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Special Report: Intro to Healthcare Communications 2022

A cartoon image of a living room with a news anchor on the TV screen with banner that reads "special report" and a fish in a fish tank on the side dresser

Let’s make this multiple choice. Pick one or more to describe takeaways associated with current communications trends.

A. People have the attention span of a goldfish.

B. Local news is dead.

C. People aren’t willing to consider opposing viewpoints.

D. People trust family and friends.

E. People don’t trust institutions.

F. People watch, not read.

G. All of the above.

You went for G, right? Because when it comes to communications today, each of those axioms pops up with regularity. It’s impossible to catch – and hold – your audience’s attention. There’s little room for discourse. And we won’t even start on the impact of short, flashy and content-lite videos published to TikTok, Snap or YouTube.

How’s anyone supposed to cut through the noise when there’s a serious point to make and the world is distracted scrolling through memes?

We know. But first, let’s see if your choice was correct. Our proof points come from a survey Jarrard Inc. conducted in early April. Responses that follow come from 800 US adults who answered questions about how they prefer to receive information, how often and whom they trust to provide it.

Here’s what we found:

A. People have the attention span of a goldfish

58% Regularly read long-form content

Not exactly. People do prefer shorter content. But they will take the time to go deeper. More than a third of respondents said they’re more likely to read short-form content on any given day, versus just 15 percent who said long-form. But a plurality – more than four in 10 – said the average day was likely to include both. In addition, 58 percent said they read long content a few times a week or daily – the same total as short content.

On an average day, are you more likely to read long-form or short-form content?

Donut chart with 6% "unsure," 15% "long," 37% "short," and 43% both

B. Local news is dead

Wrong. It’s not. Well over half of survey respondents selected local TV as a source of news, and more than a quarter picked it as their top choice.

Where do you go for your news? (Pick all that apply)

A bar graph with the x-axis representing news sources and the y-axis representing percentage (up to 60%).

What is your top choice for getting news?

A bar graph with the x-axis representing news sources and the y-axis representing percentage (up to 30%).

Though perhaps surprising, these findings are consistent with other studies over the past few years. A rapid decline in local TV viewership was arrested and somewhat reversed during the stay-at-home days of the pandemic.

A collage of local news headline clips

C. People trust family and friends

This checks out. Especially the family part. Throughout human history, people have made their way into tribes and are skeptical of outsiders. It’s evolutionary hardwiring in place to boost safety and overall success. Ergo, it makes sense that when asked about who they trust, family tops the list in a statistical dead heat with doctors. An important note here about that trust in doctors: If you’ve been following our surveys for a while, you know that we consistently highlight physicians and nurses as trusted voices on healthcare issues. This survey – related to but distinct from that series – asked a more general question about whether people trust information in general from different sources, not just healthcare information. That doctors remain at the top of the list shows the depth of that inherent trust, even beyond their professional expertise.

The slightly wider circle of friends and neighbors is far less trusted, yet still sits at almost 50 percent. People want social proof and trust loved ones – even above information they find when looking for insight on a topic.

Importantly, though, expertise is still highly valued, with academic experts and nurses rounding out the list of most-trusted individuals. Family matters, but so does deep professional training. CEOs, brace yourselves. You barely avoid the bottom spot, perennially occupied by politicians.

C. People trust family and friends

This checks out. Especially the family part. Throughout human history, people have made their way into tribes and are skeptical of outsiders. It’s evolutionary hardwiring in place to boost safety and overall success. Ergo, it makes sense that when asked about who they trust, family tops the list in a statistical dead heat with doctors. An important note here about that trust in doctors: If you’ve been following our surveys for a while, you know that we consistently highlight physicians and nurses as trusted voices on healthcare issues. This survey – related to but distinct from that series – asked a more general question about whether people trust information in general from different sources, not just healthcare information. That doctors remain at the top of the list shows the depth of that inherent trust, even beyond their professional expertise.

The slightly wider circle of friends and neighbors is far less trusted, yet still sits at almost 50 percent. People want social proof and trust loved ones – even above information they find when looking for insight on a topic.

Importantly, though, expertise is still highly valued, with academic experts and nurses rounding out the list of most-trusted individuals. Family matters, but so does deep professional training. CEOs, brace yourselves. You barely avoid the bottom spot, perennially occupied by politicians.

How much do you trust information from each of the following sources?

(Scale of 1-5: 1 = Do not trust, 3 = Neutral, 4-5 = Do trust)

A horizontal stacked bar graph representing the percentage of trusted individuals

In general, how much do you trust information from…

(Scale of 1-10: 1-3 = Very little, 4-5 = A little, 6-7 = Somewhat, 8-10 = A great deal)

A horizontal stacked bar graph representing the percentage of trust by sources

D. People aren’t willing to consider opposing viewpoints

How likely are you to change your opinion based on a statement by/discussion with someone with an opposing viewpoint?

A donut graph with 13% "very likely," 26% "very unlikely," 35% "unlikely," and 26% "somewhat likely."

In the past year, have you changed your opinion based on a statement by/discussion with someone with an opposing viewpoint?

A donut graph with 20% "unsure," 39% "yes," and 41% "no."

This was quite the surprise. In this time of bumper stickers, polarization and tribalism, it seems counter to the conventional wisdom that people might be willing to consider ideas they don’t already agree with. Yet, almost four in 10 respondents say they had in the past year changed their opinion based on ideas from someone with an opposing viewpoint. And another 40 percent says they just might.

Of course, this is all self-reported and might reflect the respondents’ desire to be perceived as open-minded than actual open-mindedness in practice. Even so, this is cause for optimism. Because, at minimum, there’s a segment of the population that wants to be thought of as open-minded.

E. People don’t trust institutions

True. If family and doctors are highly trusted, CEOs are, well, not. Though not asked in the survey, it’s not a big leap to see how the idea of a “CEO” here could be interpreted as either the individual – the head of a corporation – or as a proxy for the corporation itself. The dark suit, if you will. This is a warning for any institution and leader. People are relational, looking for information and reassurance from other individuals while holding a notable skepticism of organizations.

F. People watch, not read

Video is king. If you’re in marketing and communications, you’re keenly aware that short, visually engaging content is the way to consumers’ hearts. Our survey reinforced this position. Almost half of people expressed a preference for video – 18 points above written text and 3.5-times more than audio. This doesn’t mean that other media are dead. Just that visual content must be a core component of any communications strategy.

Which format do you prefer for receiving/consuming news and information?

A donut graph with 14% "no preference," 46% "video," 28% "written text," and 13% "audio."

Advice

Those are the findings. Now, what does it all mean for healthcare communications?

From our survey, one core message supersedes all others:

There’s a tendency to measure success by activity, not influence. Yet the real movement may be hidden.

It’s away from measurable campaigns like social media and billboards. And it’s found in the conversations between doctors and patients, family and friends. The ROI of relationships and interpersonal trust is unquantifiable but invaluable.

For marketing and communications advisors, this is straight talk that bears repeating: Our activity is not “it.” The hard work is in earning the conversations that take place around the dinner table.

There’s hardcore – though perhaps not entirely quantifiable – benefit to “Dinner Table ROI.” The local and personal nature of communications, trust and healthcare – along with the high trust doctors and nurses continue to enjoy – means that healthcare brands may very well be sturdier than the hot-take Twitterati say they are. The experience a strong brand provides is far more enduring than a Twitter storm. If you’ve built a strong reputation, then when the hot takes come in, those dinner conversations will include a heavy dose of people telling their loved ones, “That wasn’t my experience,” or, “I’d still go see Dr. Smith.”

We’ve written before that providers should not passively rely on an historic positive reputation. Or on the personal trust between doctor and patient. Foundational as those things may be, they’re not inviolable. Patients can choose to follow a physician rather than a hospital. And the low trust in institutions means that no corporate reputation is safe, especially in a time when hospitals are under significant fire. We stand by that advice and suggest that the strength healthcare organizations maintain is a starting point to build from, not a resting place.

How to build? Forget the Three Rs. Your answer lies in Six Ts.

Time

The first step to moving someone to action isn’t giving them new information. It’s overcoming resistance to receiving new information. “It’s a long journey to persuade people even to receive the information, much less change their mind based on it,” said Teresa Hicks, associate vice president in Jarrard Inc.’s National and Academic Health Systems Practice.

So focus internally first to make the most of that time, says Abby McNeil, vice president in the National and Academic Health Systems Practice. While there’s a lot of value to be had in media relationships (see sidebar) healthcare communications leaders need to focus initially on physicians, employees, partners, and other internal stakeholders. “Because we trust people we know most, their experience, along with the patient/consumer experience, is what moves the needle fastest with brands either in a positive or negative way.”

Trust

There’s good and bad in the trust numbers from our survey. On one hand, it’s easier to receive information from a cherished sister or brother instead of reading a stack of articles for yourself. “There’s an element of comfort that comes from that relationship,” Hicks noted. Yet depending on the information shared between sisters, that could be a good thing – “Go get your COVID-19 vaccine!” – or a bad thing – “the COVID-19 vaccine contains tracking devices!”

Kim Fox, partner and Regional Practice lead at Jarrard Inc., added, “The dinner table is a safe place. You can explore your perspective and feelings there. You can openly be your true self, whereas you often can’t in other settings.”

