If you are amongst the a lot of folks in current years who have had to wait six months or much more to get a doctor’s appointment with a rheumatologist, for instance, or an oncologist, you will be interested in what MyMichigan Overall health President and CEO Lydia Watson had to say about how the hospital is attempting to resolve that challenge.
In an expansive, hour-lengthy interview, Watson discussed staffing challenges that the Midland-headquartered wellness method shares with healthcare providers nationwide, amongst a lot of other subjects.
Watson answered inquiries from Everyday News Editor Dave Clark and Managing Editor Dan Chalk about subjects ranging from MyMichigan Healthcare Center Midland’s Magnet recognition for nursing excellence to MyMichigan’s efforts to replace retiring physicians to the death of former CEO Diane Postler-Slattery and her husband, Don, in a plane crash.
Following are some of the highlights of the interview.
In 2022, MyMichigan Healthcare Center Midland became the very first health-related center in the Wonderful Lakes Bay Region to accomplish Magnet recognition as a reflection of its nursing professionalism, teamwork and superiority in patient care.
The American Nurses Credentialing Center’s Magnet Recognition Plan distinguishes organizations across the globe that meet rigorous requirements for nursing excellence. There are presently 580 Magnet recognized hospitals worldwide and, of these, only 14 are in Michigan.
MyMichigan Overall health President and CEO Lydia Watson explained the significance of that achievement, what it will take to retain it and how the late Diane Postler-Slattery inspired hospital employees to operate to earn the designation.
Midland Everyday News: What is a Magnet hospital?
Dr. Watson: Magnet is a plan designated by organizations exactly where nursing leaders have effectively aligned their nursing strategic targets to boost the organization’s patient outcomes. So there’s a direct hyperlink involving a Magnet organization and patient outcomes. I’ll speak a tiny bit much more about what these are particularly and exactly where we have noticed big improvement by taking this journey.
Interestingly sufficient, it was Diane Postler-Slattery, who was a nurse herself and had knowledge coming from a Magnet organization in Wisconsin ahead of she came to us, who actually lit the fire below our nursing leadership to take into consideration becoming or applying for Magnet recognition. So the push for becoming magnet was inspired by her.
MDN: How does this make for improved outcomes for individuals?
DW: The plan begins as a road map on how to accomplish nursing excellence. There’s a concentrate on enhancing specific hospital metrics, so the ones that I can inform you that particularly have been enhanced in our organization and in most Magnet organizations are greater patient satisfaction, particularly with nurse communication at the bedside, getting acceptable discharge data (and that is ordinarily provided by our nursing employees), Magnet hospitals have reduced 30-day mortality prices general … so, a reduced threat of mortality in the very first 30 days immediately after you leave the hospital.
There have a tendency to be reduced infection prices in Magnet hospitals, greater job satisfaction amongst the nurses, reduced nurses leaving the organization, so decreased turnover of nurses in that organization.
What it requires is for nursing leadership to make a commitment and appear internally at their structure. So 1 of the factor that took spot in our organization is there actually wasn’t an organization of nursing leadership, chain of command, and techniques of disseminating data properly and regularly. What they did was to type nursing councils. Every single nursing council has a leader, and every of these councils oversees (a subject) of value. There’s a high-quality and security council, for instance. Councils are charged with overseeing specific locations and creating certain they have overall performance measures that they meet.
MDN: And it is all employee-driven?
DW: It is all employee-driven all nurse-driven. They are accumulating their personal information, they sit down and evaluation the information and see exactly where their possibilities exist, and then they come up with initiatives to make improvements and make factors improved. After you are designated Magnet – and there are only 14 hospitals in Michigan that are presently designated Magnet, 600 across the nation – you hold that recognition or that certification for 4 years. Then you have to reapply.
MDN: How has the Magnet designation impacted the morale of the nurses at this hospital?
