Plug and Play: You are Not Bought, You are Built

On December 11, Juan Soto signed a 15-year, $765 million contract with the New York Mets. It’s the largest free agent contract in Major League Baseball – and sports – history. The Mets outbid several teams, including the Los Angeles Dodgers and New York Yankees, for Soto’s services.

The Pittsburgh Pirates, once one of MLB’s most successful teams, were not among those teams. They do not have the revenue to support such a signing. To compete against teams with larger revenue bases, they must build a solid minor league system, stock it with promising young players, hire the right coaching staff to develop those players, and cross their fingers that they avoid injuries and develop into competent ballplayers.

Healthcare systems in today’s landscape are no different. The larger systems, such as the Mayo Clinic and Cleveland Clinic, have probably 50 people lining up for every open job they post. A 60-bed behavioral health system in Canton, Ohio can’t attract the top talent like its larger counterparts, but is still expected to compete with them.

Still, like smaller-market baseball teams, it’s possible for smaller healthcare systems to compete. To do so, you need to ask yourself two questions – who are you and what are you measuring?

Who are You?

For real – what type of organization are you? If you are a smaller healthcare system, don’t build an education program that is more suited for the larger organizations. A smaller healthcare system requires smaller components in their program, but greater details.

For example, the smaller health system in Canton gets a nurse right out of school. She’s likely not an RN but an LPN, has three months of experience rather than three years, and is enthusiastic about her career rather than jaded. What do you do? For starters, you paint with a broad brush and expose her to every role and responsibility on the floor. You train her to be a mental health technician, teach her to see patients in their rooms, and show her how to capture data on an iPad. You let her sit at the nurses’ station and document assessments in the computer. You train her to go into the medication room and hand out medication as required. And you also train her in the kitchen to pass out meals. Why? Well, for starters, you are a small organization, facing staffing issues and call-offs every day. The more skills you give her, the greater flexibility that you have with your workforce every day. She becomes a Swiss army knife, able to go into any role with relative ease.

This is important, because you are creating sustainability. You aren’t able to compete with the big boys; you don’t have the revenue, talent or experience. You need to ensure that you keep the lights on every day. The only way to do it is creating a nimble workforce with a skillset that allows talents to be plug and play – able to go on any floor and in any job and succeed.

What are You Doing?

Easy: making money. You are not trying to make money for ONE year, you are trying to make money for the next TEN years and beyond. That requires playing the long game, creating metrics to measure important tasks and skills, and getting better at them.

This means looking at every department: figuring out what is important to them, measuring it, defining metrics, and setting expectations to get better over time. For example, in the quality department, we measure things like quality checks and quality assurance. We also look at hospital specifics, such as the number of incidents we had over a month, the number of falls and hospital-acquired infections and the number of charts reviewed. Each metric is assigned a quality metric, and everything is tracked. If a fall does occur, then it is quality’s job to collaborate with nursing leadership to figure out what happened, plant operations’ job to assess floor conditions and ensure safety, etc. If you do this month over month for each department, then you have a year’s worth of data to assess where you are good, where you need work, and the skills you can build on.

You also want to take into account feedback from both staff and patients. Outcome-inspired surveys are key here. Ask your patients about their length of stay, how service was, if they like their food, how were they treated, etc. Ask staff about their conditions in the workplace, their co-workers or staff, etc. Ask these questions on a 1-10 scale, so you can again measure month over month.

You do this long-enough, you will know where you are good and where you need work.

As painful as this is to admit, the Pirates are a feeder system for the Yankees. They develop players and the Yankees come in, pay them more money, and take them away. But that doesn’t mean the Pirates do not have a sustainable team, with a chance to win. They do, with the right strategy.

Healthcare systems are the same. You may be smaller, but you are more nimble than larger organizations. You may have less experienced employees, but they are more enthusiastic. Use this to your advantage and create a culture where people want to be, and you will succeed.

John R. Nocero, Ph.D., and Andrea L. Bordonaro, MAT, blog on LinkedIn as “The Q-Kids,” discussing everything related to clinical research education, inspiration, and professional connection.

John is the Director of Quality at Sunrise Vista in Canton, Ohio. He has worked in clinical research since 2003 and is inspired by the Irish professional wrestler Becky Lynch, whose personal and professional story centers on achievement, tenacity, grit, and overcoming adversity.

Andrea has taught first grade in Willoughby, Ohio for 25 years. She earned a Bachelor of Science in elementary education from John Carroll University and a Master’s Degree in the Art of Teaching and Education from Marygrove College.