The MHA received media coverage the week of May 15 regarding a shortage of two critical chemotherapy medications, hospital nurse staffing legislation and the well-being of hospital workers. A press release was published May 17 by the MHA regarding the shortage of cisplatin and carboplatin and the strategies hospitals and health systems are implementing to continue chemotherapy treatments for patients.
MHA representatives appearing in published stories include CEO Brian Peters and Executive Vice President Laura Appel. MONL President Kim Meeker, RN, BSN, MBA, also appears in a story on the nurse staffing legislation, while MHA Keystone Center WELL-B partner Bryan Sexton, PhD, from the Duke Center for Healthcare Safety and Quality, appears in a story about how hospitals assist healthcare workers with feelings of grief and loss.
Below is a collection of headlines from around the state.
The following joint statement can be attributed to Brian Peters, CEO of the Michigan Health & Hospital Association, and Kim Meeker, RN, BSN, MBA, president of the Michigan Organization for Nursing Leadership (MONL).
A package of bills announced today in the Michigan Legislature has the potential to severely harm hospitals and access to important services for patients, if ultimately passed. Proponents of the legislation falsely claim this will address nursing shortages in Michigan, but those claims couldn’t be further from the truth. Michigan hospitals are trying to fill 8,500 job openings for nurses. Instituting a one-size-fits-all mandate requiring hospitals hire more nurses who do not currently exist will limit the services hospitals can offer to their communities, prolong the time it takes for a patient to receive care and hinder the ability of hospitals to respond to a crisis in fear of violating Michigan law.
Tangible, proven steps are needed to attract more nurses to Michigan. Those include passing legislation that allows Michigan to join the Nurse Licensure Compact, expanding Michigan Reconnect eligibility and increasing penalties for those who commit acts of violence against healthcare workers.
Michigan hospitals and health systems have been hard at work addressing nursing shortages over recent years. Those efforts include:
Obtaining a total of $300 million in state funding that has benefitted at least 69,000 healthcare workers for the purposes of the recruitment, retention and training through Public Act 9 of 2022 and Public Act 5 of 2023.
Securing additional nurse training opportunities including expanded state policy allowing four-year BSN programs at community colleges.
Expanding Michigan Reconnect to allow funds to support Michiganders moving from a licensed practice nurse (LPN) to a registered nurse, or from a patient care technician certificate to a LPN.
Modernizing the scope of practice for certified registered nurse anesthetists which allows flexibility for each hospital to choose the anesthesia care model that best fits its location, staffing and resources under Public Act 53 of 2021.
Providing emotional well-being support to healthcare workers through a partnership with the Duke Center for Healthcare Safety and Quality that has so far assisted 5,000 healthcare workers from 144 organizations throughout Michigan.
Nursing careers not only provide stable, well compensated jobs with a set of transferrable skills that rarely become obsolete, but in a rewarding environment that truly make a difference in the lives of the patients they serve. The MHA and our member hospitals and health systems, together with MONL, remain committed to focusing on effective solutions that support Michigan nurses and ensure safe patient care.
“Individual commitment to a group effort – that is what makes a team work, a company work, a society work, a civilization work.”— Vince Lombardi
Talent acquisition is always top of mind for all business leaders. Demand for workers now outpaces supply throughout the U.S., but particularly here in Michigan due to our demographic realities, including an aging baby-boom generation entering retirement in significant numbers. A recent presentation by Michigan Senate Fiscal Agency Chief Economist David Zin summarizes these challenges, as Michigan has the eleventh highest median age in the country, a metric which has been increasing rapidly in recent years.
This challenge is clearly felt by Michigan hospitals and health systems, as many retirement decisions made by healthcare workers accelerated during and because of the pandemic. The use of contract agencies for nurses exploded while hospitals also reduced the number of staffed beds in their facilities due to worker shortages. The financial repercussions of these shortages had Michigan hospitals spending more than $1 billion more on contract labor and recruitment and retention expenses in 2022 than in 2020, according to a MHA workforce report.
Although current staffing levels have stabilized somewhat in the state, the demand remains high. According to a March 2023 survey of 95% of the MHA membership, there were over 27,000 job openings in Michigan hospitals, including nearly 8,500 open nursing positions.