DW: You know, I would say the day that they received the national designation – and I occurred to be attending in the area exactly where the recognition was provided – the excitement was palpable. The pride in that group of what was achieved was heart-warming and it was just an unbelievable knowledge. So they have been quite proud of themselves, as they really should have been.
You know, when we very first began the journey, there was a couple of naysayers. After they have been all on board – and that is for the reason that the leaders instilled in them the value – (this) was going to influence patient care and assist us to offer greater-high-quality, safer care. In the method it brought, I would say, a closer-knit group with each other for the reason that they have been sharing the journey with each other – improved communication, improved satisfaction, improved outcomes.
MDN: How have been they in a position to earn the Magnet certification for the duration of the pandemic? Mainly because that has to have been 1 of the most stressful instances to be in medicine, right?
DW: I actually think it is for the reason that they had a aim. They had leaders who have been regularly providing them the very same messages, complimenting them on their achievements, reminding every person of the why – why it is nonetheless vital to concentrate on performing these factors so that we give the finest care to our individuals and offer the higher-high-quality, superb care to our communities.
CLARK: Let’s speak about the doctor shortage. There appears to be 3 factors at play: There’s not as a lot of folks going into medicine. There’s the retirements that often take place as careers wrap up. And then there are “early retirements” – folks who are deciding on to leave the profession a great deal earlier than their predecessors.
WATSON: You are specifically proper. These are the buckets. This is not just us this is a national challenge. We are all seeing the very same trends and have the very same issues. I study a thing not also lengthy ago that mentioned that in 2022, there have been much more physicians that retired or left the practice than there have been health-related students that graduated. That is alarming. And so, yes, there is a shortage.
It is quite competitive proper now to attempt to recruit physicians. We are not suffering for the reason that of any retirements for the reason that we’ve either had succession arranging or as we knew folks have been retiring, we have been currently recruiting to fill these spots ahead of folks left. When necessary, we will use agency physicians, Locum Tenens, to fill gaps if there is a gap.
CLARK: I’m guessing that you saw this coming a couple of years out. What was the program to prepare for this?
WATSON: Properly, I believe we’ve often had a fantastic program. We have a method exactly where we, with normal cadence, about each and every two years, attempt to interview physicians that we know are later-profession and get a really feel for what their retirement plans are. And then we have, we contact it a recruiting map, of what we do we will need to recruit this year, what do we will need to recruit subsequent year, what do we will need to begin recruiting for some of these really hard-to-recruit even earlier than we ordinarily would for much more classic spots.
So there is a method exactly where we attempt to recognize what our wants are going to be, and get these positions authorized ahead of time so we can begin recruiting.
What is diverse these days than our standard, standard recruiting method is that we had early retirements partially for the reason that of the anxiety of COVID.
Physicians and nurses worked exceptionally really hard for the duration of these instances. If we necessary assist and you got known as, folks came in. But I believe a lot of that, we have been all operating on adrenaline to do what we necessary to do to take care of what we necessary to take care of. After factors began to let up, that is when we began to see some of our physicians say, “OK, I’m accomplished.” So in these distinct locations, we’ve had to do further recruiting.
We’ve had to get revolutionary in recruiting. We have partnerships with Michigan State University and Central Michigan University. We are a web-site exactly where their health-related students are on campus with us. We’ve accomplished some early recruiting of students and residents. We have two residency applications in our organization, each loved ones practice and 1 of our largest wants is often key care. So we will begin recruiting residents and hopefully sign them even in their very first or second year of residency if we know they are candidates that we want to retain.
CLARK: What are the largest locations of will need proper now at this hospital? Exactly where are your staffing numbers low?
WATSON: A couple of our largest wants proper now are rheumatology, endocrinology, and hematology/oncology. One particular of the rewards that we have is our partnership with the University of Michigan. Michigan Medicine owns a minority interest in us. Mainly because of that connection, they regularly can assist us if we are going by means of a gap, exactly where their physicians can come up and assist to fill that will need till we can recruit. Plus we can attempt to recruit from their residency applications.
