Hello, and welcome to Healthcare Insider, a sponsored content podcast series from Modern Healthcare Custom Media. I'm your host, Camille Baxter. And today, we are speaking with Paulette Anest, Head of Clinical Education Solutions at AMN Healthcare. Paulette has 25 years of experience in the healthcare industry, which includes research, clinical practice, human resources management, leadership, education, and innovation. In her role at AMN Healthcare, Paulette provides clinical consultation, thought leadership, and strategic partnerships to develop and implement innovative business strategies and solutions for workforce development, engagement, and retention that result in cost efficiencies and high quality customer experience. Paulette is a human-centered leader who thrives in an atmosphere of challenge, inspiration, and innovation. Her motto is dream big and deliver your best. Paulette, thank you so much for being here today.
Thank you, Camille. It's a real pleasure and a privilege to be with you and our audience.
25 years of experience in healthcare is quite an accomplishment. Your journey in healthcare began as a staff nurse in the labor, delivery, and maternal fetal unit at the Johns Hopkins Hospital. Can you tell us a little bit about your career trajectory from a nurse to Head of Clinical and Education Solutions at AMN Healthcare and what drives you?
I'd be happy to share a little bit about my journey, Camille, and thank you for the question. Well, when I think about my journey, which really began in San Diego as I was pursuing medicine, or at least pre-medicine at UCSD, I came across a nurse recruiter from the Johns Hopkins Hospital who had a conversation with me, and that conversation opened up a door of possibility and the door of opportunity. And I think back to that time, in really future state, and how important it is to be open to these discussions, and also to walk through doors of opportunity that present different challenges in your life, and really, that are in line with vision and values. And for me, it was always about healing, and helping people, and being part of a caregiver community. And what she relayed to me that day was the opportunity to be a part of a legacy institution, which the Johns Hopkins School of Nursing is and remains today as the leader in education, but also to be part of a broader, diverse, global community of nurse professionals.
And it was just a very inspiring conversation, very timely in my life, as I was caring for my dear uncle who had stage four liver cancer. So it was a meaningful conversation and a mentoring conversation, and that started my trajectory into nursing and in the baccalaureate program at Johns Hopkins, which I would just say to all of our audience, that there are many wonderful institutions across the United States who inspire nurses to deliver excellent care across rural and urban communities.
And so when I was in that program, again, I found another mentor who really paved the way for me to approach my passion for caring for women and children. And those mentors were, again, diverse, maternal fetal medicine specialist, a nurse practitioner, and a clinical nurse specialist. And they all opened the doors for advancing my learning, my skills, my thinking, using evidence-based practices. And then, ultimately, that learning translated to being the first new grad in labor and delivery at that organization, and really learning from the best of the best.
What that taught me was, as I moved through my career from Johns Hopkins and then two other organizations, including Long Beach Memorial and Cedar Sinai Medical Center, all wonderful teaching and academic medical centers, is that my job as a leader at the bedside, and then leading as a manager of labor and delivery, and as a director of nursing over maternal child health when I was in New York, is it's my obligation and a privilege to open doors for others and to create pathways for leadership development through professional governance, through new grad programs, transition to practice programs, and creating opportunities for those who are second degree nurses who bring, again, diverse perspective to the healthcare environment.
So I've always felt it was my duty to pay it forward because so many people have opened doors in my career. And that really brought me to AMN Healthcare more than seven years ago. And again, it was a personal life experience with my father who had a stroke. And I moved back to San Diego to be with him and be his primary caregiver. But this opportunity with AMN came up because it provided the national perspective around workforce, which I was always very passionate about, and to be able to make a more national impact on workforce development, engagement, and retention so that we can improve our community health outcomes.
So it's just really been an amazing journey. The leaders at AMN Healthcare are so incredibly passionate about, not only improving population health equity and diversity equity inclusion through the work that we do, but creating a workforce that feels the passion, and pride, and their purpose in our daily work. So it's just really been an inspiring journey.
It really sounds like it. And thank you for sharing that, Paulette. I think it's so important for our listeners to hear about some of the things that happen along that path of our career journeys and the different people and experiences that motivate us and help us to continue to develop.
