Interview with Deborah Wesley, RN, BN, MSN, MHA
CEO, Addison County Home Health and Hospice
Addison County Home Health and Hospice, a non-profit community VNA for 50-plus years, is nestled in the Green Mountains of Vermont.
Deborah joined Addison County Home Health and Hospice in 2017. Prior to joining Addison, she worked in Connecticut developing home care agencies and hospices for 30 years.
The organization provides home care services that include skilled nursing, rehabilitation services, medical social work, and ancillary support services that promote healing, quality of life, and independence.
She is humbled daily to be part of a team that gets to fulfill their mission every day.
Cultivating a Strong Culture to Improve Retention and Recruitment
A workplace culture of ownership is key. A successful engagement culture empowers staff and clinicians to make decisions and contributions to increase the overall engagement for the entire organization.
Shifting Leadership and Culture
In a recent study by Ernst & Young:
- 54% of healthcare workers are leaving their jobs because their boss wasn’t empathetic to the struggles that they were having at work.
- 49% said that their employers were unsympathetic to their personal lives.
Interview with Deborah Wesley
A part of our leadership team is caring about each other. We care about our employees. I strategically did not place my office in an administrative aisle. My office is burrowed down deep into the clinical side of our office with my door always open. There isn’t a day that there’s not an aide, a PCA, or an RN who stops by who just may want to have a conversation.
Our leadership team has been there. If people feel heard, they feel respected. It’s not about getting what they want, it’s about being heard and respected. That is a core element of our leadership program.
We encourage people to join and be part of change. I give them a blank piece of paper. What are we going to do? How are we going to do this? There’s no box to define that. How do you see this program? Here are the rules, here are the regulations.
Nothing is more wonderful than a staff meeting when we have a lot of different inputs and opinions. People are willing to state, not complain. Complaining doesn’t work. It’s stating their needs and stating what is best for the mission, not what is best for themselves, but best for our mission. There is that balance.
We must take care of our employees, and we must be able to attract new employees. If we have an organization that is committed to our employees, then the rest follows.
Changing Our Recruitment Strategy to a Team-Based Effort
2021 is being referred to as the great resignation or the big quit. Leaders are looking at new retention and recruitment strategies to overcome the challenge.
Recruiting has always been a huge challenge. What we learned as we really looked at our practices and our efficiencies outside this pandemic and before, is what we were doing. We reviewed everything we did with our systems and our processes. We looked at the parties involved. We used our EHR as a strategic piece of our recruitment plan. We used the systems, the processes, the technology, the interoperability, and we saw that as a tremendous piece of how we were going to recruit and retain staff.
Our human resources team and I really talked about the fact that we no longer recruit. Our team recruits. It’s our clinicians in the field who are recruiting their peers to come and work with them.
Here’s an example: We had a nurse from our hospice team retire and we published a job notice on a Monday. On Thursday, the position was filled. It was word of mouth of our employees that filled the position. This person we hired had been waiting for a vacancy, and that excited me.
Empowering Team-Based Technology Buy-In
Organizations are offering more flexibility and thinking about how the work that is currently being done can be done another way and with efficiency.
As we took on our EHR and how it evolved, our staff became front and center about making decisions about the technology. They’re front and center about participating in beta trials so that they can influence how the technology is designed and works so it aligns with their needs and workflows. We want people willing to step outside their comfort zone. If everybody agreed with me, I’d be bored. So, when we really looked at this evolution, we looked at those people that were willing to stake their claim.
We encourage our staff to participate in trials, to participate in building of programs. We’ve had people evaluating our voice-to-text technology to see if they were comfortable with it. They’ve participated in developing individualized care plans and a lot of different things within the system. It gives them a belonging and a connection that they’ve built it. They feel as if they own a piece of it and having a stake in that really retains people and helps them stay connected.
Differentiation Strategies to Achieve Work-Life Balance
Healthcare leaders will need to put solutions in place that acknowledge the pressure and stress that clinicians experience every day and provide practical support to help the workforce thrive.
For many clinicians, the line separating work and life is blurred. The term “burnout” is often used, and unfortunately, the feeling of burnout and work-life imbalance existed long before the COVID-19 pandemic.
The pandemic did create a bigger problem for home care clinicians, as more post-acute care patients opted for or were referred to home health services. This trend not only highlighted existing logistical challenges for clinicians, but it also shed light on a key contributor to clinicians’ frustration: inefficient technology.
Technology: A Differentiator to Work-Life Balance
When effectively incorporated into workflows, the right technology can alleviate clinician stress – and can even positively impact an agency’s revenue potential.
A Look at the Numbers
- 43% of providers spend six or more hours per week charting after-hours.
- Providers work an average of 51.4 hours per week.
- Nearly one in four (23.5%) providers work 61 to 80 hours per week and experienced burnout at some point in their working life.
- 99% of nurses surveyed experienced burnout at some point in their working life.
Upgrading the agency’s EHR built excitement among clinicians because of its ease of use. Because healthcare is documentation heavy and highly regulated, having an EHR system that communicates with other health systems helps to lighten clinicians’ workload for better job satisfaction.
Creating Better Clinician Efficiencies
I think before we moved to our current EHR, there was a real inequity of work-life balance. There was just so much redundancy of documentation. People were so far behind they would go on forever. As we moved into our EHR, we began to understand and really adopt its efficiencies and interoperability. We really pushed for that work-life balance.
Productivity and Communications
Everybody must meet the same productivity standards as their peers. If they’re unable to meet those, then we really drill down and look at what are those issues. Is it more training? More education? More support? Organizational skills? We really try to offer all of those. And then we work with people to ensure that when their day is done, their day is done.
I encourage people to turn on their iPad and start their day with a cup of coffee at home in their jammies to begin to plan their day and organize themselves without having to rush themselves out the door. And, to end their day at home.
We have a lot of methods of communication on our iPad. We have secure texting. We have email. We have methods of communicating through our EHR, and we encourage people to not be on call at the end of the day. You turn it off. If I need to find you, I know how to reach you, but we do not do that. We don’t encourage messages being sent regarding patients or any care after five o’clock or before eight o’clock. And we really put limits on how much we send even to each other during the day because we want to reduce that fatigue. We really encourage that balance with everyone.
It is our staff that are excited about what they do and how we support them. We offer that work-life balance, empower them to do their job, and give them the tools to have that balance in their life. They know that their leaders will walk alongside them and support them. When they are happier, they stay, they are engaged, and bring their best selves to work.
Tools That Make Clinicians a Priority
The most important objective for care-at-home organizations has not changed. It’s to deliver the best possible patient care, but the systems and processes that make it possible to deliver this level of care must be clinician focused.
Clinicians want to partner with their patients, but committed clinicians often feel overworked because of their patient workload and various administrative tasks that are not part of the direct patient care experience. Patients’ expectations are also changing, as they now seek a more connected, seamless patient care experience. Technology can help clinicians meet these evolving patient expectations. Partnering with a strategic technology partner helps to align clinician goals, identify ways to streamline workflows, and support better care experiences.
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