Becker's Spine Review

28 28 HEALTHCARE NEWS 5 trillion-dollar questions hanging over hospitals By Molly Gamble B ig questions tend to have no easy answers. Fortunately, few people would say they went into healthcare for its ease. e following questions about hospitals' culture, leadership, survival and opportunity come with a trillion-dollar price tag given the importance of hospitals and health systems in the $4.3 trillion U.S. healthcare industry. 1. How will leaders insist on quality first in a world where it's increasingly harder to keep trains on time? Hospitals and health systems have had no shortage of operational challenges since the COVID-19 pandemic began. ese organizations at any given time have been or still are short professionals, personal protective equipment, beds, cribs, blood, helium, contrast dye, infant formula, IV tubing, amoxicillin and more than 100 other drugs. Aer years of working in these conditions, it is understandable why healthcare professionals may think with a scarcity mindset. is is something strong leaders recognize and will work to shake in 2023, given the known- knowns about the psychology of scarcity. When people feel they lack something, they lose cognitive abilities elsewhere and tend to overvalue immediate benefits at the expense of future ones. Should supply problems persist for two to three more years, hospitals and health systems may near a dangerous intersection where scarcity mindset becomes scarcity culture, hurting patient safety and experience, care quality and outcomes, and employee morale and well-being as a result. e year ahead will be a great test and an opportunity for leaders to unapologetically prioritize quality within every meeting, rounding session, budgetary decision, huddle and town hall, and then follow through with actions aligned with quality-first thinking and commentary. Working toward a long-term vision and upholding excellence in the quality of healthcare delivery can be difficult when short-term solutions are available. But leaders who prioritize quality throughout 2023 will shape and improve culture. 2. Who or what will bring medicine past the scope-of-practice fights and turf wars that have persisted for decades? It is naive to think these tensions will dissolve completely, but it would be encouraging if in 2023 the industry could begin moving past the all- too-familiar stalemates and fears of "scope creep," in which physicians oppose expanded scope of practice for non-physician medical professionals. Many professions have political squabbles and sticking points that are less palpable to outsiders. Scope-of-practice discord may fall in that category — unless you are in medicine or close to people in the field, it can easily go undetected. But just as it is naive to think physicians and advanced practice providers will reach immediate harmony, so too is it naive to think that aware Americans who watch nightly news segments about healthcare's labor crisis and face an average wait of 26 days for a medical appointment will have much sympathy for physicians' staunch resistance to change. e U.S. could see an estimated shortage of between 37,800 and 124,000 physicians by 2034, according to the Association of American Medical Colleges. Ideally, 2023 is the year in which stakeholders begin to move past the usual tactics, arguments and protectionist thinking and move toward pragmaticism about physician-led care teams that empower advanced practice providers to care for patients to the extent of the education and training they have. e leaders or organizations who move the needle on this stand to make a name for themselves and earn a chapter or two in the story of American healthcare. 3. Which employers will win and which will lose in lowering the cost of healthcare? Employers have long been incentivized to do two things: keep their workers healthy and spend less money doing it. News of companies' healthcare ventures can be seen 'Operation Nightingale': Feds charge 25 in sweeping nurse diploma scheme By Mackenzie Bean T wenty-five people have been charged for their alleged participation in a coordinated scheme to sell aspiring nurses thousands of fake nursing degree documents, the Justice Department said Jan. 25. The scheme involved selling more than 7,600 fraudulent diplomas and transcripts from three now shuttered nursing schools in Florida to aspiring nurses who had not actually completed the necessary coursework to graduate or sit for the National Council Licensure Examination. Aspiring nurses would allegedly pay $10,000 or more for the fake diplomas, which fast-tracked the process for them to take the NCLEX test. Applicants who passed the test and gained licensure then allegedly used the fake documents to secure employment "with unwitting healthcare providers throughout the country," officials said. "This is probably one of the most brazen schemes that I've seen. And it does shock the mind," Omar Perez Aybar, special agent in charge with HHS' Office of Inspector General, told ABC News. The inspector general's office, FBI and Justice Department launched "Operation Nightingale" — named after Florence Nightingale, the founder of modern nursing — to take down the scheme after a Florida state audit identified poor NCLEX passing rates at the three nursing schools. In total, 25 people face criminal wire fraud and wire fraud conspiracy charges in five states: Florida, New York, New Jersey, Texas and Delaware. If convicted, the defendants face up to 20 years in jail. Mr. Aybar said additional action may be taken against nursing applicants who allegedly purchased the fake diplomas. n

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