Unity Point Health Case Study, New Healthcare Changes

UnityPoint Health or UPH, an Iowa-based healthcare provider, ranks among the 15 largest nonprofit health systems in the U.S. UPH is also the fourth largest non-denominational system within the U.S., with 28,000 national employees and over 5500 between their various Des Moines based hospitals and clinics. As is the case with all healthcare providers after the passing of the Affordable Care Act in 2010, UPH has an obligation to achieve a “triple aim” through their services, defined by the metrics of improved patient experience, reduced cost, and better health outcomes for populations.

In 2015, Randall Wilson, associate research director for Jobs for the Future, published a case study detailing the ways in which UPH has been fulfilling its obligations to achieve this “triple aim” approach to its services. Jobs for the Future or JFF is a national nonprofit organization that builds educational and economic opportunities for underserved populations across the country. This article serves as an overview of the findings of this case study, and the ways in which UPH works every day to provide the highest quality of healthcare services to patients across its various facilities.

Case Study Overview

As the American healthcare industry has historically been flawed and imperfect, various reforms have been proposed in recent years to tackle what is a nationwide issue. These reforms seek to better connect the separate facets of the healthcare experience, from the home to the hospital to the pharmacy. Moreover, UPH aims to shift the focus from outpatient stays and hospital visits altogether to instead focus on maintaining healthy communities. From the perspective of UPH, this will take the form of giving patients more access to UPH clinics, promoting prevention, prioritizing the self-management of healthcare conditions, and greatly reducing preventable hospital readmissions.

In order to achieve these reformative goals, UPH has developed an infrastructure to help provide more comprehensive healthcare services. This infrastructure emphasizes decreasing the high turnover rate in critical frontline healthcare positions, as well as the challenges and difficulties that prevent some frontline workers from effectively transitioning into supervisory and managerial roles. In response, UPH has made significant investments in their frontline healthcare staff as demonstrated by:

• Implementing workforce planning and analytics processes to better understand the state of the workforce and any potential engagement, turnover, or retirement risks.
• Creating a full-time retention specialist to assist and coach workers in areas of higher turnover, such as dietary, nursing, and housekeeping, in career development and further education with the goal of removing as many barriers to advancement as possible.
• Offering a program to nurture supervisory talent, which has trained 67 candidates so far, with half receiving promotions by the end of the program.
• Formulating a workforce training academy, in partnership with other local healthcare providers and professionals with career ladders keyed to specific competencies and occupations.

While UPH has been deliberate in developing its workforce through education and training opportunities, they have also been deliberate in communicating the importance of every individual employee’s job to meet business objectives. As a testament to this, UPH employees are asked on their first day to look at their job in the light of quality care measures, with the aim of achieving the bottom line, the “best outcome for every patient, every time”. UPH-Des Moines has already begun seeing positive returns concerning its efforts to link improved care to an invigorated and strengthened workforce.

For example, patient satisfaction scores have consistently trended upwards since the creation of the full-time retention specialist role. Furthermore, turnover in the departments served by this retention specialist role has dropped by 20%, equating to an estimated savings of $97,500. While considerable work must still be done to effectively tackle the various issues surrounding the healthcare industry, the following lessons can be taken from UPH’s efforts and progress to date:

• Prepare for transforming care delivery by building and maintaining an infrastructure to support investment in frontline workforce development, including participation in an employer-led workforce partnership.
• Task senior leadership, such as a Human Resources Vice President or Chief Learning Officer, with management and championing of frontline workforce development—for their expertise and support, and for maintaining executive focus and investment in workforce activities.
• Create dedicated staff roles, accountable to senior leadership, for designing and implementing frontline workforce programs, including coaching and instruction of frontline staff.
• Build the capacity for training and promoting candidates for frontline managerial and supervisory roles.
• Build the case for frontline workforce investment through the collection, analysis, and communication of evidence.
• Select definitive outcome measures targeted to business objectives, including care transformation, and financial well-being of the overall organization.
• Engage in comprehensive workforce planning and forecasting to determine potential occupational needs, responsibilities, and assignments in support of care transformation.
• Fully integrate workforce planning in accordance with development with organizational strategies for care transformation and financial success.
• Map processes of care coordination and transition, and identify touchpoints where frontline workers, in cooperation with licensed staff, can improve patient transitions, reducing duplication and improving patient experiences.
• When planning for workforce needs, employ a comprehensive view to determine areas where frontline workers, including clinical and non-clinical support staff, can assume new or different responsibilities in support of population management, care coordination, and patient

As a growing number of employers in the field of healthcare continue to make significant investments in both the skills and career growth of their frontline staff, the infrastructure of the workflow of the medical industry will continue to grow and evolve, with the aim of meetings the standard set forth by the Affordable Care Act. Moreover, many frontline workers will spend more direct time with patients than any other employee within a healthcare setting. These duties can include everything from taking vital signs and bringing patients’ meals to changing linens and registering them in or out of a hospital setting. In this way, the medical industry can deliver the level of improved service that many citizens of this country not only deserve but desperately need.