Hi, Tribe. I hope today finds you well enough. You know, whatever it is, whatever’s going on, sometimes you just have to wake up in the morning and do what you need to do—left foot, right foot, breathe. And I’m hoping part of the day listening to this podcast is a good addition.
So anyway, I am very happy to be with you discussing a topic that requires a lot of us to left foot, right foot, breathe: staffing shortages. And this staffing shortages just doesn’t impact clinical leaders and also clinicians who are getting told to increase patient load or whatever to make up for staffing shortfalls. It also impacts plan sponsors, who might be paying for what amounts to poor quality that results from a patient having to wait six months for an appointment while their cancer is progressing.
And all of these things obviously impact patients and members. So, staffing shortages and how good any given institution is at dealing with them or forestalling them is everybody in a community’s business.
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I think it’s a logical first instinct to throw money at the problem or focus on stuff like maybe, you know, mindfulness stuff. It’s also an intuitive thing to do to talk about reducing administrative burden. And sure, all of these things produce some results. But yeah … not enough, obviously. Otherwise, we would not have rampant staffing shortages and 35% of doctors thinking of quitting clinical practice.
So, as many in other industries have largely figured out, to solve the staffing problems, a big issue is always cultural alignment. Is a workplace aligned with the values of those who work there?
I’m remembering my very first management class I ever took in college. So, call this literally Management 101 on attracting and retaining talent so good people are productive and don’t leave and cause staffing shortages.
Part of the cultural alignment piece is, What do employees care about? Do they trust leadership to care about these same things? Because alignment of values enables people to show up with their hearts, not just their HOKA sneakers. And trust happens when our hearts feel connected to one another up and down the org chart.
Sometimes I wonder whether having minimal staffing shortages could be, I don’t know, some kind of KPI (key performance indicator) for enlightened leadership.
And there’s a ton of variables: geographic, desirability, and all kinds of other variables. But if not just what is written on the walls but what is actually going on in the halls aligns with the values of those working there, yeah, I could see that there’d be a lot of great people looking to work there and not leave. And kudos to leadership for setting the tone that can make that happen.
Okay, what are the root causes of staffing shortages, which, in the converse, are what’s required to attract and retain docs and nurses and everybody else to prevent staffing shortages? This is, in fact, what I talk about today with Komal Bajaj, MD. The first issue here is a breakdown of trust. There was a survey by Deloitte that Dr. Komal Bajaj talks about that revealed fewer than half (45%) of frontline clinicians trust their organization’s leadership to do what’s right for patients. Even fewer (23%) trust their leadership to do what’s right for workers.
Second requirement is an alignment of purpose and organizational goals—aligning that with the hopes and aspirations of employees. So, how do you figure out what people’s purpose is?
Oh, right. You ask them. You listen to what they tell you. Exactly. It is so interesting what can be learned from asking the right questions. But what is discerned by listening likely won’t be the answer anyone thought it would be. Because if it was the answer we all thought it would be, we probably wouldn’t have some of the problems that we currently have right now with our clinical workforces. Right?
And I’m gonna pause for effect because there’s a big, massive, unexpected reveal in this pod—and it’s coming up. Dr. Komal Bajaj did a huge survey and also references other huge surveys and came up with a purpose that has served to align healthcare workers across the country. And it is not what I would have guessed in a million years it would be.
So, spoiler alert: Skip ahead like two minutes if you don’t want me to ruin it for you. But here is a shared purpose that can align leadership and healthcare professionals around a shared mission. It’s aligning around high-quality, planet-friendly care.
Wait, what? Yeah, that was my reaction. But this is a very possible shared purpose for organizations across the country, not only along the coasts either but also in the heartlands. Many studies and surveys show this to be true.
So, let’s parse out what planet-friendly care means because I didn’t think about a bunch of this stuff initially.
First, everybody, Americans across these 50 nifty United States, thinks about care in the context of the planet locally, making sure that local pollution isn’t causing breast cancer and legions of kids with asthma.
Also, since workers frequently live in the area they serve, it’s also making sure their own water and air is not making they themselves sick. A lot of times this is also mirrored in findings on community health assessments, by the way. Lots of people are already talking and doing stuff about this whole making our community safe to live in by detoxifying the environment.