While the number of open positions may be surprising, healthcare is historically the largest private-sector employer in Michigan. The next iteration of the Economic Impact of Healthcare in Michigan report publishes May 2, which demonstrates the massive role healthcare plays in the state. Michigan healthcare organizations provided nearly 568,000 direct healthcare jobs in fiscal year 2021, with Michigan hospitals providing roughly 219,000 – or nearly 40% – of those jobs. Once wages, salaries and benefits and tax revenue are factored in, healthcare contributes nearly $100 billion to the state’s economy each year.
The value that our hospitals provide to the health and wellness of a community is obvious and is reason enough to warrant our strong support. But in addition, the magnitude to which our Michigan economy depends on healthcare can easily be overlooked. Hospitals are often the largest employer in their respective communities and serve as critical lynchpins of economic vibrancy. This is why it is so important for hospitals to engage with business and policy leaders to ensure alignment across the state in our efforts to attract and retain talent.
Healthcare careers are not only stable and well compensated, but also provide a set of transferrable skills which rarely become obsolete. We recognize that healthcare careers, particularly clinical positions, can be stressful and emotionally draining. We can’t sugarcoat the challenges associated with caring for all types of patients in organizations that operate 24/7/365.
But the MHA is here to help. In an effort to support the emotional well-being of healthcare workers, in 2021 the MHA Keystone Center launched a partnership with the Duke Center for Healthcare Safety and Quality team led by Bryan Sexton, PhD. More than 5,000 clinical and non-clinical staff from 144 organizations joined in the first 10-week Well-being Essentials for Learning Life-Balance cohort, and our work here is ongoing. We are also advocating for policy change at the state and federal level that would increase the penalties for those who commit acts of violence against our caregivers.
Through our successful advocacy work, the Michigan Legislature appropriated $75 million in funding for the recruitment, retention and training of hospital workers in Public Act 5 of 2023. This funding supplements an earlier $225 million appropriation made in Public Act 9 of 2022 and has played a large part in minimizing further losses to the healthcare workforce. The MHA was named as the fiduciary for both of these funding pools – evidence of the strong bipartisan trust in our association.
Allowing clinicians to work at the top of their license and removing administrative work is another tactic that can help attract healthcare talent. Enacting policy change that reduces rates of healthcare worker violence and expands access to behavioral health treatment are others. The work of the MHA and our members is to make sure healthcare workers have all the tools available to do their work improving and saving lives without unnecessary mandates and other interference that contributes to the challenges healthcare professionals experience.
These workforce challenges and the need for more workers also illustrates the need for local control for hospitals to determine staffing models that best represent the needs of their patients and communities. A one-size-fits-all approach doesn’t work when comparing a rural critical access hospital to an urban Level I trauma center. Successful staffing models incorporate input and feedback from nursing teams and the unique needs of the local community.
There are also a variety of other approaches the MHA and our partners at the American Hospital Association are advocating for to attract healthcare talent. This ranges from increased investment in nursing schools, nurse faculty salaries and hospital training time; enacting protections for healthcare workers against violence and intimidation; supporting apprenticeship programs for nursing assistants; and supporting expedition of visas for foreign-trained nurses.
There is no silver bullet that will fix workforce shortages. The current issue facing hospitals, as well as many other industries, is the reality that the available supply of workers simply doesn’t meet the demand. Michigan continues to be aggressive in efforts to attract businesses to the state. We must recognize our state is in competition with others for a finite amount of available healthcare workers.
Yet things can be done to grow the pie and attract more students into the healthcare talent pipeline. For example, the MHA will be focused this summer on raising awareness about the variety of jobs and career pathways that exist within health systems, and encouraging future and existing workers to consider a career in healthcare where they can truly change lives, whether they’re at the bedside or behind a computer screen.
Healthcare is the ultimate team sport, with the utmost objective – saving lives, and preserving the health and welfare of people. I hope you will join us in this endeavor and invite as many people as you can to the party.
The MHA Keystone Center recently released its 2021-2022 Annual Report, which showcases the center’s commitment to working alongside members to improve safety and quality in healthcare. Through support from Blue Cross Blue Shield of Michigan, this report highlights the profound impact collaboration and partnership amongst the Michigan healthcare community can have on Michigan’s communities.