When we known as to say we are in will need of rheumatologists, for the reason that it is taking us six months and longer to get individuals in, they told us that they themselves, Michigan Medicine, are brief 16 rheumatologists. So it is a national shortage. I would say, rheumatology, endocrinology, it is nationally.
Hematology/oncology, we take place to just have a provider who retired that we have been preparing for, along with a husband and wife doctor group that decided to leave the state and 1 of them was an oncologist. We have a greater will need for oncology (from our) individuals. So heavily recruiting. I believe that I heard final week that we are close to signing two.
CLARK: So when folks in Midland knowledge waiting for a doctor’s appointment – like I have a doctor’s appointment two weeks from now that I scheduled in July – this is the fallout of that national doctor’s shortage?
WATSON: Appropriate. That is component of it. And once again, we are heavily recruiting.
We know that access is often going to be a top rated-of-thoughts situation, and it is 1 of our focuses proper now.
We will need to get our individuals into practices much more speedily. And some of that is manpower-driven.
CLARK: What’s the answer? How do you resolve this challenge?
WATSON: Creating certain that we recognize provider burnout. Attempting to address that early sufficient so that we do not have folks that are leaving early-profession for the reason that they’re burnt out. That is No. 1.
We have some big efforts taking spot for provider burnout. The Strosacker Foundation just gave us a $300,000 grant and it is particularly for workforce burnout efforts. So not just providers, but for all workforce. That is quite thrilling.
No. two is to do some other factors for retention. We established a Provider Leadership Institute a couple of years ago immediately after we have been introduced to it in performing our burnout operate. There was some proof displaying that if you offered leadership possibilities inside your personal organization, as physicians go by means of their profession, if they know there are some other positions, particularly in leadership, that they will have access to, they are much more most likely to remain in your organization rather than jumping about.
We place with each other a Provider Leadership Institute – final year we graduated our very first cohort of ten providers. They received unique coaching in not only leadership, but factors like negotiation capabilities, conflict management, transform management, wellness care law, getting in a position to deal with some of these factors.
Currently we have noticed that many of them have currently taken on leadership positions or at least have applied for leadership roles. So we’re currently seeing that bear fruit. If we speak about how do we retain staff in common, it is to do factors that make us stand out as getting welcoming, wanting you to remain right here, and getting prepared to listen to your wants. Our HR division proper now is attempting to come up with much more versatile rewards. What can we do that will make our staff say, “Wow! Your advantage possibilities and your advantage package is a thing I am going to remain right here for, for the reason that it is distinctive and it is much more customized.”
CLARK: How a great deal does dollars play a function in these choices of exactly where physicians go? Mainly because there’s often going to be an additional method out there that is prepared to offer you a medical doctor much more dollars.
WATSON: Appropriate. That was 1 of the difficulties brought on by COVID.
What occurred with COVID is, when folks began to spend greater wages, a lot of, particularly of our nurses, and some of our providers left to take greater-paying jobs. The challenge is that the amounts of dollars that have been getting paid are not sustainable for any one. So if you hear that healthcare organizations are concerned about their finances and sustainability proper now, it is all for the reason that of that.
We designed a monster when that occurred. Now we’re attempting to reel it back.
We’re attempting to restabilize the workforce, pull back some of the premium spend that we had made use of and alternatively, rather than just paying folks much more dollars, much more dollars, much more dollars, we’re performing much more retention bonuses and saying, “OK, you left our organization to take an agency job. We want you back. You can come back and nonetheless be at the very same seniority level that you have been, the very same rewards that you have been when you left. We’ll even give you a retention bonus, but you have got to remain two years to get it.”
Dollars is vital, but dollars is not as vital these days as it was for the duration of these days when (hospitals) have been prepared to give (physicians) unbelievable wages.
CLARK: How is the hospital performing financially?