Before we jump into our conversation, I want to take a second to thank the sponsor of this episode, AMN Healthcare, AMN Healthcare is the national leader and innovator in healthcare total talent solutions. AMN provides unparalleled access to the most comprehensive network of healthcare professionals. They're also dedicated partners with healthcare organizations, and help to optimize their workforce to successfully reduce complexity, increase efficiency, and improve patient outcomes.
So today we're going to be talking to Paulette about two important topics, caregiver wellbeing and patient experience. We know the key to care is having the right mix of core and contingent talent, providing the environment where clinicians can operate at the top of their licenses, and doing that in the most efficient way. So in your words, Paulette, what can be done to improve the patient experience by enhancing the wellbeing of healthcare professionals?
Thank you, Camille, for that question. And it's such an important time in our industry to really understand the patient care experience and, really, the impact of wellbeing of our healthcare professionals. And it really does begin with how we, as human-centered leaders, deliver on compassion, how we approach the science of talent planning, engagement, and development. Improving the patient care experience is a goal of every healthcare organization across the country. But within that simple idea is an incredible amount of complexity that needs to be broken down.
When thinking about how to improve the patient care experience, we need to take a step back and really think about all the touch points of care, and what each of those look and feel like. And that it'll look different in home health than it looks like in outpatient clinics and the acute care settings, rural, urban, and otherwise, as well as what it looks like for those who are in the telehealth experience. How do they need to be designed to ensure a healthcare professional? Is at the right place and the right time to provide the care that they need at the top of that skill level that we talked about and to their fullest potential?
And then, finally, as we really take a deeper dive back, we're really looking at culture. What is the culture of the organization? What are the values and the mission and the vision that inspire people to come to work every day? Is it an environment of psychological safety? Do they feel physically safe in that environment? Are there processes and systems that embrace the type of care that providers want and need to deliver? And are there programs in place that provide the care for our caregivers? So again, that they're receiving the optimal support. So they can be at their best.
Evidence from nursing and the nation really shows us that there have been a course, very extreme challenges, and incredible impact. And the 2021 survey of registered nurses from AMN Healthcare suggests that this care and support isn't consistently being provided at the level and in the ways healthcare professionals need. In fact, the distress caused by the pandemic among nurses is driving some of them away. And we all know that this is a really difficult decision for nurses to leave their profession or to leave their jobs.
According to our survey, approximately 23% of nurses said it was somewhat likely or extremely likely that they would leave the field of nursing because of the pandemic. This is incredibly troublesome as this figure represents almost a million nurses. Now, again, we're already in an extreme shortage and we need every nurse to bring their best self and to feel supported no matter what environment that they're working in. And so we really want to make some significant changes with our partners across the industry to retain nurses in the workforce.
Let's dig into that a little further because, of course, in order to deliver the good patient experience, you have to have your staff that are prepared and supported to do that. So what happens to the patient experience if the healthcare staffing isn't supported or being cared for.
Thank you, Camille. And this is near and dear to my heart. If you talk to any nurse executive, today you're talking to me, we'll share our stories and our experiences over the course of our career, where we worked in less than optimal circumstances and how we emerged from the crisis and the chaos. And so there are many examples of that over the course of the pandemic. And certainly, there has been research published, and most recently, from Eastern Michigan university, which stated that when healthcare facilities have insufficient nurses on staff, the welfare patients can be compromised. I think everybody would agree. That's very true. However, there's other details that we need to look at when we think about insufficient staffing, and that's really the impact on patient care outcomes. And that leads to families and patients really feeling insecure, dissatisfied, unsafe in an environment when they don't have the staff that they need to support them.
So in addition to, if there's insufficient staffing for nurses, when the healthcare facility overall is understaffed with other healthcare workers, that same amount of work falls to fewer nurses who typically end up working longer hours. Doing so with little to no relief can cause certainly a breakdown in mental, emotional, and physical health. So what we're seeing across the country are that staffing issues during the pandemic have resulted in this scenario playing out.
Data from our survey in 2021 showed that concern among nurses about the impact the pandemic is having on their personal and professional lives was high. 51% had concerns about work-related health risks, which I think we're seeing more of which, unfortunately, is hostility, and civility, and violence in the workplace. That has a deeper impact on the emotional outcomes of the pandemic, which is that 62% of nurses reported being emotionally drained. 57% felt that they were burnt out on most days, and 51% worried that their job is affecting their health.