Report highlights include:
An introduction to the MHA Keystone Center’s Health Equity Task Force, which was assembled to provide guidance to members in their efforts to redesign and implement interventions that address disparities in care.
An overview of the well-being program (WELL-B) launched in partnership with Duke Center for Healthcare Safety and Quality to address workplace burnout in healthcare.
A birds-eye view of the collaboration taking place to address increasing opioid use disorder cases.
“Every child begins the world again.” ― Henry David Thoreau
In all of my life experiences to date, none have been so challenging in every sense as those times when my young children were hospitalized in the NICU, fighting for their very lives. We were incredibly fortunate to have positive outcomes with both of them, thanks to the efforts of our Michigan hospitals and the incredible people who work there every day.
I share this perspective because there is a crisis throughout Michigan that truly hits home with me. I know the angst and exhaustion being felt by far too many parents right now – emotions that are also being acutely felt by our heroic caregivers. In short, it feels like déjà vu in Michigan’s children’s hospitals, but instead of a surge of COVID-19 patients stressing capacity to the limits, our facilities are strained by a high number of pediatric patients suffering from respiratory illnesses largely driven by RSV. Similar tactics that have been implemented in prior years, such as initiating incident command systems, have been in operation to ensure appropriate direction and communication is occurring throughout those systems impacted by this crisis.
Hospitals operating at capacity is nothing new and the staffing challenges that continue to result in Michigan operating with 1,700 fewer staffed beds than we had prior to the pandemic are well documented. What we’re seeing today is the real impact of what those staffing challenges mean: longer wait times in the emergency department, lack of available beds for patient transports (particularly in rural Michigan) and pediatric ICUs operating at beyond 100% capacity.
There are few professionals in the world that have proven to be more resilient than healthcare workers, whether they are physicians, nurses, respiratory therapists, environmental service workers…the list goes on and on (and I am proud to say that the MHA Keystone Center has played an important role with the launch of our WELL-B initiative that continues to provide resiliency tools for our clinicians and other team members). But as residents of our communities, we can no longer take our healthcare workers and the access to care they provide for granted. These workers, and their organizations, need help.
Thankfully, the Michigan Legislature provided funding earlier this year through Public Act 9 to improve the recruitment, retention and training of healthcare workers. So far, over 69,000 healthcare workers have benefitted from that funding and it has helped to stabilize existing staffing levels. Hospitals are also exploring innovative ways to grow the talent pipeline, such as investment in higher education partnerships and other apprenticeships. However, while impactful, this funding is a finger in the dyke. Without additional attention, the problem will persist.
Addressing the strain on our children’s hospitals is a multi-pronged approach, and in addition to the aforementioned work of our MHA Keystone Center, we are also deriving input and guidance from our MHA Council on Children’s Health, led by Laura Appel, executive vice president for government relations and public affairs, as well as our system chief medical officer (CMO) group, led by our own CMO Gary Roth, DO.
While the MHA will continue to pursue legislative and regulatory solutions to the staffing crisis, there are actions anyone can undertake to help our healthcare workers caring for very sick children across Michigan, particularly as COVID-19, RSV and the flu converge to drive hospitalizations.
First and foremost, ensure that both you and your children are up to date on all the relevant vaccinations that are now readily available. The MHA is a long-time supporter of I Vaccinate which is a good source of information on vaccines, and our MHA Senior Vice President of Public Affairs and Communications Ruthanne Sudderth continues to be our point person with this organization. Second, practice proper hygiene, including handwashing and staying home when sick. Third, seek the appropriate setting for care; visit the hospital for emergencies but contact your primary care physician or an urgent care facility for testing or care for mild symptoms. Lastly – and very importantly – be sure to express some grace and appreciation for any healthcare worker you meet. As we approach the winter and holiday season, they are here to provide exceptional care to all who need it and deserve to be treated with respect both on and off duty.
If you have not done so already, please join me in sharing this messaging within your networks. Our hospitals need the support from our partners in healthcare, the business community and in Lansing and Washington, DC to weather this storm. Respiratory illnesses will always be here, but there are many small actions we can take to care for the health and wellness of our communities well into the future.