WATSON: We are performing OK. We are not performing as properly as we would like to be. We are focusing on our workforce shortages and attempting to eradicate premium spend, agency operate, for the reason that that is a enormous price – millions of dollars a month. We also have some margin enhancement initiatives that are taking spot and we’re focusing on enhancing access, for the reason that if we can get individuals in, then we can offer the solutions that also assist us to create the dollars.
We are not in a poor scenario. We’re not panicking.
We’re not exactly where we would like to be, but we are focused on having back on track.
CLARK: Is that monetary situation due to the medical doctor shortage or is that also some of the remnants of COVID care charges?
WATSON: I would say that the two largest factors are nonetheless paying agency and premium spend and the other factor that we are searching at is length of remain.
Our individuals are admitted to the hospital, and primarily based on the way that payers or insurance coverage corporations or Medicare and Medicaid spend you, you get a specific quantity of dollars for a diagnosis, no matter if the patient is right here for two days or 32 days. As you can envision, if you are right here for much more than the anticipated length of remain for the typical patient with that diagnosis, we are spending much more dollars to continue to take care of these individuals with no having reimbursed for it. Our (patient) length of remain is greater than it ever has been in the previous.
Once more, it is a mixture of elements. One particular, there are sicker individuals with much more complicated difficulties. The other factor is it is been quite tough when individuals are prepared to be discharged and will need to go to lengthy-term care facilities. We’ve had individuals right here for a couple of months waiting for a lengthy-term care bed. The very same goes for behavioral wellness.
That mixture of factors is costing us much more with significantly less reimbursement and that is placing us out of balance.
CLARK: It appears like we are just scratching the surface exploring the benefits of telemedicine. Is that a thing that could assist address staffing concerns?
WATSON: Yes. And definitely that is 1 of the factors we’re searching at as we’re attempting to boost access. Our aim is actually to make care practical, timely, and so we’ve got to get improved at performing some technological factors also. I can sign myself up to get a massage or a haircut or a table in a restaurant just by employing an app on my telephone. We really should be in a position to enable our individuals to do self-scheduling. We are functioning on it proper now to be in a position to achieve that.
We are focusing on access and I believe that if we can generate access, anything else is going to fall into spot.
CLARK: Do physicians like telemedicine?
WATSON: Yes, they do now. When we very first went into COVID, we have been piloting our very first telemedicine plan. We struggled to get physicians that would volunteer to be the very first folks to pilot it. We had only accomplished, I do not know, 50 visits in six to nine months. Now, we’ve accomplished much more than ten,000. Primarily, each and every discipline is now employing it.
That was 1 factor that COVID really helped us to be thriving in.
CHALK: It appears like Michigan’s Correct To Perform law is going to be repealed. Do you count on to see any impact right here?
WATSON: I would say in Midland I am not also concerned about it. All through our organization we do have some unions, so we’re waiting to see. We just renegotiated union contracts with nurses in Alma and Alpena.
CHALK: As we wrap up, we want to go back to March 2022. It is been 1 year due to the fact the death of (former MyMichigan Overall health CEO) Diane Postler-Slattery and her husband, Don. How did losing Diane impact you personally?
WATSON: At the time I was the Chief Healthcare Officer, so Diane was my boss. But I had, as properly as my husband, created a friendship with Diane and her husband Don. (Their deaths came as) a full shock. I can keep in mind when we have been notified, Greg Rogers and I have been in a meeting with each other. Our administrative assistant just came flying in by means of the door and gave us the news. Greg and I just looked at every other and mentioned, “She can not be proper. No way. This didn’t take place.”
We had to strategize speedily how to get the data out and in what order, for the reason that we didn’t want the neighborhood to know ahead of the board knew, ahead of our staff knew. So we got Millie (Jezior) and the rest of the PR group with each other and came up with a program, and inside a couple of hours we had to notify every person.
(It was) just profound shock I believe to the point exactly where the shock was so intense that it kicked our adrenaline in. We have been in a position to believe by means of, all proper, this is a crisis, we know how to deal with crises. What do we will need to do? That period most likely took spot more than 4 or 5 days. Soon after that is actually when the grief set in.
