Healthcare CEOs explain how to respond to the biggest challenges in the industry

Health care providers have been at the centre of the global battle against the COVID-19 pandemic. Especially frontline workers have put their own health and wellbeing at risk to care for patients and safe lives. While hospitals were initially struggling with insufficient protective equipment and a lack of information, the focus has increasingly turned towards staff shortages and mental health challenges.

Even before the pandemic, the global shortage in health care workers was troubling. The World Health Organisation (WHO) predicted the shortage to more than double from 7 million in 2016 to 18 million by 2030. The pandemic has only exacerbated the challenge.

In addition, key studies have revealed significant mental health challenges amongst health care workers. On World Health Day 2022, the WHO is putting global attention towards urgent actions needed to keep humans and the planet healthy. These shall foster a movement to create societies focused on wellbeing.

We have asked 6 health care executives to reflect on their biggest challenges and what solutions they are envisioning.

Dr Rod Hochman, President and Chief Executive Officer, Providence.

"There are numerous forces driving health care and all sectors of society to respond and transform like never before, and the impacts are exacerbated by the pandemic. These pressures should be considered as we respond to profound health care workforce shortages and develop robust support systems for our caregivers.

Entering the third year of a world-changing health disaster, health systems have been rapidly adapting to both meet the needs of patients and care for their caregivers. We are using telemonitoring to allow patients heal at home and keep our caregivers safe, and are developing other telehealth models. Collaborations are creating and integrating AI and digital solutions to support providers, along with vital research to find potential new treatment paths for COVID-19.

Following the stress and burnout frontline health care workers have experienced during the past two years, many of us have declared 2022 the year of the caregiver. Healing and rebuilding our workforce are paramount and we’re investing to make that happen. New workforce-centered mental health programs create safe spaces, and we offer free counseling for caregivers and their families plus a range of other supportive services. Human resource strategies include inspiring and developing our people through recognition, referral and recruitment bonuses, fair and equitable pay, predictive hiring and scheduling, and tuition reimbursement. We are recruiting in new ways, and I believe nonprofit health care offers deep meaning that attracts and keeps clinicians and other workers.

Technology advances will take us a long way, but health care is about human connection. It’s the people in our sector who inspire me to be optimistic about its future."

Shobana Kamineni, Executive Vice-Chairperson, Apollo Hospitals Enterprise Limited.

"The coronavirus pandemic raised some daunting questions within the health care workforce. Issues were exacerbated exponentially during the pandemic. Two of them especially proved challenging:

1. Globally, a shortfall of 18 million workers has been predicted by 2030.

2. With growing demand for new skills – especially digital - there is an urgent requirement to reskill and upscale. Currently, there is a huge demand supply gap in people – especially those with the skillsets required for the adoption of digital health care platforms. A strong solution to bridge both challenges is the adoption of telehealth. Telehealth tools have helped bridge the workforce demand-supply gap and catered not only to COVID-19, but other non-Communicable diseases (NCDs) as well. Teleconsultations at Apollo Hospitals new age omnichannel platform 24/7 have grown over 4.5 times; from 0.3 million to 1.3 million, year on year.

The pandemic has given window to leapfrog in the delivery of technology-driven health care, as machine learning (ML) and artificial intelligence (AI) are transforming the health care landscape as never before. With surge in demand for telehealth, home health care and remote diagnostic professionals, we have to reboot the skills required for delivering health care on new and altered platforms. This also allows systems to manage treatment better despite limited workforce.

For implementation of public health measures leveraging data and predictive analytics for disease surveillance, immunisation, vector control, and R&D, we need a strong skills ecosystem based technologies such as AI, ML, molecular biology, and satellite-based landscape epidemiology. Integrated ground action by all stakeholders such as governments, public and private sectors must create a global rapid action health care workforce that can play a pivotal role in fighting future pandemics, especially in less resilient regions."

Dr Marc Harrison, President and Chief Executive Officer, Intermountain Healthcare.

"It’s no secret. Caregivers across the world are burned out – driven largely by the pandemic over the last two years. What do we do about it? Listen and learn from them, be humble as leaders, find ways to support them, invest in them, and have fun again. And finally, implement a better model of care that reminds people why they chose this profession to begin with.

Let’s start here. Through our continuous improvement process, we’ve implemented over 50,000 caregiver ideas—ideas that make us stronger, better, and more efficient as an organization. We have made changes to our benefits or added new ones because of caregivers feedback, like increasing fertility coverage and adding chiropractic care. At the height of the Omicron surge in Utah, caregivers on the frontlines told us they would work more and cover shifts, instead of using traveler nurses. To that end, we established competitive incentive structures. They’ve also shared that they want opportunities to invest in their careers. We listened. We have invested heavily in caregiver development, including an education program in partnership with InStride—called PEAK—that offers caregivers or one of their immediate family members an opportunity to pursue new degrees for $5,000 a year. Over 10,000 caregivers have enrolled in the program.

I think it’s also important to be humble and embrace a do-over as a leader. I banned non-diet sodas when I first came on as president and CEO of Intermountain Healthcare. In what may seem like a small decision, it proved to be an important one. The decision was unpopular, and caregivers and patients alike clamored to bring back soda to our facilities. I listened. And I reversed course. Moreover, I shared with them why I did with honest and transparent humility as a leader.

These are just a small handful of approaches that can better engage our teams – some seemingly trivial and others far more critical operationally. But they all have one important common thread. As leaders, we must listen and be responsive to caregivers’ ideas and needs."

Jeff Huber, Chief Executive Officer, Home Instead; President, Honor Technology, Inc.

"In order to improve the aging experience around the world we need to elevate the caregiving profession. The vast majority of older adults prefer to age at home, but many don’t have this choice. A key driver of lack of choice is the global shortage of trained, care professionals who can provide the high quality home care our older citizens need.

