This article is brought to you by Axxess. The article is based on an interview that took place during a virtual panel discussion with Christina Andrews, Director of Professional Services at Axxess, Dean Forman, Chief Operating Officer at Chapters Health System, and Sonnie Linebarger, Chief Operating Officer at Bristol Hospice. The panel took place virtually on March 22, 2022. This is an excerpt from the session, which has been edited for length and clarity.
Christina Andrews: Hello, and welcome to our conversation today, How to Effectively Manage Hospice Workforce Challenges. Axxess is a leading technology company serving organizations that provide health care in home. We offer a complete suite of easy to use innovative software solutions for both the hospice home health as well as home care providers, empowering them to grow their business and to serve patients and their families and the communities that they operate within.
I am joined today by Sonnie Linebarger, of Bristol Hospice, and also the host of the Evoke Greatness Podcast. She’s an innovative healthcare leader with expertise in operations, sales, financial management, for both hospice and palliative care. I’m also joined by Dean, from Chapters Health System. He oversees the day-to-day operations of all of the Chapters Health affiliates, as well as the corporate support initiative, which enables Chapters Health to refine the care for those with demanding conditions.
When we think about the fact that tens of thousands of Americans are becoming Medicare-eligible daily, that need for hospice specialists increases. What we have today and what we’re going to need in the future, is a gap that we have to bridge. Positioning your organizations as the employer of choice is going to be key.
Sonnie and Dean are extremely eager today to discuss strategies that can be used to welcome clinicians back into the workforce, those who experienced burnout because of the pandemic and also to attract new health care, individuals from other sectors, and bricks and mortar. They’re also going to highlight unique strategies that have helped them to be more effective in the distribution of their current staff, and the importance of assessing the employee experience. Our goal is to bring to the forefront a strategy that you’ve used in the past, maybe to refine a strategy, or to give you something new to layer into your playbook.
We’re going to take our session today and break it up into five key strategies. We’re going to start with our first strategy now which is employee experience. Really quickly before I address the panel, Gallup stated that organizations that focus on designing and assessing an employee experience program can systematically target burnout, and we know that burnout leads to turnover. This experience encompasses the entire journey an employee has with an organization. We have to think about connecting employee engagement to that employee experience, and that starts at the application process. In recent conversations with both Dean and Sonnie, they discussed the importance of an employee experience program.
Sonnie, can you tell the virtual audience what your current process is for collecting employee feedback?
Sonnie Linebarger: Yes, I think the employee experience itself, the employee experience that each employer provides is a really critical piece of the puzzle that you’re putting together to create culture, to create the everyday experience for them. Equally as important is gauging how they’re feeling about their employee experience, and so we do a number of things at Bristol. We actually do like an entree survey about 14 days in after they’ve started employment.
We want to figure out what that employee experience early on is looking like. We want to understand, is there anything that we’re falling short on in those first couple of weeks, being able to provide them the training and resources necessary to be successful in whatever role that they’re starting in. We put a lot of emphasis there as they enter into the company. Then equally as important, we take a look at annual surveys, annual employee satisfaction, experience, and what they are like. We do some periodic surveys based on something that may come up.
Then we also do exit surveys. It’s really getting that pulse point a number of times throughout their period of employment to really get a feel for what the employee experience is looking like, and then to really pay close attention to where we are falling short. I think that recognizing and doing the work is worth it. It’s that investment we’re putting into the experience.
Andrews: Yes, it’s beautiful. It sounds like you have a very healthy cadence of that litmus test because the experience that occurs every single day for our employees, so excellent. Dean, how about you? What does your current process look like?
Dean Forman: At Chapters, we have a multifaceted approach to this, but I think like most of us have realized, this is a journey to build on the back of a culture of imperative. We do employee surveys pretty much and we do a full survey every other year, and a poll survey the offsetting year. There are some annual surveys that occur on a yearly basis.
The big investment that we’ve made now is four years in the making that Andrew our CEO started, which is town halls. We try to do a minimum of two town halls each year, one in the spring and one in the fall. We use that town hall as an opportunity to get in front of our organization at all levels, right from the CEO to the home health aides and the entire back office. The effort that goes into supporting those are providing direct patient care. We don’t really review finances and we don’t review census. Rather, we talk about the industry and where it’s going. The reason why Chapters has a mindset for growth even during a time where they’re all thinking, why are you worried about growth, we’re having our problems hailing what we have.
Every six months or so we give them a flavor for how we expect the environment to change. Because we heard very clearly on annual surveys that the organization wasn’t sure about where the organization was going. We’re very focused now on where we’re going and why. As part of that, we do some high-level updates. We create a cadence and an expectation where we sit with them. In this particular round that we just completed, got a great turnout.
We can sit with a group of people and have a conversation. The value is developing a dialogue. With a dialogue that’s how organizations move forward in a way that’s consistent with hearing the voice of our team members. We talk a little bit about having a couple of hundred position descriptions and those types of things. At the end of the day, there’s really two position descriptions in the organization.
There’s a position description that says you’re providing direct patient care and caring for patients directly, or you’re someone in the organization that’s supporting those that do. We keep this cultural focus in a very simple way.
These things run about 90 minutes or so, and within 30 minutes to 40 minutes, we’re moving to Q&A. Then we do upwards of 20 plus of these in a 75 day period. We’re taking minutes, we take notes. 80% of what we hear is common and the other 20% might be affiliate or area-specific. We roster everything, and then we use that as a report.
We look for low-hanging fruit that we can adjust, and then we park in a lot of things that might take some time to figure out. Then the next time we go, we report back on, “Hey, this is what we heard last time. This is what we talked about. These are the measures we were able to accomplish. These are the measures we couldn’t and why.” We tell them not every organization can do everything, but if we demonstrate that we’re listening and that we’re acting on that and it doesn’t have to be universal, but if we demonstrate that we’re acting on some of the elements, they understand that they’re being heard.
That’s a critical investment that we’ve made because it’s a huge block of time and our geography of Florida is expanding, we’re getting to a good start and it’s a big investment. Then finally, Andrew has what I’m going to call a blog. There’s an ‘Ask Andrew’ on our internal homepage for our website. Over time, people have become more and more comfortable going there and either asking a question or putting forth a grievance, or it could be any number of things because sometimes the public venue isn’t a place where they would have put something on the table.
Andrews: Great. Many venues.
Forman: We monitor that. We answer everything that comes through that blog personally, and then we monitor the blog. If we know we got high volume in the blog, that’s a temperature check for us. We know we’ve got energy in the environment, and we need to do some broader communication. Our process to collect employee feedback is multi-layered but at the end of the day, it’s that town hall I think that brings the most value because we’re there, we’re with them, we’re listening, and we’re responding. There’s a lot of work to do here. We’re doing this for the next 75 days. There are 25, 30 of these things but at the end and we’re just nearing the end right now. Just like the bedside, it gives more back to us than we could have ever expected to give to it. That’s where we’re at.
Andrews: I love the multifaceted approach. There is something to be said about that in-person venue, that engagement to hear from their leaders, and that follow up and follow-through of this is what we heard and this is what we’ve accomplished.
Then for those who are addressing it quarterly, kind of along the lines with Sonnie, you’ve got that consistent litmus test. Let’s take this a level deeper here. Sonnie had brought up a really unique strategy to assess the employee experience, as you all remembered, at application. Sonnie if you don’t mind taking a few moments and talking to us about that and what you uncovered.
This excerpt has been edited for length and clarity. To watch the full discussion on video, please visit:
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