(We have been) figuring out how to console every other and other employees members: Be out there, be transparent, be open, be visible. All of these factors have been super vital.
I believe that 1 of the factors that we all agreed upon early on is that 1 of the finest techniques that we could assist our employees and staff get by means of that grieving phase was to honor some of the factors that we have been inspired by, that came from Diane. And so I just produced a tiny list of some of the factors that we did, that we continued to concentrate on and honor.
1st of all, (Diane) focused on folks and relationships, and so we continued to do that internally. She balanced operate and striving for excellence and was adamant about pushing and meeting targets and not slacking off, for the reason that it was all for the proper factor. It was all for the fantastic of our neighborhood and the wellness of our individuals and our employees. We nonetheless strove for excellence. We didn’t let the foot off the gas pedal with the initiatives we had in spot, factors like Magnet (certification).
We continued to concentrate on creating certain that we balanced operate with enjoyable. That was quite vital to (Diane). Something that was in spot, we attempted to retain factors as standard as achievable as far as schedules go and what our expectations have been, and that seemed to assist. Lots of of us went to their funeral in Wisconsin. I believe that helped these of us who felt actually close to her to have some closure. Then the service and tribute that we gave to her back in Midland, also properly attended. The staff have been in a position to express how they felt.
Her loss designed a lot of transform. Instantly Greg Rogers stepped in. He had been the chief operating officer. He stepped in as CEO till we figured out what the program was going to be. She and Don passed away in March – Greg was arranging on retiring in April. We very first replaced his position, so Brian Cross became the Chief Operating Officer. That left a vacancy in Midland, so Chuck Sherwin became the president there. I ended up getting vetted by the board and interviewed for the CEO position and was named subsequent CEO so that Greg – (who had been) attempting to retire for 3 or 4 years – ultimately was in a position to retire effectively.
When I took that position, it left a vacancy for Chief Healthcare Officer, which Dr. Paul Berg filled. And that left his president of the doctor enterprise position open, and we just inside the final two weeks filled that spot with Dr. Dave Jordahl.
So that entire method took from June till March, to get the succession of leaders reorganized and in spot. The fantastic news is that none of these folks have been new. I believe that helped our employees. If we would have brought a lot of external folks into new positions, that could have had big damaging repercussions. So even even though a lot of of us are in diverse positions, at least we’re identified. And the majority of our staff are quite comfy for the reason that of that.
We’re focusing on culture to make certain we sustain the culture that Diane helped to initiate. It is a culture of excellence, a culture of teamwork, getting patient-centered, and of not providing up. We’re challenging, we’re resilient.
We, for years now, have been performing a thing known as “Three Very good Points.” We promoted that a lot for the duration of this transition period. Any time we spoke to our staff or did videos, we would finish with 3 Very good Points. Just before you go to bed, you recall 3 fantastic factors that occurred to you or for you for the duration of the day – individual, at operate, what ever. If you create them down, there are really scientific research that show that performing that for a period of two weeks increases sleep, decreases anxiousness, and is as fantastic as Prozac. I personally just do it each and every day.
CHALK: I get the feeling that factors could have gone a lot differently. It was a pivotal moment final March exactly where you had just had a profound loss. If the proper folks hadn’t been in a position to take the proper positions, it would have stopped a lot of momentum, a lot of progress that had been produced up till she died.
WATSON: That is a wonderful summary. Diane spent a lot of time deciding on the group that she constructed. Mainly because of that, we have been in a position to step in and do what we necessary to do with comfort and, in her honor, to make certain that we didn’t drop any of the progress we had produced even though she was right here.
CHALK: One particular year later, how would you describe the hospital these days? How are you performing?
WATSON: I would say we are performing properly.
We are led by wonderful leaders who embrace the culture that she helped to initiate, and we are carrying on.
We are focused on supplying superb care to our communities and taking care of every other.