But planet-friendly or planet-aware, maybe, healthcare is also—so this is number two—making sure that supply chains aren’t interrupted by hurricanes.
Third point here, besides, number one, keeping track of environmental, social determinants of health and weather-related supply chain problems, we also have curbing waste. Doing stuff like, How do we reduce single-use plastic in the OR that is getting put out on trays, not used, and then chucked?
And there’s two issues with that: One is the landfill waste problem, but it’s also extremely wastefully expensive for no reason. The hospital is spending money buying gear and then literally just throwing it away without using it. I could not think of a better definition of just pure waste than this.
A fourth, why there’s alignment across the board here for why this matters, this planet-friendly care matters. There’s lots of federal, state, and local grants available to serve these ends. So, there’s financially net-positive reasons from the hospital standpoint to go in this direction, too.
So again, alignment, and alignment builds trust. Trust leads to a workforce less prone to everybody leaving.
I loved this conversation with Dr. Komal Bajaj, and it is chock-full of really great research peppered with me saying, “Wait, what?” a whole bunch of times. So, please do listen to the show and go on the same learning journey that I did.
My guest today, as I have said multiple times already, is Dr. Komal Bajaj. Dr. Bajaj is an ob-gyn who serves as the chief quality officer for a couple of hospitals in the Bronx, New York, that are part of the municipal health system of New York. She also now serves as medical director of sustainability for the municipal health system NYC Health + Hospitals.
Oh, lastly, I want to give a shout-out to Megan Antonelli and the HealthIMPACT events that she runs. Originally, I had seen Dr. Komal Bajaj speak at one of those events. They are in New York City. There’s actually another one coming up on January 22 and 23, 2025.
These events are for healthcare leaders. There’s usually a lot of hospital execs and other executives who are there. This one in January, though—I’m just looking—you know who’s gonna be there? Chelsea Clinton. If you’re looking for a reason to come to New York City, there you go.
Also mentioned in this episode are NYC Health + Hospitals, Megan Antonelli, HealthIMPACT Live, Cynthia Fisher, and Patient Rights Advocate.
You can learn more at the Office of Climate Change and Health Equity and the Agency for Healthcare Research and Quality.
You can also follow Dr. Bajaj on LinkedIn.
Komal Bajaj, MD, MS-HPEd, is an agency-building healthcare leader, catalyzing transformation across all facets of healthcare delivery. Dr. Bajaj’s work sits at the nexus of quality, technology, and environmental sustainability. She serves as chief quality officer of NYC Health + Hospitals/Jacobi/North Central Bronx and medical director of sustainability for NYC Health + Hospitals. Dr. Bajaj is an advisor to a variety of public and private entities, including the Agency for Healthcare Research and Quality. She was appointed by the Secretary of Health and Human Services to the National Advisory Council in 2022.
Dr. Bajaj is a professor of obstetrics and gynecology at Albert Einstein College of Medicine and was named as one of Becker’s Hospital Review Top Patient Safety Experts in 2024. She was an inaugural National Academy of Medicine Diagnostic Excellence Scholar. Dr. Bajaj’s work is regularly featured in media outlets such as New York Times, NPR, Modern Healthcare, Becker’s Hospital Review, as well as the New England Journal of Medicine, JAMA Health Forum, and the Institute for Healthcare Improvement. She is a Fellow of the New York Academy of Medicine.
08:20 How do we quantify the issue of staffing shortages?
11:18 Why do we need to look at the root cause of the shortages?
11:51 Deloitte survey on staffing shortages.
11:54 Why is trust one of the core problems when it comes to staffing shortages?
13:59 “Healthcare workers have choice.”
15:34 What are the strongest correlations that influence healthcare workers’ desire to stay?
18:17 What things give healthcare workers the most pause?
19:36 The U.S. Department of Health and Human Services Health Sector climate pledge.
20:20 The Commonwealth Fund survey on what health systems can do to address climate change.
22:29 What do we do about sustainable, climate-friendly healthcare being a driving factor in staffing?
27:28 How do you meet the desires of healthcare workers where they’re at?
@KomalBajajMD discusses #staffingshortages on our #healthcarepodcast. #healthcare #podcast #pharma #healthcareleadership #healthcaretransformation #healthcareinnovation
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