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MODERN HEALTHCARE: Now, let’s get into our conversation with Casey Willis-Abner.
MODERN HEALTHCARE: Hello, Casey. How are you? Thank you so much for being here.
CASSANDRA WILLIS-ABNER: Oh, thank you so much for having me. It’s a privilege and a pleasure to be a part of this discussion today.
MODERN HEALTHCARE: I want to start with just a couple of data points and then we’ll dive into our questions. The first data point is that according to a 2014 report by the American Hospital Association, disregarding generational differences can lead to high employee turnover rates, which leads to increased spending on recruitment, training, and retention.
The second point is that in 2018, turnover for bedside nurses alone was more than 17%, and that cost hospitals up to $6.9 million a year. And lastly, fostering team building across generations has been shown to improve patient outcomes, which can reduce the overall cost of care.
Those are just some data points to frame our discussion. Let’s start with you and, sort of, the stretch of your career. At the beginning of your career, what was the workplace like when you first started in healthcare? And then, what are some of the major changes you’ve noticed as younger workers have come in behind you?
CASSANDRA WILLIS-ABNER: I actually went from undergraduate to a graduate program, so I went straight through. I started really, really early in the healthcare industry and my first job after going through a yearlong fellowship was a director position. That's — we’re talking 30 years ago. So, my first job, I was the center director of a health center at a federally qualified community health center in Cleveland. And as the director of that center, everybody who worked in the center, I was their people leader. Ironically, I was the youngest person at the health center. So —
MODERN HEALTHCARE: Yeah. You were probably what, 23? Or 24?
CASSANDRA WILLIS-ABNER: 22, just about to turn 23. And there’s a long story. I didn’t go to the 12th grade and — happened to be 22, about to turn 23, as this director in an inner city, federally qualified community health center in Cleveland. And so it’s interesting because all my career — and through high school and college and graduate school — everybody knew me as Casey. But I actually had to think about how I needed to go into this job situation as a 22-year-old who probably looked 16 at the time in the inner city of Cleveland. I needed to not be Casey, and I needed to get a little bit more maturity in my whole persona. And so I reverted back to the name that my mother and father gave me, and that was Cassandra.
MODERN HEALTHCARE: Okay.
CASSANDRA WILLIS-ABNER: And I felt like Cassandra really gave me a little bit more credibility and more maturity. And so, I entered into the workplace as Cassandra. And as I look back and I think about the experience of new grads, whether undergraduate or graduate school, there's a lot more competition in the area of healthcare administration these days. A lot more people are graduating from programs and have graduated from programs since I left the University of Michigan School of Public Health. And so there’s competition.
Another thing that I’ve noticed is there are less jobs in healthcare organizations in leadership levels because over the years, organizations have been looking at how to achieve synergy, and how to reduce the expenses, and improve efficiencies. And so, many leadership positions have a breadth and a bigger scope of responsibilities than maybe some of the narrow scopes and positions that I can recall existed back when I started — and even in the early 2000s. And so, all of that, of course, was done to be able to meet margin, so that healthcare organizations could care for families and care for the communities that they were taking care of. I’d say my experiences coming out into a leadership position is likely a lot different from those people who are coming out and starting in the workplace now.
MODERN HEALTHCARE: And it sounds like you’re referring to just how the landscape changes as there’s more mergers and acquisitions. Health systems have become bigger. Trying to achieve those synergies and also trying to control cost — that creates a smaller pool of administrative positions for people looking to head in that level.
CASSANDRA WILLIS-ABNER: Exactly. If you think about it — if you take that example a step further, people are staying in jobs longer now, right? People used to retire a little bit earlier. Just because of a variety of reasons, people are staying in jobs a lot longer. So, when there’s no movement in positions and people have tenures that can last much, much longer than before — along with the things that you just described — that also creates less opportunities for those entering the workplace, as well as those who are trying to maneuver through it.