Physician burnout has also become a very serious staffing challenges for healthcare facilities. 13% of healthcare leaders surveyed in the 2022 Survey of Locum Tenens Staffing Trends indicated that they use locum tenens physicians, and other providers to address burnout by reducing the workload of their permanent staff. So that's one of the workforce solutions, is finding a way to balance workload. Healthcare executives are fully aware of the challenge of provider burnout. Healthcare worker burnout can have costly repercussions for the healthcare system, with the best estimates linked to the costs of replacing staff. Researchers estimate that annual burnout-related turnover costs are $9 billion for nurses, and 2.6 to 6.3 billion for physicians. These estimates do not include turnover among other types of healthcare workers across the continuum.
So with all these challenges that affect, not only the individual, but the system as a whole, are there any positive changes or solutions that healthcare organizations can make to offset some of these discouraging signs?
Yes, Camille, there are tangible strategies and solutions that can be implemented to reduce stress, provide managers more time to support their teams, and ensure staffing can be managed more efficiently and effectively. Many organizations are investing heavily in telehealth, total wellbeing programs, and redesigning models of care with technology-enabled workforce solutions. In addition, utilizing employee engagement surveys and taking action on the findings is important to building a culture of trust, caring, and excellence. So it's incredibly important that we listen to our workforce, and that we develop programs with them, and that we develop programs that are meaningful and accessible 24/7.
From our leadership solutions division, one piece of good news from our ninth annual healthcare trend survey is that engagement among leadership and healthcare professionals is high, despite the challenges of the last 18 plus months. Battling COVID-19 has pulled many clinicians together, generating incremental improvement in engagement. Another encouraging result from the 2021 Survey of Registered Nurses is that, though the challenges of the pandemic, a large majority of nurses retain a fundamentally positive view of the profession. Over the years, are in surveys by AMN Healthcare, have shown persistently high career satisfaction among nurses. And the pandemic has only marginally affected this. This positive change starts in what some may think is an unlikely place. Camille, and that's with our finance department.
That's surprising to me. Tell me about how change starts in the finance department. How does that work?
Well, our Healthcare Organization's Finance Department provides productivity targets and staffing metrics for departments across the system. Now, these financial instruments indicate how many and what types of staff are needed at certain demand points. However, it's common that even in organizations with strong financial teams, are producing targets that do not reflect the reality of departments providing the care. Now, typically, this is because those who are making daily staffing decisions aren't involved in budgeting conversations, nor do they necessarily have the advanced training in healthcare finance management.
Now, it's a journey that really starts with a strategic and operational plan informed by nurse executive leaders who are trained in healthcare finance management, and have the ultimate accountability over the largest part of the budget in an organization and that labor and capital budget that supports both workforce planning, not just for nurses, but other healthcare professionals, but also, the capital budget, which involves equipment, and instrumentation, and devices, all things that are important to the workflows that are designed to deliver patient care services.
So before any talent planning initiatives started, organizations should implement a solution design process. This is a collaborative process that helps healthcare leaders navigate strategic initiatives and resources required to achieve their goals and objectives. An important component of talent planning is conducting a staffing plan assessment. Now, this assessment is part what comes out of this collaborative process, and it really looks at four distinct areas to evaluate accurate staffing levels, and identifying productivity, financial and operational opportunities. The first area is to identify the appropriate staffing levels for each department. What are the staffing needs based upon actual and predicted patient work volumes? The third is to quantify the financial impact of productive staffing plans. And then lastly, looking for additional cost savings measures and a pattern of exceeding targeted wage rates with unpredictive outcomes.
So because the staffing is just the secret sauce, I mean, that's what allows the organization to be successful and to deliver that patient experience, how does a healthcare organization acquire the right mix of talent?
That's a great question. Once the initial work of a staffing assessment plan is completed, and those targets are set, an organization can assess the gaps in what staffing levels should be and what challenge is already employed within the health system. Keeping recruiting for diversity on track is also very important, and it's a factor that's really essential to the healthcare system's long term success. Really, from there, the work begins to acquire and develop the full spectrum and source of talent to deliver great patient care. So when we think about the right mix of talent, it's going to look different for one unit to the next or one department to the next based on the care needs, and again, the acuity of those patients. In some models, it might be more of what we see, which is primary nursing, and other models, it's team-based care. But what's important is to really look at how care is delegated, how it's supervised, and how it's supported throughout the continuum.