How big is the caregiving gap? Germany already faces a shortfall of 120,000 care workers. Singapore must grow its care professional workforce by 130 percent over the next decade to meet demand. And the challenge will continue to grow more urgent as the world’s population rapidly ages. The number of people aged 65 and older will more than double from about 700 million today to 1.5 billion by 2050.

As we age, we often need help with tasks of daily living – from bathing and dressing to shopping and preparing meals – in order to remain at home. Many of us will require assistance managing chronic conditions like diabetes, cardiovascular disease or chronic respiratory disease along with other serious diseases such as Alzheimer’s and other forms of dementia. These diseases alone are projected to impact 82 million people by 2030 and 152 million by 2050. Care professionals provide support with wellness, disease management, prevention, and activities of daily living. They also reduce social isolation, which is critical to a healthy, empowered aging experience.

The growing shortage of home care professionals can’t be remedied by simply recruiting more people. It requires elevating caregiving as a rewarding career, reframing public understanding of the profession and the value it delivers, and fully integrating home care into the health care ecosystem. To jumpstart this process, Home Instead, a world leader in homecare for older adults, and the Global Coalition on Aging recently released the report, “Building the Caregiving Workforce Our Aging World Needs,” as a catalyst to elevate the caregiving profession worldwide.

Building a robust, thriving workforce of professional caregivers is vital not just to better protect older adults from health threats, but to also meet the needs of our rapidly aging global society. Such a workforce can satisfy the demands and desires of older people to age at home; provide peace of mind to family members and friends who want high quality care for their loved ones; and ensure a dynamic continuum of care for individuals everywhere."

Robert C. Garrett, Chief Executive Officer, Hackensack Meridian Health.

"There's no question that after two years of battling COVID-19, numerous fault lines emerged in American health care: inadequate primary care; not enough focus on prevention and maintaining health; unequal access to care; and limited options for mental health and addiction treatment. To effectively tackle these challenges, health care providers must move beyond traditional health care to address issues that greatly impact health in our communities, including housing and food insecurity, transportation issues, mental health, substance abuse and other social issues.

The COVID-19 pandemic has underscored the need to improve access to high quality, affordable health care. There's no path to improve health care without significant investment in social determinants of health strategies. Health care must move from acute episodic care to a more holistic and equitable approach to health and better care management. The pandemic was especially cruel to Americans with diabetes, obesity, and other chronic and costly illnesses. It disproportionately impacted communities of color much more dramatically than white communities.

The COVID-19 crisis has also helped us understand that providing behavioral health care to communities is a top priority. We need to urgently provide more access, more coordinated care, and innovate treatment. The pandemic has taken a toll on the nation’s mental health, with 3 in 10 adults in the U.S. reporting symptoms consistent with depression or anxiety disorder since April 2020, according to the Kaiser Foundation. The demand for pediatric behavioral health visits increased by 90 percent throughout our health network in the last two years.

Even before the pandemic, it was clear that behavioral health care in this nation is at a crisis point. More than 47,000 Americans took their lives in 2019, a national record, according to the CDC. Suicide rates increased 33 percent from 1999 to 2019. And for children, the stats are even more staggering.

And let’s not forget those at the heart of our communities – our health care team – who have selflessly served our patients and communities during the darkest days of the pandemic. Our nation’s health care workforce has been through so much in the last two years — repeated surges, the deaths of nearly one-million Americans — and for many this has resulted in post-traumatic stress. They, too, have been affected personally by COVID-19, and the virus has stretched the workforce thin.

It’s no surprise that about 1 in 5 U.S. health care workers have left the job since the pandemic started. We need to invest in our workforce, promote a positive culture to prevent burnout and ensure the wellbeing of our providers, because the truth is, we cannot improve health care without the talent and workforce to deliver that compassionate care each and every day."

Bruce A. Meyer, President, Jefferson Health.

"To recover from the pandemic, we must recognize the moral damage done to our culture and our workforce. For health professionals, the pandemic has entailed two years of what is called 'moral injury.' The trauma of being unable to prevent unnecessary deaths along with the extraordinary working conditions, has led to feeling ‘broken’ because of working on the frontlines of COVID-19.

There is a 'moral injury' to our society as well. Even as medical science performed miracles, we saw disproportionate deaths among communities of color and the poor. The loss of jobs and businesses and the delayed learning suffered by our children will leave scars as we grieve for those who died alone.

I offer these lessons for rebuilding our social culture:

1. We must recognize what our health professionals have endured. For many, the most recent spike of cases of the Omicron variant was a breaking point – working to save the lives of people who had rejected the vaccines. At Jefferson, we prioritize wellness and self-care, offering a four-tier pyramid of emotional support, ranging from self-help resources to unit-based and peer support, to group therapy, and scaling up to professional counseling.

2. We cannot fix this alone. We need coalitions to tackle the biggest issues of moral injury in our society. For example, early in 2020 Jefferson Health partnered with Aramark to develop protocols for safety at all workplaces. We saw environmental service workers shift from fear to security as these procedures proved their efficacy. The World Economic Forum is an ideal place to continue to build those partnerships.

3. We must reinvent care delivery and helping people age. Nursing homes emptied as their residents caught COVID-19 and died, while brick-and-mortar hospitals neared capacity during patient surges. That’s why at Jefferson Health, we’re expanding our in-home health services because we know it will reduce the costs of care and improve patient and family experience.

4. We must put people first in everything we do. At Jefferson we spent the money to ensure personal protective equipment and staffing to allow loved ones to be present at the beginning and end of life as we fought to support them in those critical moments.

5. Finally, as I have repeatedly told our employees, in dealing with the crisis and while we recover from it, we must all offer ourselves, and each other, an extra measure of grace."