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Workforce Development Implications for Health Care Systems During COVID-19 and Beyond


Investing further in the development of health care staff in often overlooked aspects, such as digital technology and business acumen, can lead to incremental differences in engagement and productivity.

Investing further in the development of health care staff in often overlooked aspects, such as digital technology and even business acumen, can lead to incremental differences in engagement and productivity, said Andrew Malley, chief executive officer of Dignity Health Global Education.


AJMC®: Hello, I'm Matthew Gavidia. Today on the MJH Life Sciences’ Medical World News, The American Journal of Managed Care® is pleased to welcome Andrew Malley, chief executive officer (CEO) of Dignity Health Global Education.

Great to have you on, Andrew. Can you just introduce yourself and tell us a little bit about your work?

Malley: Yes, Matthew, lovely to meet you. I'm Andrew Malley, CEO of Dignity Health Global Education. We're a workforce development company, primarily offering a range of credit bearing and non–credit-bearing courses online globally, but primarily in the United States, to health care workers, ranging from clinicians to business practitioners, administrators, to analysts.

AJMC®: Can you speak on the current state of workforce development amid the pandemic, particularly any initiatives that have grown in influence or interest in recent months?

Malley: The COVID-19 pandemic has really highlighted issues around workforce development. And if I step back just a little bit, one of the issues in health care, historically, is that health care has been forced to run like a business, which to a certain extent makes a lot of sense. You want to control your budgets, your spend, efficiency, and that's all great. But there is a human element to health care, which isn't in other industries. So, for example, during a pandemic, you can't compare the issues Apple has with their supply chain in China with the issues happening in health care at the moment. I mean, they're just not even comparable. So, in that sense, health care is of a different planet in terms of its importance and what it means to people.

What that means is, historically, things like training budgets, learning, and development have been under invested in–it can't be like that anymore. What we've learned during this pandemic is if you want people to be responsive in the best ways to deal with pressure, to be more resilient, then you have to approach it in a completely new way. You have to invest in it, you have to be best-in-class, you have to support your staff.

For example, one of the things we've done recently in our company, we launched a program, a mini MBA it's called, with the University of Arizona. The mini MBA historically is kind of a non–credit-bearing program, which is around business practice, business acumen. So, in health care, that's what's needed anyway as people transition from clinical practice to business practice. But one thing we wanted to focus on, and be mindful of the challenges in health care, was resiliency, mindset, bouncing back from difficult circumstances. But when we did our focus groups, we just realized that people were sick of it.

They were sick of hearing about resiliency, they were sick about being told what to do all the time, they wanted a new focus. And health care wasn’t listening to them in their training needs. So, what we did is we brought in Super Bowl winners, olympic athletes, medalists, world champions, to come in our course and do modules, courses on resiliency, winning, being a champion, coming back from difficult circumstances, refocusing, reenergizing. And I'll tell you something, health care workers love it, because it's interesting, it's human, they can relate to these sort of superhuman characters that are talking to them. But one of the main reasons we did it was because we just had to approach in a different way. You have to bring the best-in-class to health care.

Health care systems, hospitals will understand that tick boxes and checkboxes are not good enough anymore. People need to be invested in, and that will also help your staff, your patients. They'll be more confident, they'll be more competent, and they'll stay longer, they'll be in the job longer, which is another problem that health care has. So, there's so many good reasons to do it. COVID-19 has shone a light, and I really, really am optimistic that coming out of this, and when we reflect, there'll be changes, and we'll be there to support people for sure.

AJMC®: The COVID-19 pandemic has brought several challenges to health care systems, much as you just alluded to. Notably, the emergence of telehealth and deferral in health care services have become prominent this year and last year as well. What benefits may a greater focus on workforce development bring to health systems tackling these issues and related effects during this time?

Malley: Well, workforce development is an overused term, but often doesn't come with many examples. So, I always think of one really great example, about the benefit of workforce development. A really good example I can give you is the military. If you take the military unit, on a good year, they might have up to 6 months of training. So, what that really means is that when it comes down to practice, they're well prepared. They know what they're doing. They know their role. They know what's expected of them. And that kind of workforce development in the military—let's call it workforce development, because that's essentially what it is—is what we need to bring to things like health care. And if you do that, the outcomes will be absolutely tremendous.

So, some of the challenges in health care right now are litigation, business acumen, data, cybersecurity, all these modern day issues that you will not ever get to grips with unless you invest in health care in a flexible way, in an innovative way, in a digital way—from my point of view, at least—and unless you do it on a consistent basis. Not 2 days a year, but like the military, 6 months a year. If you're not doing that, again, you won't get to grips with these modern challenges.

So, I think what the pandemic will give rise to, and I very much hope this, will be to embrace digital education, digital technology, flexibility that allow for people to constantly improve, constantly get better at their jobs. It's much needed, and again, I very much believe that what you put in you’ll get out.

So, by way of example, we have a health care leadership academy with Duke University. When staff start their programs with us, nurses in particular, there's one module they all hate: finance. They all dread it. They see it coming, and we survey them before they start, and all of them are like, "Oh, I don't know anything about finance, I'm a nurse."

When we survey them after the course, all of them love that program, for a very simple reason: they understand it now. They feel better, they feel confident, whilst beforehand that doubt doesn't naturally come, it comes because you don't feel confident. So, again, they had practice at it, they were shown how to do it again and again and again. It was applied to their job. Now they feel better, and I think COVID-19 will, much like telehealth, have the embracement of that kind of technology and I think will be hopefully similar in workforce development as well.

AJMC®: In looking at 2021 and beyond, how can health care organizations better optimize their workforce development programs?

Malley: So, one of the trends I expect in 2021 that I really, really want to see is a more rounded approach to training, education, workforce development, where rather than purely teaching areas of clinical engagement, which are very important, we also train people for the modern world. Data, I mean, how much data is in health care? It's unbelievable, right? And finance, again, think of the budgets in health care. Cyber security, and I don't mean you have to become a whiz in cybersecurity, but your awareness of the issue. And think about health care at the moment; it’s constantly being attacked by malware. In fact, 80% of all malware attacks in America are against health care.

So, these skills or competencies really need more attention. If people were more grounded in ethics and compliance, that would be a great win for health care. So, if you imagine now the litigation in health care, it's enormous in the United States. I read up to like $35 billion over the last couple of years in litigation. And by and large, these aren't huge crimes or misdemeanors; it's not health systems robbing people or murder, all those kind of things. By and large, litigation is taken out on relatively minor issues, essentially mistakes. People are making mistakes and being sued for it.

Now, you could argue that all day long about the validity of that, but the fact is, it's happening. And therefore, you need education, ethics, and compliance and just be that little bit more grounded in business, that little bit more grounded in data. If your whole workforce was 5% to 10% better at all those things—again, marginal gains—your whole business would lift.

AJMC®: To learn more, visit our website at ajmc.com. I’m Matthew Gavidia, thanks for joining us!

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