For healthcare organizations, the charge then is:

And what of spokespeople? Well, your physicians, nurses and academic experts remain high on the trust list. CEOs? Not so much. We think that in many cases, the word “CEO” could easily be viewed by many as a proxy for “corporation.” When faced with a critical message – or even just day-to-day communications – provider organizations must be careful to use the person who is best suited to deliver it, even if that person may not be the most prominent. We typically see this in advertising: It’s white coats in hospital TV ads, not suits.

Of course, there’s also a big difference between “CEOs” in general and Jane Doe, CEO of Anytown Medical Center. So, there’s certainly an opportunity for any leader to be a trusted voice. That trust must be cultivated, which McNeil references in media training sessions. “I tell leaders they have to make deposits in the community trust bank daily, because at some point there will be an issue or a crisis, and they’ll have to make a withdrawal,” she said. “Those deposits happen at every single touchpoint with the brand.”

Last note here: Fox pointed out another subtle but important distinction in the trust numbers. “People don’t trust celebrities. Providers should be careful about if and when they use celebrities as spokespeople.” she said. “They’re known, but not trusted.”

Why Are Doctors So Highly Trusted?

We noted above that doctors aren’t just trusted on health information, they’re trusted even when the question is about information writ large. Why? Fox had an idea. Perhaps it’s because of their unique position as recipients of our secrets. “We may trust doctors because they hear things that we won’t say even to our families,” Fox suggested. While the dinner table is, in Fox’s terminology, a safe space, the doctors’ office is reserved for discussing a subset of deeply personal concerns. Arguably, clergy have historically held this position, yet they fell in the middle of the trust list in our survey (fallout from the decline of organized religion, perhaps).  Could it be that the knowledge that our medical caregivers know things about us no one else does lead to trust, or even force it? Or is the trust necessary up front for us to feel comfortable being open with our physician? It’s an intriguing chicken and egg question we don’t have an answer to but will be pondering.

Translation

Almost everything we know has been interpreted for us by someone who understands it better than we do.

Sounds scary, but is it? Not really. We need experts to discover and then translate since no one knows everything. Society needs specialists to develop ideas and make discoveries, but then it also needs a series of people to translate that information into something we all can use. And at the end of that chain must be a trusted, one-on-one interaction.

That’s why hearing from a family member is far more palatable than digging through mountains of primary literature.

So too with health information. Healthcare providers need to remember that the process of translation is good and necessary. Done correctly, the process makes the complex and unintelligible something that can be processed by, well, anyone who isn’t the expert. This means investing in people and processes that can review critical messages and adapt them as needed. It’s taking an active approach – not just asking a charismatic physician to go out and extoll the virtues of vaccines or colonoscopies. It’s building a pipeline to finesse information into a format and level that is exactly what the audience needs. Playing a huge role in this is your marketing and communications team who should both identify the core message, shape and review it for accessibility and then develop final products that engage the end user.

Training

Smart healthcare providers invest in training trusted voices to communicate effectively.

“We can work to make the people who can translate trusted,” said Hicks. “But… that’s a lot harder than finding someone who’s already trusted and giving them the skills they need to translate.” That doesn’t mean sending community leaders to a crash course in immunology and vaccine development, but it does mean sitting down with them and the specialists – those in the first and second layers of translation, if you will – to walk through the information, its impact and how people should respond.

You’re familiar with examples of health systems working with clergy to promote the COVID-19 vaccine. Another example could be a local facility engaging with EMS directors across a community to explain how and why consolidation of emergency services will work – and why it makes sense for the community.

“Whatever the topic is, finding the people who already have earned the trust of their community and investing in convincing those people to share the information is the way to go,” Hicks said. “Because this survey shows that people trust relationships more than they trust data.”

Tactics

Whatever the message and whomever the messenger is, how should it be delivered? Here’s where that preference for short form and video comes in to play. The data is clear and is largely consistent with marketing and communications best practices, so we won’t dwell on this tactic for long.

Still, it’s worth noting that the results reinforce the value of brief videos, delivered on a regular basis. People are looking at short-form news a few times a week. They strongly prefer video over audio and text. Therefore, they’re primed for that style of communication when it comes time to look at health information.

But remember that, despite the preference for short-form content, there’s a place for long-form. Those quick hit pieces can be backed up by deeper materials for those who want more. Fox noted that there is always a need for multiple channels. The survey, she said, reminds us that “People will still read a good story. Not everything has to be three paragraphs long. There’s a market there for deep content, as long as it’s well-written, well-researched and thoughtful.”

Touchpoints

By that, we mean experience. Consider the “body language” of an organization and the experience it offers. “Perception comes down to experience,” McNeil said.

The right words at the right time are important but not remotely sufficient. More significant is creating a good experience at every stage of the patient and employee journey through the organization. She referred to the survey data as “a callback to how we show up with patients and consumers, with employees and physicians, every single time.”

Remember that a sizeable portion of the population either is open-minded or wants to be perceived as open-minded. Remember, almost 40 percent of survey respondents said they had changed their opinion in the past year based on an opposing viewpoint. Both demonstrate sensitivity to social norms.

Therefore, those leading communications for provider organizations should be encouraged to keep up with efforts to persuade – whether the issue is public health measures or service line changes.

The key is to build those messages into bite-sized, emotionally compelling nuggets that can be easily delivered through personal relationships far away from the PSAs and media campaigns. Then, as the door is cracked wider, have ready more in-depth information that will build momentum towards the end goal rather than put people into vapor lock through confusion, defensiveness and decision paralysis.

Remember: Every opportunity to back the story up by a personal, positive and comfortable experience serves as a deposit in the bank.

“No presentation with vast amounts of data will be palatable enough to make someone change their mind,” said Hicks. “It has to be the relationship that does that.”

Closing Thoughts

Where’s Local Media In All This?

A key finding of our survey was that local news is not dead. What should healthcare providers do with that? Our Jarrard Inc. team has some thoughts on the state of the media:

  • Generalist Reporters. There’s a wide variation in local TV reporting. Many reporters are doing their best on limited budgets and lack of resources needed to specialize in healthcare, business, etc. As you work to form meaningful, educating relationships with the editorial staff or news director, work hard to translate and put the news into context for them.”
  • Relationship Building. Like anything, building that relationship takes time. Meet with the reporter or news director to talk through key issues and serve in that translator role. Ongoing, long-form conversations build a personal relationship and give the reporter a vested interest. Make them feel a partner in serving the community. Professional responsibility means journalists will want to know that they’ve done their homework, looked at both sides and appropriately simplified complex information so it’s available to the public. You can be an asset in this process.
  • Beware the Dark Side. We’re talking about the push for ratings, sensationalization. Provider organizations interacting with TV reporters need to be aware of details like sweeps week, the four times each year when ratings are calculated. Though it’s not necessarily a negative, Muck Rack’s 2022 State of Journalism survey found that reporters say having a subject connected to a trending story was the best way to make a story shareable. Similarly, local reporters are often working to move up to a bigger market. Most are doing that by doing great work and telling important stories well. But there are, as with anything, exceptions to that generalization. Ratings will be in the back of the reporter’s mind. Layer on top of that the need to tell stories in 30-90 seconds and there’s a risk of sensationalizing.

Want more specifics on how reporters want to be pitched? Here are a few very tactical stats from the Muck Rack State of Journalism report:

4 Average number of beats each journalist covers

84 % Journalists who consider academic experts credible sources

66% Journalists who consider CEOs credible sources

4
Average number of beats each journalist covers
84
Journalists who consider academic experts credible sources
66
Journalists who consider CEOs credible sources
94
Reporters citing direct emails as preferred way to be pitched

Questions about how to communicate more effectively with the audiences that matter? We can help.

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Navigating the C-Suite: Beyond “Go Back and Write About it”

A long, 18-person office table in the middle of a conference room with floor-to-ceiling windows and light beaming through

This week we were honored to help produce a full panel discussion with four top healthcare marketing and communications leaders discussing team dynamics and navigating the C-suite. It’s a conversation around how marketing leaders and their teams can use their seat at the table to not just be scribes for their hospital or health system but to serve as strategic leaders and advisors.

The team includes:

  • Susan Alcorn, of counsel here at Jarrard who previously spent time as chief communications officer at Rochester Regional Health and Geisinger Health System
  • Beth Toal, vice president of communications and marketing at St. Luke’s Health System in Idaho
  • Michael Knecht, chief marketing and communications officer at RWJ Barnabas Health in New Jersey
  • Gayle Sweitzer, vice president of marketing and corporate communication at the University of Kansas Hospital

This conversation is a prelude to a panel discussion the group will be having on Tuesday, May 17th at the Health Care Marketing and Physician Strategy Summit (HMPS) in Salt Lake City. For more on the event, check out healthcarestrategy.com.

Be sure to listen and subscribe to the High Stakes Podcast.

Photo by Benjamin Child on Unsplash

Event Recap: Healthcare Private Equity at HPE Miami 2022

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Note: This piece was originally published over the weekend in our Sunday newsletter. Want content like this delivered to your inbox before it hits our blog? Subscribe here.

The Big Story: Crafting the next-generation value creation playbook in healthcare private equity

“While the pandemic has disrupted demand for certain healthcare sectors, it has accelerated innovation and provided an opportunity for investment in other areas. In particular, there’s been rapid growth in virtual and home-based care delivery, along with the adoption of technology platforms.”

