Workforce poses greatest challenge to future of Iowa’s health care

Recruiting and maintaining an adequate workforce will be the biggest challenged faced by health systems as they look to the future of health care in the state, local health care leaders say.

Health care systems statewide will need to continue supporting the front line staff currently responding to the ongoing pandemic, and take innovative steps to improve the strength of the workforce, leaders of Eastern Iowa health facilities said during a discussion on the future of health care during The Gazette’s 2021 Iowa Ideas Conference.

In particular, that effort to recruit a new workforce should focus on improving the racial and ethnic diversity of health care staff within hospitals and clinics, UnityPoint Health-Cedar Rapids President and CEO Michelle Niermann said.

“I think the realization for us is that we don’t, from an employee perspective, look like the community as much as we should,” Niermann said. “We know the demographics of our communities are changing and we know people are not necessarily choosing us for health care careers.

“We do have to get back on that path of developing workforce.”

Workforce diversity also will help systems as they work address the disparity of health outcomes individuals experience based on their race or other factors, which has been highlighted throughout the pandemic.

The Eastern Iowa health care leaders speaking on Friday’s panel emphasized the need to collaborate with public health officials and other health care entities on these issues, as well as the need to find opportunities for policy to help improve outcomes.

“There is no success in the health care system unless we get equitable outcomes and access for everyone,” said Suresh Gunasekaran, president and CEO of the University of Iowa Hospitals and Clinics.

The need for health care through an inclusion lens was echoed by Joe Lock, president and chief executive officer of the Eastern Iowa Health Center, the federally qualified health center in Cedar Rapids.

Lock said 39 languages were spoken during the organization’s 69,000 outpatient clinic visits over the past year. Seventy-seven percent of EIHC patients also are at or below the federal poverty level, he added.

“That’s just the reality,” Lock said. “… It’s important we are culturally competent and we embrace diversity, equity and inclusion and just continue to focus on that moving forward.”

Health care officials also are working to enhance supports for current staff who have been responding to the pandemic since March 2020, Lock said.

Pandemic response has been a marathon over the past year and a half and, as a result, many front line workers are experiencing burnout. Local leaders say many workers have retired early, taken jobs as traveling health care providers or otherwise changed their careers.

“But the baseline amount of work coming in the door remains the same for the remaining staff. It’s a tough situation,” Gunasekaran said.

Lessons learned from COVID-19

Heath care leaders have taken away a lot of lessons from the COVID-19 pandemic, including how to scale up response quickly and how to navigate challenges with the supply of critical resources.

They’ve also had to navigate a new dynamic of being a public voice for pandemic response.

“We’ve long been mentored to be leaders of our health care entity,” Gunasekaran said. “But (COVID-19) really challenged us as an industry to suddenly be thrust into being public leaders.”

Gunasekaran said he sees success in Iowa-based health care systems’ collaboration with other systems across the region during the pandemic, and he sees success in the public health officials’ ability to effectively communicate guidance as the coronavirus spread throughout the community.

“All of our wins were community wins,” he said.

The failures that were occurred were results of an under-resourced public health infrastructure, Gunasekaran said.

To better prepare for the next pandemic, more investment needs to be made in the public health infrastructure, he said. Local agencies have been chronically underfunded for years, and hospitals need accurate information on the spread of the disease to respond effectively.

Improving the vaccine rate

Increasing the rate of Iowans vaccinated against COVID-19 continues to be a priority for public health officials and health care systems.

According to state coronavirus data, a little more than 1.6 million Iowas were fully vaccinated as of Wednesday. That’s nearly 52 percent of the state population and about 61 percent of Iowans aged 12 and older.

“We all need to do a better job to advocate for these vaccines,” Lock said.

Rather than vilify individuals for not having been vaccinated, Gunasekaran said health care officials should embrace patients on their journey toward vaccination. Providers need to be better about humanizing those individuals and accept that hesitancy is normal.

“We deal with this journey all the time in health care where people are hesitant to make lifestyle changes or as they’re making health care decisions,” he said.

“We can figure out ways to embrace our sister, embrace our brother. I think that’s the really important part.”

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