The state of the palliative care workforce is at an inflection point, as employers see both challenges and opportunities in their strategies to boost recruitment and retention.
Palliative care providers have weathered many challenges in recent years, including evolving regulations and reimbursement structures, a global pandemic and widespread staffing shortages.
Workforce shortages have long plagued the health care system, but the approaches to building up future palliative care clinicians are evolving, according to Susan Reinhard, senior vice president and director of the AARP Public Policy Institute. Reinhard is also chief strategist of AARP’s Center to Champion Nursing in America and Family Caregiving Initiatives.
Palliative providers are increasingly recognizing that younger generations and those newer to the field often lack awareness of the mental, physical and psychological challenges of serious illness care delivery, Reinhard stated.
Building better supports that help train and prepare future palliative workforces is a crucial need amid rising demand, she said at a recent conference held by the Coalition to Transform Advanced Care (C-TAC) and the Center to Advance Palliative Care (CAPC).
“We’ve had nursing and health care worker shortages before, but this is different,” Reinhard said at the C-TAC–CAPC Leadership Summit in Washington, D.C. “New nursing entrants are seeing that this takes a lot of development. Students haven’t had as much direct care experience. They were doing a lot of simulations, but they would get into the actual environment and say, ‘Wait a minute. This is wild.’ The commonality we saw is that we have to do things differently. We can’t just work around retention; we have to change the work environment.”
Technology is playing an increasingly important role in preparing the next wave of palliative professionals to understand the nuances of serious illness care delivery, Reinhard said.
“People have questions about [this care], and that’s where virtual nursing and AI can come in,” she said. “It’s ensuring that workers really understand things like how AI can reduce charting, and that can be so huge to reduce the burden on physicians, nurses and others. Technology can be huge in changing care delivery, scheduling and trying to understand where care is needed and matching it up with the right workers. It’s about that staff ratio and finding more people with more confidence to deliver this care.”
Navigating a sea of changes has strengthened palliative care organizations in their ability to be adaptive and creative with their workforce development strategies, according to Dr. Jay Bhatt, managing director at Deloitte Health.
“One interesting thing that COVID illuminated is that you’re a health company not just for your employees, but [also] those that you care for, and for those that care for you from a caregiving standpoint,” Bhatt said at the conference. “That, alongside regulatory tailwinds and the economic case has created this opportunity to really accelerate how this care looks different. We [also] have a system that is very payment-specific in the care model. It’s reorienting across the board what are the menus of the right care model that include direct care workers, family caregivers and other kinds of health workers. How do we align support to do that, because that’ll get us to the next level.”
Bhatt is also executive director of the Deloitte Center for Health Solutions (DCHS) and the Deloitte Health Equity Institute.
One key to growing the palliative care workforce is building an organizational culture that encourages employee feedback and engagement, he said. This is an important part of building trust among staff and understanding areas with room for improvement, he said.
Trust is a significant factor in workforce retention, according to Bhatt.
Nearly a quarter of front-line clinicians across the continuum lack trust in their organization’s leadership, including those working for palliative care providers, a recent Deloitte study found.
“Our research suggests that we see a trust deficit of 23% of the frontline workforce do not trust leadership and organizations,” Bhatt said. “If we do nothing different, it is in crisis and it is urgent.”