What We Heard at HPE Miami 2022

(2-minute read)

The opportunities and rapid growth were big topics at HPE Miami 2022, but the conversation didn’t end there. In fact, those were just starting points. The annual event, hosted and produced by global law firm McDermott Will & Emery, attracted more than 700 attendees from corners of the industry spanning investment, banking, legal and supporting services (including at least three strategic communications pros).

If we had to pick one word to summarize the trends we heard, it would probably be “leveling.” Investors remain optimistic and active, yet there was a sense that the industry is taking a bit of a breath. Here’s what that looks like:

Global disruption = wait-and-see.

  • There was concern about possible continued or exacerbated inflation and added pressure on the healthcare workforce, but beyond that the crystal ball stayed on the shelf.
  • Why? With Russia’s horrific invasion of Ukraine casting shadows, attendees were wary of looking too far into the future. “We don’t know” isn’t a particularly compelling take, but it’s a reasonable one in the face of today’s deep human concerns and economic volatility.

Plateauing pace.

  • Across the board, 2021 was an explosive year for healthcare PE investing, with several firms noting that they made a record number of investments in promising new technologies and unheralded opportunities to improve healthcare.
  • Yes, but: The result was a rise in valuations that attendees agreed was unsustainable. A common refrain was that 2022 will be a year of “refocusing” and “rebasing,” with valuations leveling off. One attendee suggested that this year will provide a “Zen” moment for healthcare investing.

Many paths to a deal.

  • While 2022 is expected to breathe, that doesn’t mean there won’t be opportunity. Between new family offices, European firms opening offices in the US, special purpose acquisition companies (SPACs)* and a significant reservoir of capital that firms may now be ready to deploy, there are more sources of funds than ever.
  • Plus: Transactions can go through faster, thanks to an accelerated transaction process brought on by the pandemic that shows no sign of reverting. Some bankers said they closed deals last year having never met the client or the buyer in person at all.
  • *Though still a reasonably popular financing mechanism, we heard rumblings that interest in SPACs is cooling. SEC Chairman Gensler has pushed his agency to come up with new, tighter rules surrounding SPACs, and the investment community is watching closely to see where it all lands.

Patients first.

  • As for what’s considered an attractive investment, attendees are continuing to keep their eye on anything that makes patient engagement better, faster, more convenient and less costly.
  • Think: Care in the home, outpatient settings or virtually, interoperability, value-based care and physician specialty roll-ups – to name a few.

Show, don’t tell.

  • There was a level of open pragmatism as the PE community discussed moving from investments based on the art of what’s possible back to those with defined execution and practicality on their way to creating value and improving delivery of care.
  • Put another way: Investing in what companies with a clear path to delivery vs. liberal promises to deliver.

Propping up people.

  • One attendee uniquely framed it this way: The healthcare services sector is fundamentally talent management.
  • Technology, care delivery models and process efficiency may get the headlines. But at its core, it’s people providing a service – a profound and personal service – to other people. Individuals doing that work are mission-driven, financial compensation isn’t the end-all-be-all, and labor is the number one challenge for healthcare today.
  • Therefore: In 2022 and beyond, health services companies must build meaningful cultures that make employees and clinicians proud to work there.

The last word.

  • The event itself was extraordinarily well-received by attendees. Here’s Jarrard Inc. partner and chief development officer Anne Hancock Toomey:
  • “McDermott did a phenomenal job creating an environment where people got to be together for the first time in two years and did it in a safe and fun way – outside in the fresh air and sunshine. More than 700 attendees from across healthcare investing. There was buoyancy among the crowd. Just so thrilled to be in person again.”

This piece was originally published over the weekend in our Sunday Quick Think newsletter. Fill out the form to get that in your inbox every week.

Arnold and the Art of Capturing Attention

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Note: This piece was originally published over the weekend in our Sunday newsletter. Want content like this delivered to your inbox before it hits our blog? Subscribe here.

The Big Story: Arnold Schwarzenegger speaks to Russians in emotional plea against war in Ukraine

A masterclass in communications.

The headline tells you exactly what happened late last week. But it comes nowhere near capturing the why, the how, the pure power of one public figure wading with deep authenticity into geopolitics. But powerful it was. Catching our attention. Holding us rapt. Moving us.

Watch it twice. Once to feel it. And then again to understand how it works.

We’re witnessing an extraordinary moment of powerful communications and communicators.

Russia’s brutal invasion of Ukraine has unleashed a parallel communications battle the likes of which we haven’t seen in this generation and which is beyond the scope of our weekly Quick Think. No surprise if textbooks are written about the situation, featuring, among other things:

  • The eloquent, razor-sharp messages – delivered through words and deeds – of Ukraine President Volodymyr Zelensky.
  • The harnessing of social media for “You Are There” journalism and “Are You Really There?” manipulation.
  • The Orwellian efforts by Russia to change the narrative against a sea of troubles, to block a tide of digital and tragically tangible information that cannot be denied.

But for today, we look at a single example from someone whose career trajectory broadly mirrors that of Zelensky – from kitschy actor to prominent politician. That training alone is worth noting when it comes to communications.

Outlandishly long in our distracted age of no attention spans, Arnold Schwarzenegger’s unexpected video – viewed by more than 30 million watchers within in 24 hours of its release – speaks directly to the people of Russia. We’ve captured several outstanding aspects of his compelling, at times personal message. If you take away just one thing, let it be this: The messenger must match the moment. Nothing brings home profound facts and difficult calls to action more than clear-eyed honesty and personal stories well and sincerely told.

Beyond that, a bit of video analysis…

  • It’s built for maximum reach. Schwarzenegger starts by telegraphing a basic communications principle. He says that he’s posting the video on multiple channels to make it as accessible as possible. It’s also subtitled in both Russian and English.
  • It’s built to target specific audiences. Difficult to pull off in a single piece, Schwarzenegger speaks sequentially to Russian soldiers, Russian citizens and Russian leaders – and then even more directly to Putin. The core message remains consistent as the specifics are adjusted for the audience. And in doing so, he is never manipulative. He tells viewers exactly who he’s speaking to – no games, no obfuscation, full transparency.
  • It’s direct about the goal from the start. Schwarzenegger begins by looking into the camera and giving a personal message to the people of Russia, expresses his life-long connection and affection for them, and then explaining where he’s going with it all. The environment is set to emphasize the directness and empathy: a tight shot of him at a table with a sober, but soft, expression.
  • It’s anchored by stories. After his intro, Schwarzenegger tells a story about his connection with Russia and the conflict that connection caused between him and his father – because of his father’s own painful connection to Russia from World War II. Throughout the remaining minutes, he continues to weave in personal stories.
  • It establishes credibility and rapport. Before detailing how the Russian people have been lied to, Schwarzenegger says, “No one likes to hear something critical of their government. But…as a longtime friend of the Russian people, I hope you will hear what I have to say.” By this point he’s already demonstrated his affinity for those very people. He also points out his consistency. He’s not targeting Russians but is “speaking with the same heartfelt concern” that he did to Americans after January 6, 2021.
  • It points no fingers (except at Putin and the Kremlin). He is surgically careful to separate the people to whom he is speaking from their leaders. He is explicit that they are not to blame. On the contrary, he assures them they have been misled. In effect, he comes alongside them with an arm around the shoulder rather than facing them down.
  • It’s methodical. Schwarzenegger knocks down the major points of current Kremlin propaganda one at a time. The Russian people, he said, have been told the invasion is a rescue operation to de-Nazify Ukraine. “This is not true,” he intones. He states facts and frames them with stories. Not only is Ukraine not being led by Nazis, but the current president is a Jew “whose father’s three brothers were all murdered by the Nazis.”
  • It offers emotional context for facts. For example, he shares the fact that civilian centers have been targeted and backs it up with the emotional stories and images from the deaths of mothers and children in the maternity hospital bombing. Even relatively dry data is given emotional weight. He doesn’t just say that the UN has condemned Russia. He adds that 141 members voted against Russia – with only four voting in favor.
  • It includes clear calls to action. Schwarzenegger asks the various audiences to understand they’re being fed propaganda and to consider that what he says is the reality. He asks people to spread the truth. He asks soldiers to consider the effects of the action they’ve been told to take. More than 11 million Russians have family connections to Ukraine and so, “Every bullet you shoot, you shoot a brother or sister.” He calls on Putin, by name, to end the invasion. But for every viewer, an unspoken challenge is clear: Now that you know, what will you do?
  • It ends with words of support and encouragement. To those Russians who have protested and spoken out he says, “The world has seen your bravery. You are my new heroes.” It’s true, and it helps the medicine go down.

A masterclass indeed.

This piece was originally published over the weekend in our Sunday Quick Think newsletter. Fill out the form to get that in your inbox every week.

The Quick Think: Engage Your Readers With This One Simple Trick

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Note: This piece was originally published over the weekend in our Sunday newsletter. Want content like this delivered to your inbox before it hits our blog? Subscribe here.

A good Monday morning to you: Today’s Quick Think is 773 words, a 3-minute read.

1 Big Thing: Axios Wants Us to Read Everything in Bullet Points

A four-year-old media company has risen rapidly to provide excellent reporting in an ultra-consistent, bullet-based format that is arguably changing the way we look at our inbox.

