Articles

Winter 2022 - Message from Your Regent

Message From Your ACHE Regent
Winter 2022


Hospital. @Home. No doubt these two words have become entrenched in your daily discussions. With technological advances and a widening acceptance and uptake of these in application, it is only logical that we pursue such an approach to fulfill our patient centric missions.

Like many of you, it is an area I have been involved in operationalizing. It has become an effective option for providing inpatient care for certain patients, as it affords the patient with receiving the acute care they need in the comfort of their technology-converted home.

It is not a new concept; certainly it has been contemplated for years. However, with the recent dramatic adoption rate of video communication, secure data transfer protocols and other supporting technologies, even some of the staunchest who have pumped the brakes on such an idea in the past now support this approach. What does it mean for the traditional hosteled patients in our acute care organizations? There is utility for both. After all, higher acuity patients will continue to require the care only available with localization of professionals, equipment, and environment.

We know that patients, as any customer, want easy, simple, competent interactions with their healthcare team. In that regard, there is little difference from other services they seek. If there is a button (or just a few clicks) they can pursue to access services or care providers, they will. And we have been increasingly seeing this in the ambulatory setting. It may be a shift in viewpoint for many. This may be the case as healthcare may oft be seen as such a large behemoth that is slow to change when it comes to workflows that suit the organizational efficiency versus those that suit the desires of patients for whom we exist. I believe with our leadership, this continues to improve.

At the same time, this presents a huge opportunity for us. It gives us yet another way to connect with the communities we serve. It gives us a way to build better ties with both our current and future patients. It is my experience that I most often see healthcare organizations build work systems around current patients, but little around future patients. Beyond a relatively general marketing campaign, there are few examples of connected approaches to meet the evolving patient desires for how they receive care. Offering acute care in the patient’s home, when clinically appropriate, is a changed mindset from, “this is it, this is where we provide care, come to us” to “we recognize the desire you have for in-home care, and we are rising to that”. We not only can improve patient satisfaction, but can also generate engagement and loyalty. If deployed well, we can steer patients toward other health services and products that the patient may need over time. It also allows us the opportunity to build the relationship needed with our patients to proactively nudge them toward their health needs (that perhaps they are not good at) and assist them with reminders by connecting them to other patient supporting platforms and connecting services we offer. So in the end, it can be a win-win.

In all things ACHE, I remain your humble servant,



Trent A. Beach, PharmD, FACHE
Regent for Tennessee
[email protected]

Tennessee's Healthcare Workforce Shortage

Dr. Lisa Piercey

Commissioner, Tennessee Department of Health

March 21st, 2022

Whether it is restaurant wait staff, grocery store cashiers, or bedside nurses, it is safe to say that every business has been limping through staffing shortages over the last 18+ months. Yet, nowhere are these challenges felt more acutely – or arguably, have a bigger impact – than in the healthcare workforce.

Like states across the nation, the unrelenting workload, combined with vicarious trauma and moral injury, of the COVID-19 pandemic have driven Tennessee’s healthcare workforce to exhaustion and burnout. Because of this, many have voluntarily left the industry altogether, and sadly, a not insignificant portion have involuntarily departed our ranks due to disease – or even death – from COVID. 

Further, for those still in the workforce, the promise of high pay rates and novel environments has lured many into the contract staffing agency realm, particularly the younger and more mobile bedside nurses, with no assurance of a speedy return to traditional employment models. This enhanced competition for staff, growing wage inflation, and an expanding gig economy collectively pose an ongoing strain for healthcare organizations now and well into the future.

While we have all longed for returning to “normal,” the reality is that the shift in pandemic-related behavior, of both employees and consumers, is likely permanent. Likewise, it is crystal clear that we will be dealing with the waxing and waning of COVID caseloads for months or years to come. Thus, staffing flexibility is the new imperative of healthcare providers, to which our steeped-in-tradition industry is not fully accustomed. 

We must transform stagnant, long-term staffing models into a stable yet malleable need-based structure to accommodate the unexpected, and often rapid, shifts in workforce supply and demand from infection surges and market forces. While we continue our work in the community to reduce unnecessary demand, we can stabilize our supply of employees through recruitment and retention strategies. We must innovate the old model and take steps to create flexible work schedules and settings, ensure competitive compensation, and pursue an enhanced focus on the policy and societal issues important to today’s workforce, such as health equity, organizational diversity, cultural connectivity, and social justice.

To augment these critical private sector advances, Governor Bill Lee’s administration and Tennessee’s General Assembly are ratcheting up efforts in the public sector to help address the healthcare workforce issue, both immediately and for years to come. Federal COVID relief funds continue to be used for staffing assistance grants for hospitals and long-term care facilities, and American Rescue Plan (ARP) dollars are actively being considered for practice transformation grants, which will foster technological efficiencies to offset staffing shortages. Likewise, a budgetary package for expansion of the dental workforce pipeline and board rules for relaxation of EMS scope of practice are moving through the legislative process.

In addition to the continuation of the Tennessee State Loan Repayment Program (TSLRP), which offers educational loan repayment for PCPs practicing for at least two years in a health professional shortage area (HPSA), the Tennessee Department of Health will play a lead role in a soon-to-be-announced, public-private collaborative effort to develop a comprehensive plan for addressing the healthcare workforce needs across the state, at all points along the delivery spectrum.

Tennessee’s healthcare staffing shortage has been brewing for years and has reached a boiling point. Overcoming this “burn” will require creativity, innovation, and cooperation amongst providers, payors, and policymakers to position us for a more sustainable future of delivering high quality and efficient care to our patients.