MODERN HEALTHCARE: And that brings up another topic. Nancy Schlichting, she was the former CEO of Henry Ford —
CASSANDRA WILLIS-ABNER: Yes.
MODERN HEALTHCARE: She mentioned that succession planning is really not happening the way it should. So, you have senior leaders staying in these positions longer but not prioritizing grooming that up-and-coming leader to replace them.
CASSANDRA WILLIS-ABNER: Yeah.
MODERN HEALTHCARE: And it can create some issues.
CASSANDRA WILLIS-ABNER: I do agree with that. And you mentioned Nancy, you know, she’s a healthcare leader that I absolutely look up to and had actually an opportunity to be on a call with her a couple of weeks ago. And she was methodical, and she was very proactive in helping to groom her successor. And I think that it really caught the attention and caught the eye of a lot of people, a lot of leaders who could see exactly how she was intentional. Took time to ensure the success of that leader who was taking the reins upon her retirement. So, I think that that was a good point. And succession planning is something that all organizations probably could do a better job at.
MODERN HEALTHCARE: So, on this podcast we talk a lot about inclusion. So far, that discussion has focused on including womens’ perspectives in leadership circles, in consideration for leadership positions. We’ve also talked about inclusion of people of color, but I feel like there’s cultural differences based on age, as well. And when you talk about inclusion, we also have to talk about including people of different generations. Some of the misconceptions that we have about certain generations can be dispelled, right? So, some say Millennials are lazy, and some say the boomers are stuck in their ways. What stereotypes or misconceptions do you often hear that can lead people to exclude someone based on age?
CASSANDRA WILLIS-ABNER: We have had the opportunity to hear a lot about women, and people of color, and all important stuff. And we need to hear more about women, and people of color, and people that are differently abled, and people who are veterans. But the generation conversation, we can’t escape it. We shouldn’t close our eyes or turn our head from it because it is so relevant in how we get work done. Not just in the healthcare industry but just, in our country, you know, and just in life. And you’re right, there are many stereotypes and misconceptions that cause people, unfortunately, to be excluded sometimes.
The technologically challenged is something that might be associated with those considered to be boomers. The Millennials are — have a stereotype about just not being loyal to an organization and they hop jobs. So, that could go to the back of the hiring manager’s mind because they’re looking for somebody who they want to retain over a significant period of time. You hear stereotypes about Millennials being never satisfied and always wanting more without putting the time in. They’re all stereotypes which are unfortunate assumptions that are not true for individuals.
And so, I’d say that hiring managers, organizations have to be really intentional about hiring practices, about how decisions are being made. How do you take bias out of the hiring process? And we hear a lot about that, about women and people of color. But the same type of thought needs to be given towards generations and eliminating these stereotypes from any decision that we’re making to hire individuals.
MODERN HEALTHCARE: Yeah. I mean, even as you gave your background story on being hired into a leadership position in your early 20s, my first thought was — what did you have to go through to constantly prove yourself and command that respect as a director? Simply because people were discounting you because you were young.
CASSANDRA WILLIS-ABNER: That is so true. It's almost like you were there, right? And let me just take it — let me take it a step further, which was an amazing first experience. I mentioned that that first job was in Cleveland. It was in the inner city of Cleveland and on the east side of Cleveland. If your listeners know about Cleveland, it historically had been one of the most segregated cities where the east side was black and the west side was white at that particular time, and things have changed over the years. But I say that to say, when I went into this job on the east side of Cleveland, the 80 or so people who worked there were all African Americans like myself. And so, I’m sure I looked like their niece, their cousin. You know, the little girl from down the street. But I did have to prove myself every day. I had to prove that even at my young age, I could go toe-to-toe in my knowledge and my abilities with those that I was the people leader for. And actually, I could see the tables shifting. Once that level of credibility was gained, I tell you that they were very loyal, devoted, committed, collaborative individuals, and we really did a lot of good work.
