time for action at state and federal levels to help hospitals prioritize health and well-being for not just their patients, but for their employees too. There are many headlines highlighting the pervasive mental health issues among American workers today, citing unprecedented levels of anxiety, depression, and social isolation. However, unlike other workplace settings, health care employee well-being literally has life-and-death consequences — declining provider well-being has been shown to relate to poorer patient outcomes and increased costs. Consider what this may mean for you the next time you access health care services. Lower staffing levels and increasing burnout means your care team — even with the best intentions — is less able to care for you. Clinicians leftover are tired, overworked, and burned out. This is a crisis. While there is no immediate fix, state and federal policymakers can put into action changes that will address and correct health care burnout long-term. Policymakers need to support innovation in health care — especially around workforce development — through funded research and training. Hospitals and health care educators need dedicated time to understand better how recent technologies like telehealth, simulation labs or other virtual platforms can be leveraged to support clinical work and education. Similar to the funding provided by the Lorna Breen Act, hospitals need financial support to evaluate whether traditional clinical rotations and other licensure requirements can be reconsidered or even replaced by these platforms. First, hospitals cannot replace current workers if health care students cannot complete occupational requirements to work. Right now, low staffing levels mean that many hospitals do not have the capacity to support clinical rotations for health care students. Without these rotations, rising health care students cannot qualify to work. This crisis will only continue unless health care students are enabled to complete their training efficiently and effectively by studying how technology can help bridge these educational gaps due to capacity constraints. Next, policymakers should address the pay and flexibility gap between traditional hospital and agency roles by incentivizing hospitals to explore new care delivery models and regulating competition in the health care marketplace. Hospitals are in a losing battle against health care staffing agencies (especially for nurses) because of long-standing rigidity around schedules, pay, and benefits. It is difficult to retain your care team when an individual employee can get paid almost double and control their hours by taking an agency role in this current climate. Moreover, hospital workplace rigidity is especially frustrating for a predominantly female workforce who want the flexibility to support both their patients and their loved ones. If policymakers want to attract the best and brightest to health care, the U.S. government needs to simultaneously help hospitals create and sustain more expensive care models that allow for increased pay and flexibility and evaluate whether current staffing agency recruitment practices are predatory and harmful to the American health care system. Finally, policymakers need to promote health care employee well-being by formally evaluating hospitals. When hospitals are already balancing factors like safety, quality, and patient experience against the bottom line, it can be easy to forgo workforce well-being as a priority. However, according to a study by the American Hospital Association, 6 in 10 health care workers said pandemic-related stress had “harmed their mental health.” The Centers for Medicare and Medicaid Service should consider rating hospitals on employee engagement and well-being, much like existing ratings on quality and safety. National ratings like these not only affect the bottom line but also affect the general perception of the hospital itself, two critical components to sustaining active engagement on this issue from hospitals. The current discussion around mental health spurred by the pandemic should be leveraged to address the coming health care crisis now. The American public will benefit from the improved care these happier clinicians provide. Investing in the health care workforce is an investment in ourselves. Source
