Healthcare News of Note: Many health system boards find they are poorly equipped to institute DEI changes, says survey

• Most health systems are committed to updating their governance models, including by redefining who should serve on the board as well as modernizing outdated structures, but change is slow, according to a report.
• Many hospitals across the U.S. are hiring nurses from abroad to ease a critical shortage that has been worsened by the pandemic.
• “Devastating” is how U.S. Surgeon General Vivek Murthy described the effect of the pandemic on the mental health of the nation’s youth, in a report published in December.

Over the last few weeks, I have found these industry news stories that should be of interest to healthcare finance professionals.

1. Health systems move slowly toward change when it comes to diversity, equity and inclusion

Most health systems are committed to updating their governance models, including by redefining who should serve on the board as well as modernizing outdated structures. But change is coming slowly, according to a report by WittKieffer in partnership with the Health Management Academy.

“Amid the COVID-19 pandemic and sweeping social change, healthcare boards rededicated themselves to matters of diversity, equity and inclusion,” the authors wrote. “Many health system boards have found, however, that they are poorly equipped to institute change, and that their governance structures are no longer designed to fully support their strategic visions.”

Key takeaways

The report’s findings, which are based on a survey of executives from 25 leading health systems, include the following key takeaways.

• While 78% of leading health systems surveyed had a systemwide health equity strategy, only 3% reported having health equity expertise on their board. According to the authors, “There is a significant disconnect between boards’ diversity goals and their implementation.”
• Current recruitment practices are inhibiting diversity goals. Many boards have outdated policies and procedures (e.g., extended terms, no age limits) and use legacy recruiting practices (e.g., relying on their own peer networks) that prevent them from diversifying their composition.
• Boards have set clear goals on diversity, recruiting and health equity but have yet to implement many changes that will help them meet these goals. 

Variety of professional backgrounds needed

However, change is afoot. The authors noted that although about a third of board members still have traditional backgrounds in finance or strategic planning, survey results show boards are adding professionals with expertise as follows:

• Workforce – 7%
• Consumerism – 6%
• Diversity & inclusion – 5
• Health equity – 3%

“Health system boards also expressed interest in recruiting leaders with community engagement, real estate, and business innovation backgrounds, but haven’t added these skillsets at scale,” wrote the authors.

2. U.S. hospitals hiring international nurses to ease shortages worsened by the pandemic

Billings Clinic, in Billings, Montana, is just one of the many hospitals across the U.S. looking abroad to ease a shortage of nurses worsened by the pandemic, according to a Jan. 7 Kaiser Health News (KHN) article.

“The national demand is so great that it’s created a backlog of health care professionals awaiting clearance to work in the U.S.,” wrote Nick Ehli. “More than 5,000 international nurses are awaiting final visa approval, the American Association of International Healthcare Recruitment [AAIHR] reported in September.”

A ‘boom’ in requests

Lesley Hamilton-Powers, a board member of AAIHR and a vice president for Avant Healthcare Professionals in Florida, said in the article: “We are seeing an absolute boom in requests for international nurses.”

“Billings Clinic would hire 120 more nurses today if it could, hospital officials said,” wrote Ehli. “The staffing shortage was significant before the pandemic. The added demands and stress of covid have made it untenable.”

Staffing shortages nationwide

Nearly 23% of hospitals across the country were reporting staff shortages, according to a statement to the Associated Press by American Hospital Association CEO and President Rick Pollack, as cited in a Jan. 21 story . The staffing shortages were causing treatment delays, the article stated.

KHN’s Ehli wrote: “The hitch so far has been getting the nurses into the country fast enough. After jobs are offered and accepted, foreign-born nurses require a final interview to obtain a visa from the State Department, and there is a backlog for those interviews.

“Once they arrive, the international nurses in Billings will remain employees of Avant, although after three years the clinic can offer them permanent positions. Clinic administrators stressed that the nurses are paid the same as its local nurses with equivalent experience. On top of that, the hospital pays a fee to Avant.”

3. Pandemic’s effect on youth mental health has been profound, according to latest report from the U.S. Surgeon General

“Devastating” is how U.S. Surgeon General Vivek Murthy described the effect of the pandemic on the mental health of the nation’s youth, in the 2021 “U.S. Surgeon General’s Advisory on Protecting Youth Mental Health,” which was published in December.

“Mental health challenges in children, adolescents, and young adults are real and widespread,” said Murthy in a news release announcing the report. “Even before the pandemic, an alarming number of young people struggled with feelings of helplessness, depression, and thoughts of suicide — and rates have increased over the past decade. The COVID-19 pandemic further altered their experiences at home, school, and in the community, and the effect on their mental health has been devastating.”

Risk factors contributing to youth mental health symptoms

Among the risk factors listed in the report as contributing to youth mental health symptoms during the pandemic are:

• Having mental health challenges before the pandemic
• Living in an urban area or an area with more severe COVID-19 outbreaks
• Having parents or caregivers who are frontline workers
• Experiencing disruptions in routines, such as not seeing friends or going to school in person
• Experiencing trauma, such as losing a family member or caregiver to COVID-19

Top recommendations to improve youth mental health

The advisory also outlines a series of recommendations that can be applied across sectors to improve youth mental health:

• Recognize that mental health is an essential part of overall health
• Ensure that every child has access to high-quality, affordable and culturally competent mental healthcare
• Support the mental health of children and youth in educational, community and childcare settings, and expand and support the early-childhood and education workforce 
• Address the economic and social barriers that contribute to poor mental health for young people, families and caregivers

HFMA bonus content

• Listen to the latest Voices in Healthcare Finance podcast. On this episode, Rodrigo Heng-Lehtinen, executive director of the National Center for Transgender Equality, discusses how healthcare organizations can help transgender patients overcome barriers to care.
• Read the article “Hospitals need federal support to handle the ongoing staffing and financial crunch, industry leaders say” by Nick Hut, HFMA senior editor.
• To learn how to achieve a cost-effective revenue cycle, register for HFMA’s 2022 Revenue Cycle Conference March 16-18 in New Orleans.