As we’ve beendiscussing, the COVID pandemic and ensuing economic environment have driven health system job vacancies and attrition rates to all-time highs. Right now, for myriad reasons, many hospital workers are deciding that the financial, emotional, and professional benefits of working for a hospital are outweighed by the toll working in a hospital takes on them personally.
Health systems are responding to this challenge with a wide variety of discrete measures—including hiring and retention bonuses, incentive pay, employee wellbeing initiatives, and expanded professional development opportunities— that target specific groups of employees, but don’t form a long-term solution to workforce instability.
To rebuild a stable and committed workforce, health systems must create, and then communicate, a compelling employee value proposition—a concise statement highlighting why employees should work for them.
The graphic above shows what we believe are the key components of a successful employee value proposition, which must have a clear vision and focus on the things most important to employee needs: compensation, work-life balance, and career support. Systems can use the guiding questions listed in each column to craft a value proposition that is differentiated in their local labor market, informed by their level of resources, and undergirded by their own culture and values.
Only 10 days after a racially motivated mass shooting that killed 10 in a Buffalo, NY grocery store, 19 children and two teachers were murdered on Tuesday at an elementary school in Uvalde, TX. The Uvalde shooting was the 27th school shooting, and one of over 212 mass shootings, that have occurred this year alone.
Firearms recently overtook car accidents as the leading cause of childhood deaths in the US, and more than 45,000 Americans die from gun violence each year.
The Gist: Gun violence is, and has long been, a serious public health crisis in this country. It is both important to remember, yet difficult for some to accept, that many mass shootings are preventable.
Health systems, as stewards of health in their communities, can play a central role in preventing gun violence at its source, both by bolstering mental health services and advocating for the needed legislative actions—supported by a strong majority of American voters—to stem this public health crisis.
As Northwell Health CEO Michael Dowling said this week, “Our job is to save lives and prevent people from illness and death. Gun violence is not an issue on the outside—it’s a central public health issue for us. Every single hospital leader in the United States should be standing up and screaming about what an abomination this is. If you were hesitant about getting involved the day before…May 24 should have changed your perspective. It’s time.”
Americans and global leaders have responded to the May 24 shooting at a Texas elementary school with heartbreak, anger and calls for change to better fight gun violence. But if you’re paying attention, the calls out of healthcare — from trauma surgeons, pediatricians, nurses, leaders and more — carry a distinct type of exasperation and sorrow.
“I’m in one of my hospitals now, sitting with some staff talking about it — it’s just so frustrating,” Michael Dowling, president and CEO of New Hyde Park, N.Y.-based Northwell Health, told me over the phone early Wednesday morning. “This does not represent what the United States stands for — that we allow people who should never be allowed to carry a gun to do so and walk into a school and kill fourth graders.”
The attack by a lone 18-year-old gunman at Robb Elementary School in the small town of Uvalde, Texas, has left at least 19 students and two adults dead. Students in the school, grades 2 through 4, were two days away from summer vacation.
Unlike many other known threats to our health, seeing the medical community condemn mass shootings still seems to leave some Americans doing a double take. It’s increasingly difficult to see what has them confused.
In 2016, the American Medical Association declared gun violence a public health crisis after a lone gunman killed 49 people and wounded 53 more in a mass shooting in a gay nightclub in Orlando, Fla. Even after the declaration, healthcare professionals and leaders continued to defy insistence from gun rights advocates that gun violence was not within their specialty or expertise. Or as the National Rifle Association put it in simpler terms in 2018: “Someone should tell self-important anti-gun doctors to stay in their lane.” The #ThisIsOurLane movement started then. The attempt to silence medical professionals ironically made their calls for action louder.
As healthcare professionals responded to the ongoing public health emergency of COVID-19, the arms race grew and gun buying intensified — “a surge in purchasing unlike anything we’ve ever seen,” as one gun researcher at the University of California, Davis, put it. People who already owned guns bought more, and people who had never owned a gun bought them too. In 2020, firearm-related injuries were the No. 1 cause of death of children and teens, according to the CDC.
Every day, 321 people are shot in the United States, and more than 40,000 Americans die from gun violence each year. Yet some healthcare executives still fear that taking the position that gun violence is a public health crisis will throw them into political turmoil given how toxic politics are in this country. It’s one position for the AMA and its 250,000-plus members to take, but another for an individual leader who may be the face of an organization in their community. There are risks of offending board members, donors, elected officials and other constituents — including patients. But here’s the thing: There will always be a reason to delay, to soften language, to wonder if this mass shooting is the one to react to.
Mr. Dowling urges his colleagues to step it up, noting how hospital and health system leaders can be ambassadors for gun safety in their communities, given the influence they wield as the largest employers in many communities.
