Becker's Hospital Review

34 CEO / STRATEGY Hospitals feel the brain drain By Molly Gamble H ospitals are feeling an enduring consequence of experienced employees' early retirements and resignations: collective knowledge loss. "Even when missing people can be replaced, missing knowledge cannot," Ed Yong wrote for e Atlantic May 18. Beyond hospitals' challenges in recruiting and retaining employees are the stubborn and sometimes subtle problems resulting from decreasing median tenure within their organizations. e ripple effects of losing older, seasoned employees to resignations or early retirements can be harder to quantify, but are nonetheless felt by colleagues who stay, newcomers to the organization, and patients and their families. Team tenure is a significant determinant to the cost and quality of hospital care. For example, a one-year increase in the average tenure of registered nurses on a hospital unit was associated with a 1.3 percent decrease in length of stay, a 2014 study from researchers at Columbia University School of Nursing and Columbia Business School found. "I don't think the public really understands how great the loss of this generational knowledge is," Kelley Cabrera, a nurse based in New York, told Mr. Yong. She described the six-week orientation for her current job, led by some people who had been in the ER for less than a year, as "shockingly short." "When inexperienced recruits are trained by inexperienced staff, the knowledge deficit deepens, and not just in terms of medical procedures," Mr. Yong wrote. "e system has also lost indispensable social savvy — how to question an inappropriate decision, or recognize when you're out of your depth — that acts as a safeguard against medical mistakes. And with established teams now ruptured by resignations, many healthcare workers no longer know — or trust — the people at their side." National data on average tenure in healthcare has not yet caught up to compare with pre-pandemic longevity numbers. e median years of tenure with current employers for healthcare practitioners and technical occupations was 4.7 years in 2020, according to the most recent data from the U.S. Bureau of Labor Statistics, ticking up to five years for workers in hospitals. e benefits of lengthy tenures are felt at the front lines as well as hospitals' most senior levels. Marc Boom, MD, CEO of Houston Methodist, told Becker's this year the cumulative tenure of the health system's executive team was a game changer throughout the pandemic. At the start of the pandemic, Dr. Boom had been CEO for more than eight years and at the institution for almost 22. e executive team of nine leaders, including him, collectively shared more than 150 years of tenure with Houston Methodist. e team had worked together without any changes for about seven years, when the most recent person joined. is longevity lends itself to major systemwide decisions almost feeling instinctive due to their familiarity working together. "I had a team that was very tenured," Dr. Boom said. "To work with people who you've known for a long period of time — you know the ins and outs, the strengths and weaknesses. You have almost an understood language. You can talk in five-word sentences, move on and everyone goes and does their thing. ere are a lot of advantages to that." n 25% of Americans felt threatening health officials was justified amid COVID-19 closures By Molly Gamble M ore adults in the U.S. came to see harassment and threats to public health officials as warranted because of COVID-19 business closures, according to a study published July 29 in JAMA Open Network. In a survey, 1,086 U.S. adults were asked how much they believed threatening or harassing public health officials for business closures to slow COVID-19 transmission was justified. The share who believed threats were appropriate increased from 20 percent to 25 percent from November 2020 to July and August 2021. The share who believed harassment was appropriate rose from 15 percent to 21 percent in that same timeframe. There were increases in negative views of hostility toward public health officials among "higher earners, political independents, those with more education, and those most trusting of science," the study found. Researchers said the findings show American's increasingly partisan attitudes toward public health officials and conflation of their role with that of politicians. "We found that most respondents believing that attacks on public health officials were justified in November 2020 also believed that attacks on politicians were justified. This finding aligns with the general politicization of the pandemic but could also reflect the conflation of public health officials and political leaders or the view that public health officials make inherently political decisions." n

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