Becker's Hospital Review

25 COO crucial to manage reimbursement. I believe more health systems will look to cooperate across a specific region to provide local care while leveraging volume to gain efficiency and provider collaboration." Whether these transitions are successful depends on how top leadership navigates change. NorthBay Health in San Francisco is in a transformational period. Earlier this year, the system signed a letter of intent to acquire Providence Queen of the Valley Medical Center in Napa, Calif., adding a third hospital. If successful, NorthBay aims to close the deal for the 198-bed hospital by the end of the year. "Healthcare is facing real pressures, but the future is also incredibly promising," said Mark Behl, president and CEO of NorthBay Health. "We are entering one of the most innovative periods in medicine, with advances in artificial intelligence, digital health and data transforming how we diagnose our patients. At the same time, we cannot ignore the rising costs that are placing a growing strain on Californians and disproportionately affecting underserved communities, particularly Lantino/x populations. Innovation alone is not enough if patients cannot access or afford the care they need." Mr. Behl is focused on adopting new technologies and rethinking care delivery. He sees a more proactive healthcare system designed to provide more equitable care in the future. "If we align innovation with affordability and access, this moment could represent one of the most meaningful transformations in healthcare in our lifetime," he said. n No more 'old school': How Duke Health is reimagining workforce development By Scott King D urham, N.C.-based Duke Health is taking a multipronged approach to tackling workforce shortages: investing in early education pipelines, raising minimum wages and leaning into technology to stretch its existing staff further. Mary Martin, COO of Duke University Hospital, said the problem runs deeper than supply and demand. The economics of healthcare education are driving people away from the field before they ever set foot in a hospital. "After COVID, a lot of people use that opportunity to retire. I was meeting with our dietitians yesterday, and they were talking about, it's a field that requires a master's degree, and yet the pay is extremely low," Ms. Martin said. "My own daughter is a social worker; she will at some point be required to have a master's as well. People can't afford to pay back their loans. People are thinking critically hard about going into some of these fields, understanding what the pay is." Scheduling flexibility is another factor quietly pushing clinical staff out of inpatient settings and into outpatient settings, where hours are more predictable. "The old- school method is you work [12-hour shifts three days a week] if you're a nurse," she said. "That doesn't work for everyone, especially if you may be a mom with small children. So then what happens is you lose that staff to outpatient; they're working 8 [a.m.] to 5 [p.m.]. They can get their kids off to school in the morning. "We have to be more creative about how we schedule staff to meet our needs so that we can keep up with a really high- demanding job." The around-the-clock nature of inpatient care adds another layer of complexity that outpatient settings simply do not face. "It's extremely hard on the inpatient side," Ms. Martin said. "We're a 24-by-seven entity, and what we must do as inpatient leaders is figure out how to staff our services on a 24-by-seven basis, but doing it in a flexible way that meets folks' needs." To build a more sustainable talent base, Duke is looking well before students' college years. Ms. Martin is particularly energized by programs that connect high school students directly to healthcare careers — including paths that do not require a four-year degree. "There are several programs that we're involved in within the [North Carolina Research Triangle] here of using high school students and accelerating them through associate's degrees while they're still in high school," she said. "A lot of our professions require certificates and not a degree and are pretty good paying jobs." Ms. Martin sees this pipeline movement gaining momentum at the state level, with health systems across North Carolina increasingly participating in some form of early workforce development. "More and more local communities, states, etc., are exploring these options," she said. "They're not so much in pockets anymore." On the technology front, Ms. Martin sees AI and assistive tools not as a replacement for clinical staff but as a means to protect their jobs, keeping them focused on the highest- value work they were trained to do. "How am I using AI and other assistive technology so I can keep those employees at the bedside doing top of license work?" Ms. Martin said. Duke recently backed up its workforce commitment with action, raising its minimum wage to $20 — a move Ms. Martin said she hopes will help the health system stand out in an increasingly competitive labor market. n

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