“This is about protecting people’s health. This is about protecting kids’ lives. Have some courage. Stand up and do something,” he said. “Put the interest of the community in the center of what you think about each and every day. Our job is to save lives and prevent people from illness and death. Gun violence is not an issue on the outside — it’s a central public health issue for us. Every single hospital leader in the United States should be standing up and screaming about what an abomination this is.
“If you were hesitant about getting involved the day before May 24, May 24 should have changed your perspective. It’s time.”
Northwell established The Gun Violence Prevention Learning Collaborative for Health Systems and Hospitals, a grassroots initiative that gives healthcare professionals the space to have open dialogue about the impact of gun violence, share best practices and collectively take action. Learn more here.
CommonSpirit Health is requiring full COVID-19 vaccination for its 150,000 employees, the Chicago-based health system said Aug. 12.
The requirement applies to employees at CommonSpirit’s 140 hospitals and more than 1,000 care sites and facilities in 21 states. It includes physicians, advanced practice providers, volunteers and others caring for patients at health system facilities.
“As healthcare providers, we have a responsibility to help end this pandemic and protect our patients, our colleagues and those in our communities — including the most vulnerable among us,” Lloyd H. Dean, CEO of CommonSpirit, said in a news release. “An abundance of evidence shows that the vaccines are safe and highly effective. Throughout the pandemic we have made data-driven decisions that will help us best fulfill our healing mission, and requiring vaccination is critical to maintaining a safe care environment.”
The compliance deadline for the vaccination requirement is Nov. 1, although the implementation date will vary by region in accordance with local and state regulations. Employees who are not in compliance and do not obtain a medical or religious exemption risk losing their jobs.
Overlake Medical Center & Clinics invited about 110 donors who gave more than $10,000 to the Bellevue, Wash.-based health system to receive COVID-19 vaccines, drawing criticism from the state’s governor, according to The Seattle Times.
Molly Stearns, the chief development officer at Overlake, emailed the “major donors,” as they were addressed in correspondence, about 500 open appointments in its COVID-19 clinic that were set to open Jan. 23. According to The Seattle Times, donors who received the email got an access code to register for appointments.
The vaccination appointments weren’t exclusive to donors, but were open to some 4,000 people who were board members, some patients, volunteers, employees and retired health providers, Overlake told the newspaper. All registrants were supposed to meet state-specific eligibility requirements for the vaccine, according to The Seattle Times.
Tom DeBord, Overlake’s COO, told the newspaper that the invitation was sent after the hospital’s scheduling system stopped working properly. To speed up distribution, the system began contacting people whose emails they had access to, which included donors, retirees, some patients and board members.
“We’re under pressure to vaccinate people who are eligible and increase capacity. In hindsight, we could certainly look back and say this wasn’t the best way to do it,” Mr. DeBord told The Seattle Times.
Once Gov. Jay Inslee’s office found out about the “invite-only” appointments, the office asked Overlake to shut down the sign-ups, which the system did.
In a Jan. 27 statement posted to the health system’s website, Overlake said all communications with people invited to sign up for the vaccine “made clear that people must show proof of eligibility under current Washington State requirements to ultimately be vaccinated, no matter who they are or how they are affiliated with us. We recognize we made a mistake by including a subset of our donors and by not adopting a broader outreach strategy to fill these appointments, and we apologize. Our intent and commitment has always been to administer every vaccine made available to us safely, appropriately, and efficiently.”
Two members of Congress from Massachusetts have tested positive for the coronavirus, one after receiving both doses of the vaccine, a reminder that people can still be vulnerable to infection after being vaccinated, particularly in the two weeks after receiving the second dose.
Rep. Stephen F. Lynch (D-Mass.) tested positive for the virus on Friday afternoon after a staff member in his Boston office tested positive earlier in the week, his spokeswoman Molly Rose Tarpey said.
Lynch received a second dose of the Pfizer-BioNTech vaccine before the inauguration of President Biden on Jan. 20, but his office declined to specify the date it was administered. Lynch had tested negative for the virus before attending the inaugural ceremonies, Tarpey said.
“While Mr. Lynch remains asymptomatic and feels fine, he will self-quarantine and will vote by proxy in Congress during the coming week,” she said.
Tarpey added that Lynch “has followed CDC guidelines and continues to do so since he received the vaccine.”
Another Democrat from Massachusetts, Rep. Lori Trahan,announced Thursday that she had tested positive for the virus and was asymptomatic. Trahan, whose staff members have been working remotely, also said she planned to vote by proxy next week.
“I encourage everyone to continue taking this virus seriously and to follow the science and data-driven guidance to wear a mask, maintain a safe social distance from others, avoid large gatherings and stay home whenever possible,” Trahan said.