  • Katie Robertson, writing an Axios-style article in The New York Times, says, “The company’s executives think its short-format writing will build back trust in the media among busy audiences and can teach corporate America to quit its long-winded jargon.”

Why it matters: because in true absurdist fashion it gives us an excuse to pile on and, like the Times, pay our own homage to the newsletter phenomenon sweeping our inboxes. Seriously, we just checked our subscriptions and came up with Axios AM, Axios PM, Axios Vitals, Axios Sports and Axios Nashville. Not to mention competitors Morning Brew and 1440 Digest.

Why it really matters: Because the Axios style of communication works, and we see it every day with clients. Lament short attention spans all you want, but tight prose and well-written bullets are extraordinarily effective at getting the point across.

What’s happening: The rise of sound-bite newsletters is one of two things, or more likely a bit of both.

  • It’s the latest signal in the ongoing evolution of how America consumes media – short and sweet, but with rock-solid reporting behind the tiny word counts and templated format to capture our ever more fragmented attention.
  • It’s a market response to the interest people have in consuming a lot of information. Axios is communicating in a way that their audience tells them they want, but, impressively, with both high volume and a commitment to quality on every level from national to local.

Between the lines: During the pandemic, we observed – and may have occasionally participated in – the overwriting of a lot of content.

  • Provider organizations were trying hard to get large volumes of rapidly evolving, complex information out their communities.
  • Confusion and skepticism led many to use a lot of words. It’s very difficult to explain in soundbites how pandemics progress, or how a virus functions, or why we need the vast majority of the population to get vaccinated.
  • “During the pandemic we may have overcorrected from the Twitter approach and now we’re seeing a swing back to the middle,” mused our CEO David Jarrard. 

Reality check: The Axios model provides lessons for healthcare marcom, as well.

  • When navigating any kind of change, offer consistent, concise information through channels that your audience is already connected with.
  • That means building FAQ and toolkits your team can adapt with the details of any given situation, and then delivering those messages through email, posters, direct voicemail, townhalls, etc.
  • The ultimate goal is to give just enough detail to get the point across and drive a desired action. Then, if people want more or you need to backstop with additional data or context, you can point them to supporting long-form material – in Axios’ case, “Go Deeper.”

This piece was originally published over the weekend in our Sunday Quick Think newsletter. Fill out the form to get that in your inbox every week.

Special Report: Recruitment Starts with Retention

“Mom, today I found out how I can own my own store.”

Was that the first thing you said as a teenager coming home after your first day of your first job slinging guacamole at a fast-food restaurant? Nope? Wasn’t for us either.

But that did happen to a teen whose orientation at Chipotle included a pathway to go from line crew to store manager to franchisee. And what a profound lesson for healthcare organizations struggling with staffing, said Dan Collard, co-founder of Healthcare Plus Solutions Group, who recently shared the story with us.

As Collard sees it: Recruitment starts with retention when companies give employees a reason to stay and grow.

Healthcare’s persistent workforce shortage is one of the industry’s most daunting issues right now. Everything’s on the table: large sign-on bonuses, retention bonuses, raises as everyone competes to staff up, whatever it takes. Many, especially rural hospitals, are barely hanging on. A few numbers to illustrate the point:

BY THE NUMBERS

96

Rural hospitals having difficulty filling nursing roles

11

Increase in salaries and benefits reported by HCA in 2021

54%

Rural hospitals significantly increased reliance on travel nurses

75

Nurse leaders citing employee emotional health as key concern

We all know the problem illustrated by those numbers. But how did it get so complicated?

Social context. The great resignation is affecting every facet of the workforce, with retention of hourly employees particularly tenuous.

Damsky

Expectations for greater pay, better benefits, improved work-life balance, career development opportunities and a desire for a better connection with employers are leading employees to push for change and/or leave their position in pursuit of it. Nurses, techs and shared services employees are expressing those same expectations but with the added layer of the intensity of their work.

Different process. “How people are going about getting talent has evolved as nursing recruitment has been empowered by technology. That’s making it more costly and more competitive,” said Pamela Damsky, director and Performance Practice co-lead at Chartis.

Jung

Jeffrey Jung, engagement manager at Chartis, pointed to the rapid rise of placement firms and “matchmaking technologies” that help connect provider organizations with talent. Jung said the matchmaking software can increase the speed at which a nurse can be placed and make better matches on the front end to boost retention. “It’s cheaper than just using placement firms because of the technology, but the overall cost is increasing because there are so many more applicants being hired,” he said.

Jennifer O’Meara, senior digital strategist at digital marketing firm Eruptr,

O’Meara

said the recruitment campaigns her firm ran online before COVID-19 tended to be “as needed” and focused on RN recruitment. Now though, Eruptr is involved in comprehensive recruitment campaigns that run constantly across platforms. Budgets, she said, “are double and triple what we were running previously, and it’s not just SEM, it’s Facebook, it’s Instagram, it’s display ads, it’s YouTube… it’s everything.”

More competition. Atop increased cost due to shifting talent acquisition processes is the pressure to raise compensation through bonuses and higher salaries to compete with other organizations in the market for a smaller and, perhaps, more selective talent pool. Hospitals are vying for the same nurses and trying to fend off the travel firms. At the same time, nurses and other staff have far more options, with outpatient clinics and health services companies delivering outstanding care and offering attractive careers.

Frayed relationships. The pandemic has accelerated a breakdown between title bands. Leaders are working to keep the whole operation running, staff are keeping things clean and caring for patients, managers are liaising between the two. Nurses aren’t happy. They’re being asked to do more with less. The LinkedIn post from nurse Kelly Fassold illustrates it well. Fassold compellingly expresses the anger many nurses feel towards administration, regulators, hospital groups and anyone else trying to codify salary caps – or even just discuss nurse compensation. The relationship between administration and staff is broken, and nurses feel like they are – or actually are – on the outside looking in as discussions about their value take place. It understandably leads to the sentiment of being both disrespected and undervalued. “You’ve left us out of the conversation and you don’t understand what we do so how can you tell us what we’re worth?”

Surviving then solving the nursing shortage

The healthcare staffing crisis isn’t intractable, but it’s not going to be solved in the short term. Right now, healthcare execs and HR teams are doing whatever is necessary to have just enough staff on shift to deliver care. Whatever it takes. That only adds to the unsustainable feedback loop and the feeling that we’re in the middle of a land grab, making it that much harder to plan for the long term. But plan we must. In fact, we must redesign the whole thing.

To do that, we have to establish the environment for long-term change to take root. First, a few thoughts on the tactics hospitals and health systems can employ.

Current Tactics for Recruitment & Retention

Hospitals and health systems are activating a variety of strategies to staunch the bleeding of the workforce crisis. We’ve curated a list of short and long-term interventions in force today and arranged them by feasibility for different types of provider organizations. After all, very few health systems have the financial wherewithal to buy a nursing school the way HCA did with Galen College of Nursing nearly three years ago.

Remember that nursing challenges arise indirectly as well when other areas of the organization break down. Take environmental services. When that department is understaffed, nurses end up with additional responsibilities because who else will change the linens? It’s more rocks in the nurses’ backpack.

Collard referenced a health system that was struggling with retention among environmental services and other support staff. Leadership changed the employee onboarding process so that, instead of following up with new techs after 30 and 90 days, those conversations happened on days one and two. That kept new hires engaged and allowed managers to uncover questions and problems instantly rather than letting them fester, improving the likelihood that the individual would stick around.

Again, wise to stay vigilant on the indirect disruptions that spill over onto nurses and address them promptly.

Building a culture of retention

Our experts agree there’s no easy solution, and the hard, sustainable solutions involve completely rethinking how we deliver care. But then they cite something that absolutely can be accomplished: building a culture that makes people want to stay. And when people stick around, you save on acquisition and training costs, maintain workforce stability and naturally gain advocates who may recruit others.

But O’Meara cautioned: “If you have to talk so much about culture and sell people on it when recruiting, do you really have a good culture to begin with? Is that culture reflected once you get past the advertising and the recruiters who make you feel so great about everything? Is it reflected once a new hire gets into the clinical setting?”

When you look up “employee retention” on stock photography sites, this is a lot of what you’ll find. But this represents a “what not to do” approach.

Professional development

Collard

Back to guacamole. After telling the story of the young man’s first day at Chipotle, Collard drew the contrast with healthcare organizations. “On Day One, we’re more interested in getting people set up with their password for the electronic medical record and showing them which gloves to wear,” he said.

In the push to get people working on their floor as quickly as possible, there are so many priorities to check off the orientation list that nothing is a priority. In contrast, Collard asked rhetorically, what if hospitals were more like Chipotle? “What would it be like if we began to engage our clinical staff on the day they started?” He mentioned research findings that indicate nearly four of five millennials will take a job with lower pay if it’s a job they feel connected with and that provides them a clear career path. It’s not always about the money. (Although yes, the Chipotle post below does feature the money along with the career trajectory.)

Jung emphasized this point, too, but with less avocado and red onion. Before COVID-19 there was less enthusiasm for bringing in a new graduate “because they require so much hands-on involvement,” as he put it. That hesitancy to hire novice nurses and techs is changing, and what’s becoming important now for retention in a smaller labor pool is giving people a clear pathway to move and grow.