MID-SPONSOR MESSAGE: Before we continue our discussion, I’d like to again recognize Ontrak, the sponsor of today’s episode.
With just 5% of people accounting for 44% of healthcare costs, Ontrak identifies and treats those people for up to 52 weeks. With this unique sort of support, your members can achieve true behavior change and better health that can last a lifetime.
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Now, let’s get back to our discussion.
MODERN HEALTHCARE: Let’s talk about healthcare leaders who are currently in the workplace, trying to navigate the various interactions and expectations of these different generations. What are your thoughts on just, what interactions are appropriate or inappropriate? And how has that changed over the past — what, two or three decades that you’ve been in the industry?
CASSANDRA WILLIS-ABNER: In the past, we saw as much or as little of a coworker’s personal self as they allowed us to glimpse — that they brought into the workplace. But now with social media, I mean, I could tell you if you posted it, what you ate for dinner yesterday and what you had on if you took a selfie.
MODERN HEALTHCARE: Yeah.
CASSANDRA WILLIS-ABNER: And so, you know now I can say, oh this is how he or she dresses? Or this is where he or she goes? Sometimes, people use that and they’re judgmental. But then sometimes, it leads to discussions that are much less formal in the workplace. More small talk about topics that may or may not be typical or appropriate for the workplace. So, those are just some of the things that I think have caused a change. And perhaps could create some sensitivity for people leaders to know how to navigate when some of those personal discussions about certain topics have gone too far.
MODERN HEALTHCARE: And that’s why I’m not on Facebook.
CASSANDRA WILLIS-ABNER: I’m not on Facebook. I am on Linkedin, but not Facebook and Instagram and Snapchat, Tiktok. None of those.
MODERN HEALTHCARE: If you put it out there, you open yourself up to discussions about it.
CASSANDRA WILLIS-ABNER: That’s just kind of a thing that has turned into something that cuts across generations — knowing what’s appropriate and what’s not appropriate. And that does cause, in the HR space, a lot of decisions and discussions around when a colleague, an associate, an employee puts something out on social media. And what point does that have an impact on organizations? I mean, a lot of that happened last summer with any of the social justice focused, either marches or platforms. And a lot of people were sharing their personal opinions and it really was something that, again, that social media has really caused leaders to have to lead in a different way. And has caused glimpses of individuals that actually have a gray area of whether or not it’s someone representing the workplace with their opinions.
MODERN HEALTHCARE: That’s a good lead-in to the next question then, about, what are you seeing? I mean, you come from a health system background. You are now Chief Human Resources Officer for Press Ganey. So, you’re seeing a lot of what happens in health systems. What are some of the primary complaints and conflicts that you’re seeing?
CASSANDRA WILLIS-ABNER: It definitely is eye opening, working for Press Ganey. And our organization is an industry leader, providing insight on many things to include workforce engagement, patient member experience, safety, clinical excellence. And one of the really, really good things is that being the leader of data, it’s incredible when I think about the amount of data to allow for analytics. On a daily basis, we send out over 200 texts — survey texts. In a year, over 400 million. So, every day, we’re understanding either the experiences of people in the workforce, understanding the experiences of physicians, of nurses, of people who are at the bedside as caregivers, those who are a part of the caregiver team but not clinical. We’re hearing the experiences of patients and members of healthcare plans, as well.
And so with that ability, you can segment the data. When I say segment the data — if there are questions and we have the ability to understand who’s answering questions. And we segment that data by gender, race, ethnicity, generation. I mean, there’s so many different ways to look at it. And so, the beauty of it is that organizations are paying attention to the segments of their population. Whether it’s the workforce or whether it’s patients. When we’re talking about generations as we’re talking about in this podcast, organizations are looking at their workforce to say, “Well, what are the experiences? And what are the gaps in experiences between those in our workforce that are across generations?”