Trahan received her first shot of one of the vaccines last week, spokeswoman Francis Grubar told The Washington Post.
Occasional cases of people testing positive after receiving one or both doses are not unexpected, medical experts say. Clinical trial data published by Pfizer show that the vaccine is about 52 percent effective at preventing illness after the first shot, compared to 95 percent effectiveness seven days after the second dose.
A small number of patients can still become mildly sick even after they are fully vaccinated. But only one of the roughly 20,000 people who received both doses in the clinical trial developed severe covid-19, suggesting the vaccine is powerful protection against the most dangerous cases of the disease.
Members of Congress began getting vaccinated as early as Dec. 18, but Lynch at the time said he was “waiting for the vaccine to be first offered to health care personnel, first responders and vulnerable seniors” in his district, the Boston Herald reported. It is unclear when Lynch ultimately received his first dose of the vaccine; he would have received the second dose of the Pfizer-BioNTech vaccine about three to four weeks after the first.
Public health experts have emphasized that it usually takes one week after the second dose of the Pfizer-BioNTech vaccine to reach 95 percent efficacy and two weeks after the second dose of the Moderna vaccine to reach 94 percent efficacy.
“There’s no vaccine that I know that protects you the same day you get it,” Onyema Ogbuagu, the principal investigator for Pfizer’s vaccine trial at Yale University, told The Post’s Allyson Chiu. “On a population level, 95% efficacy still translates to 5/100, or 50/1,000, or 500/10,000 vaccinated persons still being vulnerable to symptomatic disease and maybe even more having asymptomatic carriage.”
At least 23.2 million people in the United States have received one or both doses of the vaccine. The Centers for Disease Control and Prevention recommends that vaccinated people continue to wear masks, socially distance, avoid poorly ventilated spaces and wash their hands frequently to prevent the spread of the virus.
“We also don’t yet know whether getting a covid-19 vaccine will prevent you from spreading the virus that causes covid-19 to other people, even if you don’t get sick yourself,” CDC guidelines state. “While experts learn more about the protection that covid-19 vaccines provide under real-life conditions, it will be important for everyone to continue using all the tools available to help stop this pandemic.”
Mask-wearing in particular has become politicized, including in the hallways of Congress. After the Jan. 6 siege at the Capitol, several Democrats said they feared they had been exposed to the virus after sheltering with Republican lawmakers who refused to wear masks. In the following, at least three lawmakers tested positive for the virus.
On Friday, Rep. Cori Bush (D-Mo.) accused Rep. Marjorie Taylor Greene (R-Ga.) of berating her in the hallways after she told Greene to put on a mask. The incident, coupled with other hostile rhetoric and Greene’s refusal to abide by rules and protocols put in place because of the pandemic, prompted Bush to decide to move her office away from Greene’s for safety reasons, the Missouri lawmaker said.
Anthony Fauci on Friday said that a lack of facts “likely did” cost lives over the last year in the nation’s efforts to fight the coronavirus pandemic.
In an appearance on CNN, the nation’s leading infectious diseases expert was directly asked whether a “lack of candor or facts” contributed to the number of lives lost during the coronavirus pandemic over the past year.
“You know it very likely did,” Fauci said. “You know I don’t want that … to be a sound bite, but I think if you just look at that,you can see that when you’re starting to go down paths that are not based on any science at all, that is not helpful at all, and particularly when you’re in a situation of almost being in a crisis with the number of cases and hospitalizations and deaths that we have.”
“When you start talking about things that make no sense medically and no sense scientifically, that clearly is not helpful,” he continued.
President Biden on Thursday unveiled a new national coronavirus strategy that is, in part, aimed at “restoring trust in the American people.”
When asked why that was important, Fauci recognized that the past year of dealing with the pandemic had been filled with divisiveness.
“There’s no secret. We’ve had a lot of divisiveness, we’ve had facts that were very, very clear that were questioned. People were not trusting what health officials were saying, there was great divisiveness, masks became a political issue,” Fauci said.
“So what the president was saying right from the get-go was, ‘Let’s reset this. Let everybody get on the same page, trust each other, let the science speak.’”
Fauci, who was thrust into the national spotlight last year as part of former President Trump‘s coronavirus task force, often found himself at odds with the former president. Trump frequently downplayed the severity of the virus and clashed publicly with Fauci.
Speaking during a White House press briefing on Thursday, Fauci said it was “liberating” to be working in the Biden administration.
There have been more than 24,600,000 coronavirus infections in the U.S. since the pandemic began, according to a count from Johns Hopkins University. More than 410,000 people have died.
HENRY KOTULA 