Carter

A specific example of this in healthcare comes from Dawn Carter, a veteran healthcare strategist and founding member of the Rural Healthcare Initiative. She said that from the moment they initially consider a healthcare career throughout their time with an organization, people need to see how they can grow in their job or grow into another one. Hospitals that are already helping finance additional technical/educational investments have a massive leg up – they should do everything to make those opportunities known.

Carter cited a speaker from the 2022 South Carolina Hospital Association meeting who suggested hospitals ensure that high school students understand the low-cost path to a high-paying job. Someone paying two years of technical college tuition and coming out of it with an RN can enter the market making $60,000, but there’s the potential for $200,000+ by pursuing a CRNA.

Another example? Take the entry-level hospital employees working in “central sterile” cleaning surgical equipment. The skill level is such that they could work at an Amazon warehouse for more money and skip the dirty equipment. Hospitals, Jung said, can and should create a defined career ladder for techs. Many techs are in nursing school, and if you create those relationships and provide the opportunities, they’ll eventually want to come back or continue employment when they graduate, he said. “It’s the difference between a very transactional, ‘We need you here’ and a relational, ‘We’re going to invest in you – and we’d love for you to go back to school,’” he said.

Nurse-manager relationships

Go back to that LinkedIn post above. The post, and several comments below it, are built on the idea that unless someone has done the job they can’t know what it’s worth. It’s a push against salary caps, but it also reveals the significant gap between the suits and the scrubs. And it’s a fair point. The system is broken, staff see their census and patient acuity steadily increasing and the message many hear from managers and administration is a combination of, “Keep going,” and, “We can’t give you what you want.”

But again, sometimes what people want isn’t necessarily money. “We need to be sure we have salaries that match the market, but it’s more than dollars,” Damsky said. “It’s also treating nurses with respect and meeting their needs and creating an environment where they want to be.”

Carter highlighted the desperate need for leaders to spend time with staff, having heartfelt conversations about what they’re experiencing and humbly – not defensively – discussing leadership’s position on the issues and the various imperatives they’re balancing.

Sometimes it’s effective for managers and executives to share their own stories. We’ve heard from clients whose leadership spoke during town hall meetings about their toughest moments during the pandemic. Showing that level of vulnerability was powerful and helped dampen some of the tension that had been building.

Note that these conversations shouldn’t be used as distractions from or substitutes for practical interventions. They should be a supplement, a way to both solicit helpful information about what staff need and to demonstrate that the organization is working towards a collective solution.

Leadership development

Over the past couple of years, particularly during the omicron surge, we’ve seen an increase in non-clinical staff stepping in to help fill gaps. There are stories of managers running to get blankets, leaders helping empty trash. It’s certainly not happening everywhere or all the time, but more frequently than ever before.

That’s all well and good…but interestingly, our experts noted that it’s not necessarily the best thing. Plugging holes is an important crisis response and it’s great for showing staff that leadership is engaged, willing to do whatever it takes. Even so, there are drawbacks. “Leaders have been rolling up their sleeves and diving in,” Collard noted. “If I’m in that position, it means I’m spending less time leading and more time doing on the unit.”

Reconsidering Compensation

NOT EVERYONE WANTS TO BE A TRAVEL NURSE

— Nurse A 🖤🩺 (@Nurse_Lyss) February 5, 2022

We reference compensation throughout this piece and noted that it’s not always about the money. Two reasons for that:

  • First, the key thing organizations should be providing people with is an environment that attracts them and keeps them engaged. Which, again, isn’t to say that our industry shouldn’t be taking a long hard look at financial compensation.
  • Second, the current money isn’t sustainable – for anyone, but especially rural and independent facilities. The key is remembering that different people want different things, and any given organization can highlight the things it offers that will be attractive to someone, if not everyone.

 

According to Eruptr’s Jennifer O’Meara, hospitals in bigger cities with more competitive markets are relying more on bonuses and the financial incentives, while rural facilities and systems lacking competition but without the financial wherewithal are focusing on the intangibles. Think quality and cost of living. She said that in many recruitment campaigns there’s less emphasis on the standard “great culture” line and “a big push in online campaigns and in discussions about how making this move can be better for your quality of life.”

Cessna

Joel Cessna, Eruptr’s vice president of sales pointed out another example of alternative compensation for rural locations and those that can’t compete financially: creative benefits packages. For example, five weeks of vacation vs. three. “That’s a critical thing nurses are looking for, especially when you think about the exhaustion and burnout today,” he said.

Organizations need to find ways to get leadership out of staffing and back into leading, while equipping them to lead effectively. It’s the management version of practicing at the top of one’s license. It doesn’t mean someone never steps in to do something that isn’t in their job description. It means they’re doing their best so that they can help those in their care and on their team do their best.

“Leadership development becomes really important,” said Damsky. “It’s the thing that falls by the wayside because who has time for it?” There’s a cost when leadership development is put on the back burner and, conversely, a clear benefit when it’s maintained. Damsky mentioned a client who tracks employee engagement against their organizational development work. “They ask questions like, ‘Does my manager make me feel valued?’ and track that against staff turnover. They’re looking for negative correlation,” she said.

Helping staff feel valued involves moving leader rounding beyond checklists and perfunctory appearances. Collard said that it’s training leaders and giving them the space to have relationship-centric conversations. He said, “So when a leader says, ‘How are you doing?’ it means, ‘I’m not just asking, I’m really interested. It’s just me and you right now. How are you? What do you need?’” Collard cited a large medical center where a high-caliber ER nurse quit suddenly. When the team did some digging, they found out she hadn’t left for an agency to make more money. Instead, there were things at home affecting her ability to stay at the hospitals. Per Collard, the nurse executive said, “Oh my gosh, if we’d only known, we could have done something to help her!”

Eventually, healthcare provider organizations will be able to shift some of the focus from the crisis of filling shifts to the long-term structural change that will make staffing far easier. Many had laid such groundwork pre-COVID. And there is an array of remarkable health services companies rolling out software and innovative care models to solve the problem. Artificial intelligence, remote nursing, hospital at home, standardizing meal prep across a system, automated revenue cycle – everything that will put nurses and staff in a position to do what they do best and offload much of the rest.

We’re not there yet, but the foundation is in place and the frame is starting to take shape. In the meantime, provider organizations must step back to ensure that even as they continue the necessary scramble to fill shifts, they’re laying the groundwork. That means giving everyone in the organization permission and practical support to keep going. Starting on Day One.

A Note on Nursing Labor

Nurses unions have been talking about staffing levels and compensation for years. Now, the conversation has come to them. Hospital advocacy groups could push back saying that it didn’t make sense to implement rigid staffing requirements; organizations of different types and sizes and locations needed flexibility. But on the heels of the pandemic, staffing has become a core concern, both among the public and healthcare workers – a point proven by the most recent Jarrard Inc. national survey.

47

The public citing staffing shortages as a top concern

64

Healthcare workers citing staffing shortages as a top concern

In addition, the business side has come to the forefront, and with it a rising skepticism among nurses and staff about the intentions of their employers. Some feel organizations are holding patient care over nurses’ heads while, in the background, pushing the business forward. The response is essentially: “We can’t be the only ones carrying the weight of our mission. If you expect us to be the only mission-driven people, we’ll go travel or organize and strike.” In addition, the employee-manager relationship is starting to ring hollow. Historically, a core argument against organizing is that a union only adds complexity, getting in the way of those direct conversations. But more and more nurses are feeling – or recognizing – that they don’t actually have that relationship and their voice isn’t valued. In that case, they’re not giving anything up by bringing in a third party.

There’s no easy fix for provider organizations. The solution is long term – doing the slow, hard work of engaging employees, giving them a real voice in conversations and training leadership to lead effectively. Before making any statement about valuing nurses’ input or taking any action to ostensibly boost engagement, ask whether the move represents a true, long-term commitment or is simply lip service, an attempt at a quick fix. Worried about organized labor? Give people a way to not need that third party.

Questions about employee engagement? We can help.

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The Quick Think: The Lorax

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Note: This piece was originally published over the weekend in our Sunday newsletter. Want content like this delivered to your inbox before it hits our blog? Subscribe here.

2-minute read

The Big Story: Staffing overtakes financial challenges as top concern among hospital CEOs, survey finds

The workforce shortage is perhaps the biggest topic of conversation across the industry right now. While some providers and staffing agencies are offering large sign-on bonuses, others are going for retention bonuses and raises. Everyone is trying to staff up, whatever it takes. Many, especially but by no means exclusively rural hospitals, are barely hanging on.

What it Means for Our Healthcare System

Pandemic shortages accelerated the growth of temp and travel nursing, effectively changing the compensation model for RNs. That’s created a feedback loop where the shortage has become both cause and effect. Hospitals can’t maintain the tab for travel nurses – yet many can’t properly staff up without them. The jaw-dropping $40,000 signing bonuses are stopgap and not sustainable.

Dawn Carter, a veteran healthcare strategist and founding member of the Rural Healthcare Initiative, likened the situation to The Lorax, Dr. Seuss’ foray into environmentalism that describes the dangers of overusing a resource to the point that it disappears. We need nurses, and they deserve to be well-compensated. Full stop. It’s incumbent on us to design a system that allows that to happen. A system that sustains the forest.

While many are working feverishly to discern the long-term foundational changes necessary to compensate caregivers what they’re worth while keeping labor costs manageable, the land-grab nature of the current healthcare recruitment push continues. And it just might be catastrophic for smaller providers who can’t keep up.