People are working closely alongside each other, and it’s really important to understand if there are issues around generations. Nursing, for instance — one of the largest professions in health systems, and one of the largest groups within health systems. What can we learn from understanding the experiences of new nurses? Sometimes, many who are Millennials versus those nurses who have been around for much longer periods. And so, organizations are using the data, and generations is one of the ways that that data is being sliced. And it’s going to help organizations be able to move the needle.
To make improvements, to make population-, generation-specific improvements. I mean, because — I don’t want to go back to the stereotypes, but there are certain things that work with certain generations. And so, if we know a particular generation is having an issue with A, B, or C, then our tactics or our solutions to help reduce that variation and improve their experience should be specific. Something that sticks with that generation. So, I think it’s amazing to be able to use data to solve real-life issues in the workforce or to improve real-life situations in the area of patient care or member experience.
MODERN HEALTHCARE: Right. Because I mean you can go off your anecdotal experience, but having that data to really back up why you’re doing it can, kind of, show that you’re not just following a stereotype, you actually have information to back it up.
Last question then, what advice would you give to a healthcare leader who is hiring a team, managing a team, various age groups — they’re trying to understand how to navigate the expectations of these various generations — what advice would you give them?
CASSANDRA WILLIS-ABNER: First, I would ask them to really take a mirror to understand who they are. It’s kind of like, know thyself, right? And the reason I say that is because you know, we all have bias. We’ve grown up exposed to different situations, different conversations that have shaped us to the human beings that we are. Knowing that, I think we first have to understand that we have to mitigate our own bias. How you act and how you move on that first spot is what you have to be responsible for. That to me is probably one of the first and most important aspects of really making a decision that evaluates people fairly.
In a multi-generational team and on a diverse team, I think that one of the things that a leader should think about is making sure that everyone has a voice. Let everyone be heard. So regardless if this somebody who just came out of a nursing program or someone who’s been in their profession for 25 years — everybody needs a voice and everybody needs to be heard. That helps to increase innovation, improve collaboration.
To those novice colleagues, it helps gain credibility with the rest of the team when others hear what they have to say. So, I think that leaders have to encourage building relationships on the team. And really, they have to be the quarterbacks to do that. So, if someone isn’t speaking up or if someone is not as engaged as others, figure out how to bring that out, whether it’s a task force or committee or something. You know, give everybody an opportunity.
I think the last couple of things I would just say is just to reinforce that leaders have to use their data.
MODERN HEALTHCARE: Yeah.
CASSANDRA WILLIS-ABNER: And they have to segment it. You know, segment it, break it down as best possible without identifying who said what, or pointing to specific people in either comments or results. The importance of that, again, is how you use analytics to give you insight, so that you can create and implement different actions or solutions that work for different segments of the workforce. In this particular case, in different generations. What is it that keeps people? There may be different strategies for different people based upon what generation they’re in, what’s important to them, what their beliefs are, their core values, and the best situation that they find themselves most effective working in.
MODERN HEALTHCARE: Thank you so much. This was a really insightful conversation.
CASSANDRA WILLIS-ABNER: Thank you for bringing this very important topic to the forefront.
OUTRO COMMENTS: Thank you, Casey, for that insight on multigenerational workplaces and how it’s changed during your tenure in healthcare.
We’d also like to again thank this episode’s sponsor, Ontrak.
We’ll be expanding on this topic at the Modern Healthcare Women Leaders in Healthcare conference, July 22-23. If you register with the code (NextUp), you’ll receive a 15% discount off the conference fees and any conference add-on opportunities. To register, go to women-leaders.modernhealthcare.com.
Again, I’m your host, Kadesha Smith, CEO of CareContent. We help health systems reach their growth goals through digital marketing that focuses on the right content.
Look for more episodes of Next Up at modernhealthcare.com/podcasts, or subscribe at Apple Podcasts, Google Podcasts, or your preferred podcatcher. Thanks again for listening.