Through a partnership with the Duke Center for Healthcare Safety and Quality, the MHA Keystone Center is pleased to offer the second iteration of its WELL-B webinar series geared to support healthcare workers experiencing burnout.
Live courses will begin on Nov. 17 and take place monthly through Oct. 2023. Each one-hour session includes CME and ANCC credit. The 12 sessions are a continuation of the courses offered earlier this year. Members who did not participate in the spring cohort are encouraged to listen to the recordings to gain foundational knowledge. CME and ANCC credits are also available for the pre-recorded sessions.
Registration is also open for a 5-hour WELL-B Essentials cohort opportunity starting in Jan. 2023. The five interactive sessions will center around cultivating work-life balance, gratitude, self-compassion and awe.
Sessions for the WELL-B Essentials cohort are first come, first serve. Registrants will be assigned to the one-hour sessions from noon to 1 p.m. either Jan. 23 – 27 or Jan. 30 – Feb. 3.
“Medical education does not exist to provide students with a way of making a living, but to ensure the health of the community.” ― Rudolf Virchow
As we enter the final two months of the MHA program year, our “all-hands-on-deck” prioritization of the healthcare workforce continues, and I am pleased to share that we have made significant strides in this regard. Included in that progress is work with our partners in higher education, other Michigan healthcare associations, hospital clinical leaders and the Michigan Legislature.
One aspect of our workforce efforts is not new. For many years, the MHA has led a special Graduate Medical Education (GME) Advocacy Day, hosted at our MHA Capitol Advocacy Center (CAC) in downtown Lansing. At this event, medical students, residents from teaching hospitals and academic medical centers, and other key leaders converge on the Capitol and meet with legislators to discuss the vital importance of GME funding in the state budget process.
After a brief hiatus due to the pandemic, we are excited to play host once again for this important in-person event, as we will welcome our colleagues to the CAC on May 5.
When this event began, the primary focus was to express the importance of GME and the national prominence that Michigan has earned in medical education. We have more than 7,200 physician residents currently working in the state, which ranks fourth in the nation. In addition, Michigan is third in the country for student enrollment in public medical schools. The investment Michigan makes in GME is very valuable, as every $1 in GME generates $2.53 in federal funding in fiscal year 2022. While the current rate is enhanced due to the existing public health emergency, there is no question that GME funding for Michigan’s beginning physicians is a wise investment for the future healthcare workforce in our state. GME also improves access to care, as it allows physicians to further their medical education while delivering much-needed care to patients throughout Michigan in teaching hospitals, community clinics and laboratories.
The vital role of GME in filling the talent pipeline is more important today than ever, as Michigan hospitals (and the healthcare delivery system in general) struggle with workforce shortages that have been exacerbated by the COVID-19 pandemic. Those shortages across the state have caused Michigan to lose approximately 1,300 staffed hospital beds over the past 18 months. Nationally, the physician shortage is estimated to be between 37,800 and 124,000 by 2034, including primary care and nonprimary care specialties, as the Association of American Medical Colleges estimates two out of every five active physicians will be 65 or older within the next 10 years.
The participants in our GME Advocacy Day have experienced many of the challenges that we’ve shared with elected officials: stress, burnout, workplace violence, vaccine hesitancy and significant loss of life due to COVID-19 and a host of other medical issues. Their perspective is extremely valuable as we make the case for funding and public policy that ensures the viability of our healthcare infrastructure for years to come. In addition to full funding of the traditional GME pool, there are several related items on the radar screen here in Lansing, including:
Included in the state’s Higher Education budget proposal is House Bill 5785, which would provide funding to create a healthcare workforce collaborative between the MHA and Michigan’s public and private post-secondary educational institutions. This partnership would not only provide employers with a better understanding of statewide graduates in health professions, but further improve the knowledge of employment opportunities in healthcare for post-secondary education institutions throughout the state. Included in the collaborative would be the creation of a searchable and accessible repository that allows healthcare employers to understand current educational trends and provides prospective employees easy access to healthcare positions throughout the state.
The MHA also supports legislation designed to incentivize more medical school and advanced practice nursing program preceptors by providing new tax credits. Senate Bills 998 and 999 would create a new tax credit for individuals who agree to work as a preceptor for required clinical rotations. We believe this legislation could help increase the capacity for clinical rotations at hospitals across the state, which would also improve the talent pipeline.