We’re not parachuting in with 750 words to solve a very complex problem. But we do think Carter’s insight on how provider organizations, particularly rural and independent hospitals, might mitigate the damage now with their existing staff – is imminently shareable. Her suggestions cover both tactical interventions and messaging.

An extra week off. Literally, give your staff an extra week off. Maybe two. More hospitals are taking this approach because that time away may help with burnout and is a relatively low-cost benefit to the employee. Many hospitals are already offering other smart benefits – subsidizing gym memberships, meal delivery services and so on. But if we’re talking about people who are thinking about leaving, giving them extra space to recharge may be a wise step towards keeping them.

Professional development. What else can your employees do? Whatever it is, show them that. From the moment they first consider a healthcare career through their entire time with your organization, make clear the ways a team member can grow in the job or grow into another one. Many hospitals are already helping finance additional technical/educational investments. They should make those opportunities known.

Carter cited a speaker from last week’s South Carolina Hospital Association virtual meeting who suggested hospitals ensure that high school students understand the low-cost path to a high-paying job. Someone paying two years of technical college tuition and coming out of it with an RN can enter the market making $60,000, but there’s the potential for $200,000+ by pursuing a CRNA.

Clarity. Carter noted that much of the money paying for those stopgap measures like travel nurses is stopgap funding (federal stimulus and relief dollars). It’s temporary. This is an important point to make when addressing staff nurses who are justifiably frustrated seeing the compensation packages for their traveling peers while they’re receiving far lower raises/bonuses. Hard conversation, but it’s worth sitting down with staff to really talk about the current dynamics and explain why those levels of compensation aren’t sustainable as the one-time relief funds run out. Yes, you’ll still hear questions about why that one-time money is going to temps and not staff, but it will hopefully provide helpful context.

Connection with leadership. The critical message is that the core problem is a broken system, not uncaring leadership. This is no time to be defensive and complain about trying to operate a hospital in today’s brutal environment, especially with nurses who’ve been stretched beyond reason by the past two years. The point, rather, is to have deep, heartfelt conversations with staff about leadership’s position on the issues and the various imperatives they’re balancing.

To imbue those messages, Carter underscored the enduring value of leader rounding and one-on-ones. Find time to build relationships with staff, listen to their concerns and show genuine humanity. Sometimes that means telling your own story, too. We’ve heard from clients whose leadership spoke during town hall meetings about their toughest moments during the pandemic. Showing that level of vulnerability was powerful and helped dampen some of the tension that had been building.

Note that these conversations shouldn’t be used as distractions from or substitutes for practical interventions. They should be a supplement, a way to both solicit helpful information about what staff need and to demonstrate that you and the organization are working towards a collective solution.

This piece was originally published over the weekend in our Sunday Quick Think newsletter. Fill out the form to get that in your inbox every week.

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The Quick Think: Nursing Gigs and Workplace Culture

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Note: This piece was originally published over the weekend in our Sunday newsletter. Want content like this delivered to your inbox before it hits our blog? Subscribe here.

3-minute read

The Big Story: The gig economy is trying to solve health care’s burnout crisis

Nursing on demand? Is it shape of things to come?

Startups are building platforms to plug nurses looking for shifts into organizations with shifts to fill. Sorta like if you needed a ride and there was an app to connect you to a driver. (Someone should look into that.)

Point is, tech platforms can ostensibly help organizations staff up to the levels they need while giving nurses more control over where and when they work.

What It Means for Provider Organizations

Seeing caregivers leave for more flexible roles is one of many things putting a pit in the stomachs of healthcare executives. It’s painful for acute care providers, yet the idea of a nursing gig economy makes a lot of sense when we look at the convergence of two ongoing trends. And the ball is in organizations’ court to respond in a way that attracts, retains and supports those looking for more control.

We know nurses are burned out. Many feel disconnected from their employers. And 40 percent of healthcare workers employed within a health system don’t see that environment as their ideal. Instead, they’d prefer travel nursing, health tech, maybe even those enticing flexible gig jobs.

We also know hospitals are getting flak for being greedy Big Business. A recent New York Times video blames the deficit of hospital caregivers on hospitals’ intentional understaffing to increase their margins. These examples go right to the heart of what our research shows is a perceived gap between hospitals’ missions and their approaches to the business of healthcare. And that gap is part symptom and part source of the unsettled workforce.

When it comes to nurses, the problem is that if you can’t give these thoughtful, mission-oriented individuals an environment where they feel supported, connected or even sure that you’re prioritizing patients over money then they’ll look to leave for higher pay, a more comfortable work environment or both. Who wouldn’t?

This presents a brilliant opportunity for health services and health tech companies. If healthcare workers aren’t sure a big hospital is their ideal, then other types of providers can that professional home. Which means that today the competition between provider organizations is real and, unfortunately, there’s a zero-sum element to the whole thing.

Question is: How can we use this great reshuffling and try to get away from a zero-sum recruiting battle? Can we better support caregivers and help the right people land in the right roles, whether that’s at a huge national system or an innovative specialty clinic?

We think so, and the approach is right up Marcom’s alley:

Build personas. Consider the people you need in those nursing roles and who might want them. Younger nurses may be harder for hospitals to recruit now if they’re not tied to one place and would like to travel and make more money while doing it? Others may relish an exciting stint as a staff nurse in your level one trauma unit. Nurses with families or later in their career may be looking for the stability and consistency. Different personas are looking for different things. Know what those things are.

Learn about preferences. The best way to find out exactly what people are looking for is to ask. Yes, money may be one of the things that comes up, and it’s fair to note the discrepancy between a staff nurse’s hourly pay and that of the travel nurse filling a vacancy in the next room. But it’s not always money. We’ve heard from health systems that, based on their surveys, what employees are looking for is relatively simple. They want to be heard and recognized for the work they do. And they want to know what’s going on with the organization. Yes, financial compensation is sometimes part of it, but not all.

Show what you can offer those targeted personas. Maybe it’s the benefits and career advancement available in a large system. Or the entrepreneurial vibe and relative independence of a young health services company. Highlight how you’re unique and speak directly to those who find those characteristics compelling. Basic marketing.

Solidify your culture. Concurrent with your recruiting efforts, reinforce your good culture so current employees stay and newcomers join – and stay. You can’t fake culture. For hospitals, that means not just paying lip service to something like “having a direct relationship with our nurses.” It’s actually having a direct relationship with nurses and being able to point to exactly how you’re doing it.

A note on sustainability: Building meaningful culture requires talking and listening to employees on a regular basis. It entails aligning your recruiting and HR efforts. Organizations with success in their staffing campaigns have a chief nursing officer working closely with HR and the strategy team. With the reality of limited resources, efficiency will be a watchword in healthcare going forward. Make sure you’re aligning everyone towards the common goal of staffing.

Want more? Listen to partner Kim Fox and senior vice president Tim Stewart discuss culture and communications in our latest podcast.

This piece was originally published over the weekend in our Sunday Quick Think newsletter. Fill out the form to get that in your inbox every week.

Special Report: Aligning Needs, the Sound of Silence and Healthcare Predictions for 2022

The numbers "2022" in front of a blue background, with the "0" being a magnifying glass with the words "healthcare predictions" in the circle

Try and predict the future? It’s exactly what we all do in mid-December.

This week, we checked around with friends in our network for their takes on 2022. Friends from investing, legal, a hospital association, strategy and planning and rural healthcare.

We asked them about challenges, investing, partnerships, trust, the media – and what gets them up in the morning when they think about healthcare.

Notice that we don’t quote our clients – healthcare providers. They’re impossibly covered up and looking towards another tough year, so it’s just not a great time to bring out the crystal ball.

Several clear themes emerged. Full quotes from the interviewees follow the themes section.

Staffing alarm bells are ringing. The cost of labor is going to put a crimp on provider operations, with unsustainable travel nursing rates on one side and healthcare workers leaving (due to burnout or mandates) on the other.

Behavioral health will be a point of emphasis. The pandemic laid bare what many in the mental/behavioral health space had long been saying: Our system of caring for behavioral health isn’t good enough. Several respondents market this space as one to watch in 2022.

Technology is poised for a breakthrough. More AI, more digital tools, more ways for patients to engage with providers on both their physical and mental health needs. At the same time, technologies that saw significant growth during the pandemic – most notably telehealth – will be reassessed to bring them back in line with a more natural, sustainable level. All of this came with the caveats that 1) regulation needs to keep up and 2) we need to see proof from the many digital health companies that have taken significant investment in recent years.

Value is coming (finally?). Value showed up as both a challenge and recipient of big investment. Partnerships that advance value-based arrangements also got a nod. Now that more primary care groups have waded into value and taken on more risk, expect to see the same for specialty practices.

The sound of silence. Just as interesting as what was said might be what wasn’t. While no providers were officially interviewed, we understand from our client base that following two incredibly challenging years in the trenches, no one’s really comfortable looking into the crystal ball at year three. Providers quietly tell us it’s going to be a very tough year for them, with ongoing uncertainty. That caution and concern is a theme in and of itself.

Transparency matters in all respects. Respondents who addressed “building trust” synced on this: Communicate, and do it clearly. Be open about pricing (and not just because CMS said so).

