Health care leaders have typically pointed to resource constraints as the reason for the United States health care system’s high costs and poor outcomes. Now, as the COVID pandemic has claimed over 550,000 lives and led to over 30 million cases across a country with immense resources, it is clear that health leaders have been asking the wrong questions.
Given the prominent leadership failures in containing the pandemic, and politicization of the public health response, it is clear that health care organizations and leaders need to pay more attention to frontline workforce issues that have faced neglect for years. While COVID has led to catastrophic loss of life, it also has several important organizational lessons for health care leaders and reveals what initiatives they need to be investing in, to support the next generation of health care workers. Using recent data, the major lessons are summarized below.
Prioritize the mental health and well-being of the health care workforce
Even before the COVID pandemic, up to 60 percent of physicians reported high burnout rates, across multiple specialties. Factors ranging from administrative burdens to poor organizational management have all contributed to this collective exhaustion. It is no surprise then that the global pandemic has only made the situation worse.
Emerging evidence suggests that COVID has had a severe impact on the mental health of health care workers. This will be a challenge—both from a human resource and legal perspective—for health care leaders in the post-COVID world, and will necessitate supporting initiatives that improve access to mental health care for workers—including dedicated resources in employee benefits.
Employ diversity and inclusion initiatives in the workforce
COVID has already revealed the disproportionate burden of the disease among racial and ethnic minorities. This inequity has elevated the importance of diversifying hiring practices as well as creating inclusive environments for health care employees. Given the recent national discourse on social and political inequities, health care leaders will need to invest in, and support, a workforce that reflects the composition of the national population. These initiatives are already taking place in most nationally recognized medical schools and hospitals.
Diversity in the health care workforce will also impact care delivery models. COVID has already illustrated the importance of developing culturally competent care. Historical injustices (such as the Tuskegee study) and ongoing inequities in care delivery (such as structural racism) that minority and underserved patient populations have faced have led to diminished trust in the U.S. health care system. Health care leaders can address these concerns by investing in programs that enable the expansion of workforce diversity. Several studies underscore how minority patients often fare better under the care of minority physicians.
Focus on health and safety measures
From the beginning of the pandemic, health care workers were not being supplied with the appropriate personal protection equipment (PPE). This leadership failure led to severe moral injury among care providers, and in many cases, clinicians leaving the practice of medicine altogether. Recent evidence demonstrates the medical necessity of the frontline workforce being able to access PPE—to prevent getting infected and being able to deliver care. Health care leaders will need to place a renewed focus on the health and safety of the workforce—not just for medical reasons, but also to prevent legal liability.
Move care delivery to the virtual space
COVID has accelerated the transition of health care delivery from in-person to telehealth, increasing patients’ access to health care services. Data from the Centers for Medicare and Medicaid Services (CMS) reported that more than nine million Medicare beneficiaries received care via telehealth during the early stages of the pandemic, with a weekly increase in virtual visits from 13,000 pre-COVID to nearly 1.7 million in April, 2020.
Given the rapid adoption of telehealth during COVID, health care leaders will need to continue investing in developing capacity for health care workers to be more proficient in delivering care through virtual modalities, which will necessitate supporting increased training and educational initiatives.
Integrate data for clinical care
COVID has demonstrated the value of having a proactive approach, using real-time analytics, for data collection and interpretation. The COVID dashboard developed by researchers at Johns Hopkins University has immensely improved the tracking and monitoring of coronavirus cases across the world. Major health care systems, such as Vanderbilt University Medical Center, have realized the potential of such platforms and have already invested in developing capacity in this space to combat health inequities that arose from the pandemic. These data-driven initiatives will continue to expand and enable health care leaders to make rapid assessments and take strategic decisions, both for improving patient care and for the allocation of health care workers within an organization.
As vaccine delivery efforts are accelerated, an equitable return to the new normal is within the horizon. Last year, when policy makers were faced with containing the spread of COVID, they often made decisions that were not equitable and hurt underserved populations, as well as the health care workforce. At that time, policy makers had limited information around transmission dynamics of the coronavirus. Now, with clear lessons from a year of professional life under the shadow of the pandemic, they will not have that excuse—but they do have an opportunity for course correction.
This is an opinion and analysis article.