As we advocate in support of GME and related issues, we of course greatly appreciate the collaboration of our friends from the Michigan State Medical Society (MSMS) and Michigan Osteopathic Association (MOA). Together, our three associations make up The Partnership for Michigan’s Health, which has a long history of working together on healthcare issues of common interest, including the achievement of major medical liability reforms in the early 1990s, which established the foundation for much of our advocacy work in the Legislature and the courts ever since.
Most recently, the collective voice of our three associations, along with associations representing various other areas of healthcare, led to successfully securing $300 million in state funding for the recruitment, retention and training of healthcare workers. Collectively, the Healthcare Workforce Sustainability Coalition was created to focus on workers already within the healthcare workforce. Gov. Whitmer also recently signed Senate Bill 247 that would decrease wait times for commercial insurance prior authorization requests, a priority for all three associations. We are also united in our opposition to Senate Bill 990 that would create a serious public health risk by licensing naturopathic practitioners and classifying them as physicians. As healthcare associations, the professional careers of our members are dedicated to serving their patients and protecting the health and safety of the public. This opposition is an example of our need to protect the public from a practice that lacks scientifically proven treatment methods and clinical training.
In addition, we have long collaborated with MSMS and MOA to produce The Economic Impact of Healthcare in Michigan Report, which provides a detailed look at the extensive roles hospitals and health systems play in their local economies. Work is underway on the next issue of the report. The MHA Keystone Center Board of Directors has also designated one seat each for the MSMS and the MOA since its inception to ensure physician representation as we strategize on safety and quality improvement issues. And finally, the MHA and the MOA literally got closer last year when the MOA relocated its offices to the MHA headquarters building in Okemos – an arrangement that is unique anywhere in the country.
I’d also be remiss if I didn’t mention the MHA’s new focus on engaging with our physician leaders. For the first time ever, the MHA will be hosting activities dedicated to our physician leaders during our MHA Annual Meeting, including several sessions that will include CME credits. MHA Chief Medical Officer Dr. Gary Roth is leading these efforts, which complement his work throughout the pandemic engaging with our health system chief medical officers to facilitate consistent and reliable dialogue that allowed the MHA to efficiently provide policy updates to our clinicians as well as real-time feedback to policymakers. We’re extremely fortunate to have Dr. Roth, as the MHA is one of just a few state hospital associations with a full-time CMO on its leadership team.
Lastly, in an effort to fully support our physician colleagues (and other caregivers), the MHA Keystone Center is offering the Well-being Essentials for Learning Life-Balance (WELL-B) webinar series to prevent healthcare burnout by delivering weekly webinars on evidence-based well-being topics, including prevalence and severity of burnout, relationship resilience and being present. It is encouraging to see that over 4,000 individuals have already signed up for this innovative program.
As you can see, there is no magic pill that can solve the healthcare staffing crisis overnight. It will take many years and a multitude of public and private solutions to protect access for all of Michigan’s communities. GME is one of those key solutions, and we call on our elected officials – and all Michiganders – to give it the support it deserves.