Care models must shift. We mentioned telehealth above. Hospital at home also got a shoutout. All told, a combination of better technology, patient expectations, the steady march towards value and the influx of investment for new entrants is pushing care out of hospitals and into, well, anywhere else.

Payer-Provider relationships will thaw. Multiple respondents suggested that payer-provider partnerships will be successful contributors to the move towards value. The implication seems obvious: Delivering the care and paying for it in the most efficient way will force collaboration between often antagonistic stakeholders. As Jesse Neil of Waller put it, “The traditional ‘zero-sum’ relationship has changed.”

Needs are aligning. Dawn Carter, founder and senior partner at Ascendient, summed it up well with a story about robots delivering food in a restaurant due to workforce shortages. It’s an anecdote that demonstrates how a reduced pool of labor, improved technology and the need for reduced cost and streamlined operations can flow towards a single solution.

Dawn Carter

FOUNDER & SENIOR PARTNER

Ascendient

Where do you think the biggest investments will be made?

Non-traditional sites of care, such as hospital@home and more virtual/high-tech options. I’m hearing more and more conversations about addressing behavioral health, particularly in light of how the pandemic has exacerbated what was already not working.

What will be the biggest driver of change for healthcare?

  • Workforce challenges, which should be driving innovation. There was a recent news story about a robot delivering food in a restaurant because of staff shortages…That technology has been developed in less than two years. We are woefully behind in healthcare in terms of using AI/technology to reduce our dependence on humans.
  • Payors – public and private – with a continued push to true value-based payment models, including CMS’ goal for all beneficiaries to be in value models by 2030.

What are you most excited about for our industry in 2022?

Opportunity is ripe for extreme innovation. Who will step out of a traditionally-minded industry and take advantage?

What's the biggest challenge facing healthcare providers?

Dawn Carter

FOUNDER & SENIOR PARTNER

Ascendient

 

Human resources, particularly retaining sufficient levels of direct care providers. Premium pay for a high percentage of travel clinicians is not sustainable, yet the pandemic has exhausted the workforce, particularly nurses. I recently heard of an RN in her early 30s who has worked a COVID unit at an academic medical center since the start of the pandemic. She’s leaving because she can’t do it anymore and is taking a job working from home.

Eller Kelliher

MANAGING DIRECTOR

Jumpstart Foundry

What's the biggest challenge facing healthcare providers?

No question, it’s talent recruitment and retention. Nurse and physician burnout has been an issue facing the healthcare industry for many years, however, the COVID-19 pandemic (starting to turn endemic) has put further strain on individual providers. Whether it’s doctors, nurses or administrators, this challenge is top of everyone’s mind.

Where do you think the biggest investments will be made?

  • The biggest investments will be in technology that optimizes and extends the efforts of existing personnel. There has been a massive flood of capital into digital health/healthcare IT in the last year and I believe we’ll continue to see investors fueling innovation.

What will be the biggest driver of change for healthcare?

COVID-19 changed the way that individual patients engage with their providers and in some ways empowered them to take a front seat role in their own health decisions. That said, I believe evolving payer-provider relationships and their incentive to drive utilization will be a major force for change in the industry. It will shift not only how care is delivered, but also the roles each party plays in the overall system.

Where do you think we’ll see the most / most successful partnerships?

Over time, I think we will continue to see the industry move towards stronger payer-provider relationships. However, I’m particularly excited and bullish on the idea of retail brands – who have built a lot of trust with consumers – partnering with providers to drive both access and engagement with hard to reach patient populations. Retail brands have the opportunity to impact accessibility, affordability, and possibly even adherence. (Think of how much power brands have in influencing consumer behavior!)

What’s the one thing healthcare organizations should do to build trust with patients and the public?

Be transparent with patients and treat them like consumers who have CHOICE. This is something I’m hopeful for in 2022, but know will likely take years for the industry to actually implement.

What impact, if any, has the media had on healthcare in 2021?

It’s hard not to say that the media continues to drive division and skepticism in our country. However, as it relates to healthcare, I believe the media helped facilitate the adoption of new models of care and certainly the acceptance of telemedicine as a trusted option for care.

What are you most excited about for our industry in 2022?

We all know that the healthcare industry is slow to change, but the pace of innovation has never felt faster or more urgent than it does now. I’m excited to see how the dynamic between payer, provider, and patient shifts in 2022 and how willing each party will be in the change that seems inevitable and, frankly, needed.

What's the biggest challenge facing healthcare providers?

Staffing a facility has always been a difficult, but necessary challenge. It was surprising that some health systems were so quick to lay off workers during a shortage. This was compounded by inevitable lawsuits against the Executive Branch vaccine mandate. In 2022 and beyond I think systems will wait for the legal dust to settle before jumping the gun.

Where do you think the biggest investments will be made?

In terms of the most common investments, we’ll see IT expansion and upgrades. Relative to the most significant cost, it’ll be hospitals investing more in ambulatory care.

What will be the biggest driver of change for healthcare?

Payment expansion for telehealth along with federal legislation allowing telehealth state to state.

Where do you think we’ll see the most / most successful partnerships?

Academic health systems and community hospitals.

What impact, if any, has the media had on healthcare in 2021?

Continued expansion into telehealth, especially in the rural space.

What's the biggest challenge facing healthcare providers?

Ongoing pandemic concerns and the incredible toll that the pandemic has placed on clinicians. There is a continued threat of variants that may be resistent to vaccines that will continue to place significant stress on health systems and further erode their revenues. Coupled with that will be a workforce that is burning out due to stress, mental and emotional fatigue and politicization of healthcare in what seems like an endless war against COVID.

Where do you think the biggest investments will be made?

Over the past few years, we have seen an increase in the number of megamergers of regional/national health systems, as well as an increase in the aggregate value of the combined health systems. We expect that this trend will continue as one of the biggest investments in healthcare. In addition, expect to see a tidal wave of investments in digital health and artificial intelligence.

What will be the biggest driver of change for healthcare?

The consumerization of healthcare. Patients now more than ever have a voice in their healthcare, and that is requiring providers to respond to patient demands, whether in terms of the site of care, the manner in which a patient receives care or transparency in pricing. In addition, these expectations are now bringing new and nontraditional entrants into the market, and they are further driving change.

Where do you think we’ll see the most / most successful partnerships?

Healthcare organizations should collaborate with community partners that are representative of the different constituents within the community. This will allow for advancements in combating healthcare inequities. As part of this collaboration, healthcare providers should listen and take constructive feedback from their community partners and use this information to enact positive change.

What are you most excited about for our industry in 2022?

Historically, the healthcare industry has been slow to adopt change, even when change was clearly required and long overdue. We are now in an era of change that is occurring at lightning speed, and it’s exciting to see the advancements in how care is delivered, the use of technology and AI to create better clinical outcomes and provide for a better patient experience, recognition of social determinants of health and the role it plays in an individual’s health outcomes. In the midst of incredible adversity, our industry has worked collaboratively to save lives and in the process make considerable advancements, and I’m looking forward to seeing the evolution of changes in 2022.

Jesse Neil

PARTNER

Waller

What's the biggest challenge facing healthcare providers?

The uncertainty around the demand and permissibility of telehealth services is a wildcard for 2022. It’s no secret that physicians’ use of telehealth increased dramatically during the COVID-19 pandemic in 2020—jumping from 25 percent of physicians in 2018 to almost 80 percent of physicians in 2020, according to the American Medical Association. While some heralded the trend as a new day in healthcare, a closer look shows that telehealth use may continue to flourish in some limited areas, such as mental health or chronic care management, but that overall usage rates may settle back into more normal levels. Additionally, many of the emergency telehealth rules put in place during the pandemic have expired—meaning that many states will need to make regulatory changes to allow for the continued widespread use of telehealth services.

Where do you think the biggest investments will be made?

Collaboration with other providers has become an important tool for healthcare companies across the care spectrum, and that remains the case as we approach 2022. Valuations are strong across the board, and behavioral health, telehealth, dental and healthcare IT are of particular interest for private equity firms and other investors. Sellers are commanding higher valuations as a result of increased competition between buyers. An increase in home-based services has also been an area of increased valuations and interest, as has the orthopedic space, which notably leads the way in the shift toward value-based care among physician practices.

What will be the biggest driver of change for healthcare?

Providers, operators, investors, and policymakers agree that home-based healthcare options are transforming how healthcare is delivered and the economics that drive it. Regardless of the specialty, care at home implicates a discrete set of local, state and federal legal issues. At the same time, the regulations have not fully caught up with the various business models being adopted, and CMS and states are actively experimenting with waivers, pilot programs, and new reimbursement methodologies. Anticipating this trend, we have seen increased investment by providers, payors, and private equity firms into both provider platforms and technology companies that facilitate care at home.

Where do you think we’ll see the most / most successful partnerships?

The traditional “zero-sum” relationship between providers and payers has changed and they are no longer in their own silos. Post-acute care providers are likely to find ways to leverage clinical excellence to partner with payers and assume up- and down-side risk under value-based arrangements.

What’s the one thing healthcare organizations should do to build trust with patients and the public?

Carefully-calibrated transparency across the board but in particular clinical outcomes and pricing.

What impact, if any, has the media had on healthcare in 2021?