When recruiting permanent staff healthcare, organizations can partner with a talent acquisition company to outsource recruitment services, or use those services to supplement an internal team. Finding the right mix of talent can be very challenging for healthcare organizations. So partnering with a recruitment solutions firm, also known as RPO, enables quick and efficient hiring of quality candidates while lowering the cost, ensuring a good cultural fit and providing a better patient care experience.
Supplementing permanent staff with contingent staff is where many organizations can really get bogged down with all the components, various staffing agencies and really the administration piece of managing all of these different HR processes. So utilizing a managed services approach does really help, and allows workforce solutions providers with very specific expertise to bear the responsibility for, not only the recruitment, but the development life cycle and optimizing core contingent talent to increase efficiency and reduced costs. We have solutions that can help healthcare organizations reduce the burden and also the fallout of talent in the pipeline.
So lastly, vendor and staffing management is an area that can be simplified and should be simplified through centralization, vendor neutral portals that really enable healthcare facilities to quickly staff and manage contingent labor. Some solutions utilize a bid-driven marketplace, ensuring fair market rates. Deployment of a VMs eliminates lots of time consuming phone calls and emails to various suppliers while really greatly increasing the candidate pool. So there's various strategies that we can utilize, and that healthcare organizations can utilize to increase the mix of talent, the diversity of talent, and then ensure that there are healthcare professionals with the appropriate qualifications, credentials, and competencies to deliver safe patient care.
Once they have that right mix within the organization, how can the organization proactively manage the talent while still delivering care?
Camille, this is probably one of the most important parts of the process, is talent management and talent development. We're leading people throughout their career. We're leading people to deliver care in the best way possible. So it's one thing to recruit great talent. It's another thing to engage, develop, and retain great talent.
So the next area of focus, proactive management of scheduling and staffing, which can make all the difference in the world is to really examine the policies of the organization and how they're applied. Are they applied consistently in an equitable way? And really looking at the practices at the unit level, department level, and ensuring that there's an adoption of an enterprise mentality that really creates transparency about staffing needs, opens the door to sharing resources through, really, centralization. But the other thing about that level of transparency is it promotes fairness. It increases staff morale because they know the playing field now equalized, and we're all working under the same set of policies and expectations. And that's really also part of what we call adjust culture.
The promotion of fairness and morale boosting strategies can be carried out to how schedules are developed. This is how many organizations employ their shared governance or professional governance councils, engaging frontline team members in how they develop those schedules, really embracing their feedback and into the strategies, and giving them input into things like self scheduling, which has long been a popular method for nurses. With the right framework, self-scheduling can augment more traditional scheduling methods. It can provide a lot of work-life balance for caregivers. We want to be able to take time off for ourselves, and that's an important thing for all healthcare workers. And in order to do that, we need to plan ahead. So scheduling tools like this are really important.
So lastly, centralization's a key element of efficient deployment of staff across an organization, and even a healthcare system that is across multiple states. So utilizing a tool like this can provide the ability to see staffing in a more discreet and concrete way, and it can help people really know where the need is greatest.
Wow, Paulette, you've really shared a wealth of information with us today about talent planning. And thank you so much. Any closing thoughts you'd like to add?
Thank you, Camille. In closing, I'd really just like to share today that we are in a field and in an industry where compassion is at the heart of our mission. And it's reasonable to expect that compassion can be the leading edge of improving the patient experience, compassion for our healthcare professionals, for one another, and patients, and understanding, certainly, learning from one another, embracing different perspectives, and really implementing uniform and comprehensive talent strategies and solutions that really keep the wellbeing of our healthcare professionals at the forefront of our work every day so that they can be their best. When healthcare professionals are better supported patients receive better care or compassionate care, more efficient care, and enable them to live their healthiest and best possible life outside of the healthcare system.
Thank you so much for your time today, Paulette.
Thank you. It was so wonderful being here. Appreciate it.
This has been a sponsored episode of Healthcare Insider, created in collaboration with AMN Healthcare. For more information about AMN Healthcare, please visit amnhealthcare.com. I'm your host, Camille Baxter. Look for more episodes of Healthcare Insider at modernhealthcare.com/podcasts or subscribe at Apple Podcasts or your preferred podcatcher. Thanks for listening.