The current surge of hospitalizations due to COVID-19 has continued its downward trend. The seven-day average of hospitalizations in the U.S. as of Feb. 13 was 80,185, down from 136,534 Jan. 20. Michigan hospitalizations for confirmed and suspected cases …
Gov. Gretchen Whitmer Feb. 16 signed House Bill 5523, a $1.2 billion supplemental funding bill that focuses on keeping kids learning in-person and bolstering the state’s healthcare workforce. This legislation directs $300 million to …
The MHA will host a virtual member forum from 2 to 3 p.m. Feb. 24 to outline the MHA 2021-2022 program year’s strategic action plan, which the MHA Board of Trustees approved in August. The forum will review the priorities set for the year, progress to date, and the tactics the …
Throughout the pandemic, being nimble and recognizing that much in the social support sector is in flux has been crucial, as has being intentional about identifying key areas and needs, including housing. Housing interventions improve housing stability and health outcomes while decreasing healthcare …
The COVID-19 pandemic and the rapidly changing competitive environment are making the consumer digital experience a higher priority for healthcare marketers than ever before. With budgets rebounding and marketers accelerating efforts in personalization, healthcare marketers must invest in new …
Registration has been extended to March 29 for the Well-being Essentials for Learning Life-Balance webinar series. WELL-B is a behavioral health training program for the healthcare workforce that delivers weekly webinars on evidence-based well-being topics, including prevalence …
In partnership with the MHA Keystone Center, the Michigan Opioid Partnership and the Michigan Department of Health and Human Services, the Community Foundation for Southeast Michigan has launched an Emergency Department Medication for Opioid Use Disorder …
At its Feb. 9 meeting, the MHA Service Corporation (MHASC) board focused on supporting MHA Strategic Action Plan priorities including behavioral health, workforce sustainability, data strategy, cybersecurity and diversifying MHASC products, services, and partnerships. To receive an update …
The MHA and the Michigan Health Council announced two offerings as means for strengthening the nursing workforce. The Clinical Faculty Academy is designed to expand the pool of nurses involved in educating the next generation of nurses and to increase nursing school enrollments. …
The MHA is a member of The Root Cause Coalition, whose mission is to reverse and end the systemic root causes of health inequities for individuals and communities through cross-sector partnerships. The coalition has opened its request for proposals to present at the seventh National Summit on the …
The latest edition of Trustee Insights, the monthly digital package from the American Hospital Association, is now available and contains valuable information on board engagement. COVID-19 has tested boards’ abilities to lead in times of prolonged and daunting pressures, and time …
Laura Appel, senior vice president, health policy & innovation, MHA, was quoted in stories the week of Feb. 14 discussing issues impacting the healthcare workforce. Hospitals across the country are concerned about anticompetitive activity and questionable pricing from …
The Keckley Report
The Healthcare Value Agenda 3.0: What to Expect in 2022 and Beyond
“The value agenda in U.S. healthcare is transitioning to version 3.0. While the aim of replacing fee-for-service incentives remains the same, the next version will be decidedly different.”
Registration has been extended to March 29 for the Well-being Essentials for Learning Life-Balance (WELL-B) webinar series. WELL-B is a behavioral health training program for the healthcare workforce that delivers weekly webinars on evidence-based well-being topics, including prevalence and severity of burnout, relationship resilience and being present. Compared to anxiety and depression, burnout is relatively easier to treat and prevent.
The MHA Keystone Center, in collaboration with the Duke Center for Healthcare Safety and Quality, will host the free WELL-B webinar series in one-hour sessions starting at noon ET March 29 for 10 consecutive weeks.Bryan Sexton, PhD, and his team will deliver “bite-sized” virtual learnings to train clinical and nonclinical staff on how they can support their colleagues.
Up to 11 hours of continuing medical education credit or American Nurse Credential Center credit will be available for eligible attendees. Recordings will be available to view and share after each live session. Additional information and registration are available on the WELL-B flyer, and members are encouraged to share the flyer among colleagues. Questions may be directed to the MHA Keystone Center.
The MHA Keystone Center Patient Safety Organization (PSO) Annual Meeting brings together national safety and clinical experts each year to discuss hot topics in healthcare. It will be held virtually from 9 a.m. to 3:10 p.m. March 9.
During the past several years, there has been an increasing prevalence of workplace violence in healthcare, and COVID-19 has contributed to violent behavior. That is why a key focus for the 2022 meeting is workplace violence and well-being.
Ken Smith, CHSP, CIE, CHCM, vice president at Healthcare Safety Services, will assist hospitals and health systems in complying with The Joint Commission’s new standards on workplace violence that took effect in January. Additionally, he will identify prevention strategies and action plans to assist health systems and hospitals with increasing workplace violence due to the COVID-19 pandemic.
Bryan Sexton, PhD, director of the Duke Center for Healthcare Safety and Quality, will outline the WELL-B webinar series that will begin March 29, demonstrating the efficacy of bite-sized interventions to sustain improvements in healthcare worker well-being.
Additional presentations will focus on anticoagulation-related adverse medication events and the intersection of health equity and safety.
Registration is free and available to MHA Keystone Center PSO members. Continuing education opportunities will be offered. Members with questions may contact the MHA Keystone Center PSO.