I can’t remember a year where the media had a bigger impact on healthcare than 2021 – except perhaps 2020. I think policymakers are realizing that the media is one of the most important stakeholders when executing on public health initiatives. I don’t think any agency or media outlet has found the “secret sauce” but that responsible media coverage will be rewarded in the end.

What are you most excited about for our industry in 2022?

Providers are actively experimenting with the new value-based regulations to take advantage of the added flexibility. If our healthcare system is equipped to do anything, it is to innovate in terms of technology and, increasingly, delivery models. I’m excited to see patients reap the benefit. Getting healthcare spending on a sustainable path is one of the biggest domestic public policy challenges we have in front of us, and these new regulations are a step in the right direction.

Shawn Rossi

VICE PRESIDENT OF COMMUNICATION & MEMBER ENGAGEMENT

Mississippi Hospital Association

Where do you think the biggest investments will be made?

Technology – specifically EHR APIs and telehealth

Where do you think we’ll see the most / most successful partnerships?

Wide-scale collaboration between payers and providers, community-based organizations and hospitals, and public health departments and hospitals.

What impact, if any, has the media had on healthcare in 2021?

The media has both helped educate the public about COVID-19 and contributed to spreading misinformation. “Media” is too broad a term to consider as one these days with all of the niche news.

What are you most excited about for our industry in 2022?

A growing determination by hospitals to begin work on community health and affect social determinants of health.

What's the biggest challenge facing healthcare providers?

The biggest challenge facing healthcare providers in 2022 is a combination of a few factors:

  • Rapidly approaching compliance dates for rulemakings that have important implications for how hospitals do business;
  • The continued uncertainty surrounding the public health emergency; and
  • Diminishing public support for healthcare providers.

In many ways, regulators have returned to “business as usual,” with new or revised rules becoming effective in January 2022. However, healthcare providers are still experiencing waves of COVID, but this time with lower staffing rates and without the public support for healthcare heroes seen in 2020. In addition, many waivers that have been a lifeline to healthcare providers during the public health emergency (PHE) – from hospital at home services to the expansion of telehealth services – are at this time set to expire in January 2022, with little to no time built in for providers and their patients to gradually transition away from these flexibilities. While the PHE is likely to be extended, the pressure on healthcare providers – from staff nurses to the c-suite – to navigate such significant changes simultaneously while COVID measures are still very much in effect will be the biggest challenge for providers in the year ahead.

Where do you think the biggest investments will be made?

I expect to see investments in both organic and inorganic growth. With regard to organic growth, hospitals and health systems are focusing investment in services lines that have gained traction and reimbursement parity during the PHE. For example, hospital at home services, as well as digital health across practice areas – not just behavioral health, but also in areas in physical therapy and primary care. Wellness programs and wellness tools are also experiencing growth through commercial payer investment to help people take control of their own health beyond seeing their primary care providers. In general, areas that can empower patients to engage with their care and allow healthcare providers to provide much-needed care at lower costs are likely to win the year. In addition, many providers are “back on track” with regard to strategic acquisitions and affiliations in core business areas.

What will be the biggest driver of change for healthcare?

New market entrants and non-traditional players in healthcare will continue to be one of the biggest change drivers for healthcare in 2022. We’ve been following this trend for several years now and the past two years have underscored that the challenges facing healthcare and the demand for innovation are things that cannot be tackled in siloes. Perspectives from new healthcare entrants like retail and tech, the influx of funding from PE and VC investors, partnerships between traditional healthcare companies and new entrants, and collaborations between providers in different services areas or markets, are all drivers of change that will shape not just 2022, but the next several years in healthcare.

Where do you think we’ll see the most / most successful partnerships?

Some of the most successful partnerships will be ones that improve the patient care experience while seamlessly working within clinician workflows. Whether these partnerships are between “traditional” providers, or among traditional providers and parties from outside the healthcare space to launch something completely new, the successful ones will be where and the product or solution supports patients without overburdening clinicians, all while fitting within the complex healthcare regulatory landscape. It’s a tall order, but from what we’ve seen, parties are more than up to the challenge.

What are you most excited about for our industry in 2022?

Continuing to see what comes from the novel partnerships between hospitals and health systems and other market participants, as getting the best of both worlds working together on bold innovations is truly exciting.

Principal

Private Equity

What's the biggest challenge facing healthcare providers?

Increasing labor/other input costs and declining reimbursement. Providers will seek to adapt, and think this will accelerate a shift towards value-based arrangements to get paid for the value they deliver to patients and payers.

Where do you think the biggest investments will be made?

Specialty value-based care. As risk-bearing primary care groups seem to optimize their performance, there will be increasing focus on specialties and moving towards value-based care. Also much more focus on technology enabling provider groups and health systems to optimize performance and care delivery redesign.

What will be the biggest driver of change for healthcare?

A shift to value-based care over the next several years and its impact on improving patient experience and outcomes. Also expect to see more emphasis on preventative care versus reactive care.

Where do you think we’ll see the most / most successful partnerships?

Enablement of value-based care, with providers better enhancing payer-provider collaboration.

What impact, if any, has the media had on healthcare in 2021?

The media has highlighted the importance of providers and the services they deliver and trust built between the public and healthcare providers. It will be important to expand on that over the next several years and elevate care delivery to meet and exceed consumer demand.

What are you most excited about for our industry in 2022?

Continued change that improves quality, reduces cost, and enhances the patient experience. Consumer expectations are increasing and we are being forced to keep up.

Bite Your Tongue or Speak Up?

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Note: This piece was originally published over the weekend in our Sunday newsletter. Want content like this delivered to your inbox before it hits our blog? Subscribe here.

The Big Story: The CEO “Talking Trap”

CEOs, you might want to bite your tongues.

A new survey from the Brunswick Group says you’re overestimating the necessity and effectiveness of your organization’s communication on social issues. Yes, there’s enormous pressure on organizations to respond to everything that’s happening. But doing so without careful consideration can come off to the public as inauthentic. “The effort may come from a place of earnest engagement, but it is not being perceived that way,” the report observes. So if you choose to talk the talk, your organization needs to walk the walk.

What it Means for Your Health System

For leaders, the decision to speak is fraught. The Brunswick Group refers to it as “the talking trap.”

Basically, while corporate intentions around speaking up on hot social issues may be well-intentioned, audiences are disregarding these efforts due to “the broad alienation that most Americans (Democrats and Republicans) feel toward people and institutions of power.” If communications about an issue are poorly received, there’s the potential for them to be reputationally harmful.

Yet at the same time, we know there are times when leaders do need to speak. That’s part of being a leader, isn’t it? And with everything going on in the world, the range of topics on which they might be asked to weigh in is wider than ever.

So then how to do it effectively? The Brunswick Group report closes with excellent general recommendations to avoid the talking trap. Read them all – after you finish this note with ideas tailored for healthcare leaders and marcom officials.

It all boils down to integrated communications, similar to integrated care teams. The core structural issue is to know who’s in what lane and to coordinate appropriately. When clinicians aren’t aligned, they step on each other’s toes, information gets lost and patient care suffers. Similarly, communications efforts can be derailed by too many people trying to offer their own version of the message or offer it at the wrong time. When dealing with sensitive topics like social issues, the results can be damaging.

Consider these steps to ensure your message is received with the authenticity intended.

  1. Speak well – within your lane. You and your organization are experts on healthcare, and the public does want to hear from you on the things you know. Previous Jarrard Inc. surveys have shown that the public expects providers to speak up on healthcare topics. So before getting deeply involved in a range of issues, ensure that you are clear and consistent, firm yet humble, on the topics directly related to your work. 
  2. Do well – within your lane. Back up your message with actions. Better yet, back up your actions with your message. The Brunswick Group emphasizes the importance of tangible and significant investment (financial or otherwise) in causes related to the issue. For hospitals, that’s likely community partnerships and charity care. It’s also your work to support employees, professional development opportunities, and defined, financially-backed programs to help close racial disparities within the organization. Your mission is strong, so make sure the work you do reflects it.
  3. Recognize that there is more than one lane. “Health” encompasses so many issues, and we’re seeing a growing conversation about how social issues are health issues. Granted, we just suggested building credibility by staying in your lane. But that’s a lot harder when your lane is very wide – or when there are multiple lanes. Basically, your team needs to define the terms and come to some internal consensus on how you view the continuum of health and the myriad factors that contribute to it.
  4. Define who can and should be speaking out in each lane. One way to handle the complexity and the expectations is pretty standard: Break the work up into manageable bites. Within your organization you have nurses, administrators, physicians, social workers, care navigators and so many others. Find the right individuals within these roles to talk about the issues most closely aligned with their work. Social workers can talk about mental health or homelessness. Leadership can talk about the delivery of care to different communities. With people in the right spot, there’s minimal stepping on toes.
  5. Coordinate, prepare and activate. Whether it’s one person who will be speaking or five, define the expectations. For example, what’s appropriate for people to say as representatives of your organization – versus on their own time? As always, bring in outside voices like community leaders to help inform your thinking on the issue and your approach. Set up mechanisms for feedback – even if it’s uncomfortable. That in itself goes a long way towards demonstrating your authenticity and commitment. Finally, go out and speak – humbly, kindly, quietly but firmly – acknowledging what you know to be true and what you’re still learning, as well as how you and your organization are responding.

This piece was originally published over the weekend in our Sunday Quick Think newsletter. Fill out the form to get that in your inbox every week.