From Surviving to Thriving: Ways to Boost Employee Retention in Rural Health Care

The reality of today's health care workforce is that demand outstrips supply. For rural health care providers, building and sustaining a strong and vibrant workforce is paramount, but not easily achieved. In this conversation, Brandie Manuel, R.N., chief patient safety and quality officer at Jefferson Healthcare, discusses how the use of TeamSTEPPS and other tools are making a big difference in creating a thriving employee pipeline.


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00;00;00;14 - 00;00;24;21
Tom Haederle
The reality of today's health care workforce is this demand outstrips supply. So every health care employer knows it's more important than ever to support their people and give them good reasons to stay not just surviving, but thriving.

00;00;24;23 - 00;00;53;05
Tom Haederle
Welcome to Advancing Health, a podcast from the American Hospital Association. I'm Tom Haederle with AHA communications. For rural health care providers, especially, building and sustaining a strong and vibrant workforce that can meet the community's needs is paramount. In this podcast, recorded for the ages 2024 Rural Health Care Leadership Conference, we learn how the use of team steps and other tools has made a big difference for one rural system in Washington state, says today's guest.

00;00;53;13 - 00;00;57;08
Tom Haederle
The well-being of our team is foundational to everything we do.

00;00;57;10 - 00;01;19;05
Elisa Arespacochaga
Hi, I'm Elisa Arespacochaga vice president for clinical affairs and workforce, and today I'm joined by Brandie Manuel, chief patient safety and quality officer at Jefferson Healthcare in Port Townsend, Washington. We're talking about supporting the current health care workforce so that they can move from surviving to thriving. So, Brandie, let's start with tell me a little bit about yourself and your role at Jefferson.

00;01;19;08 - 00;01;39;26
Brandie Manuel
Thanks. I am a registered nurse. My background and I have been with Jefferson Healthcare for about 11 years. I started there as the Director of Patient Safety and Quality, and my role has evolved over time, and my interest in workforce development and supporting our workforce really goes back to wanting to provide the best patient outcomes for our community.

00;01;39;26 - 00;01;44;07
Brandie Manuel
And that's hard to do when you don't have an engaged team to take care of them.

00;01;44;09 - 00;02;12;06
Elisa Arespacochaga
Absolutely. So you're at a rural organization, but you still have to coordinate care across a huge area with a number of different partners across the continuum, some of which may be a boat ride away, some which may be several hours in a car away, all of which have an impact on the well-being of your team. So how do you coordinate some of that work to make sure that all the good you're doing for your own team continues to spread across that continuum?

00;02;12;09 - 00;02;36;00
Brandie Manuel
I think it has to do with how well we are collaborating with our external partners, as well as how well we're managing the work internally. So we've developed relationships with our paramedics. We have developed a community peer medicine program to look at fall prevention in older adults, and then we also work collaboratively with several of our partners, both across the water and even right next door.

00;02;36;02 - 00;03;02;02
Elisa Arespacochaga
That's great. So your organization, you've really understood that during the pandemic, you've really needed to help your own team thrive, because there weren't a lot of other people you could bring in. Tell me a little bit about how you really leveraged some of the work around teamwork. I know you were a big proponent of TeamSTEPPs and team training, which I am as well, but how did you leverage that work to really help your organization thrive?

00;03;02;05 - 00;03;23;07
Brandie Manuel
I think for us, we started TeamSTEPPs several years before the pandemic, which was fortunate because the tools and strategies really helped as we were navigating through that. So implementing and hardwiring things like huddles, briefs and debriefs, making sure that there's role clarity on the team and just really helping our teams use those tools to operate at the highest level that they could.

00;03;23;10 - 00;03;44;27
Brandie Manuel
Became critical during the pandemic, especially when you didn't know everybody that you were working with. We went from knowing every face in the hallway to having travelers, which we had never done before, and hiring new faces that were now covered by masks and no benefit of real social interaction outside of work. So having strong team skills and communication became pretty important.

00;03;45;00 - 00;04;09;15
Elisa Arespacochaga
And for those who don't know, TeamSTEPPs really is a rubric to take that team of experts and make them an expert team. And I love that definition, because it really is about how do you get everybody on the same page quickly? Tell me a little bit about what's up next in your plans and how you're going to sustain some of the improvements you've made in terms of really helping your teams gel and supporting them in their well-being?

00;04;09;17 - 00;04;28;21
Brandie Manuel
Yeah, we've just restarted TeamSTEPPS in person, so we did the updated curriculum, a new master trainer course in the fourth quarter. We have some new trainers coming in, and we're introducing the training as a hybrid option. So both kind of for people who've already taken it and want a refresher, but also for those who it's brand new for.

00;04;28;23 - 00;05;00;17
Brandie Manuel
And then looking at how we can embed those tools and strategies into our daily work even more than we have already, as well as our onboarding and sort of training that in addition to the work that we're doing to introduce those same tools and strategies to our medical directors and our medical staff leaders and head down the path of providing leadership tools and training for our physicians who are in leadership positions, maybe for the first time, and kind of introduce them to some of the same things we have done for our directors, managers and supervisors.

00;05;00;19 - 00;05;19;07
Elisa Arespacochaga
That's great. I know you've got a lot of different wellbeing sort of threads that are woven throughout. Can you just make that connection a little more? And I know you, you believe it. It's why you do this work. The connection between the well-being of your team and your your title. Chief patient safety and Quality Officer.

00;05;19;10 - 00;05;43;08
Brandie Manuel
The well-being of our teams really is foundational to everything we do. And for us, our mission really is to hold the trust of our community. And that starts with the people who are caring for them when they walk through the doors. So it really is personal, and it really is important that we are taking care of each other first and that our team as a whole is engaged in well and enjoying the work that they're doing.

00;05;43;11 - 00;05;47;29
Brandie Manuel
So we feel like that's really the first piece to then taking great care of our patients.

00;05;48;02 - 00;05;52;22
Elisa Arespacochaga
Absolutely. Especially since most of your patients are your your neighbors.

00;05;52;25 - 00;05;54;28
Brandie Manuel
And in some case, our coworkers.

00;05;55;00 - 00;06;15;27
Elisa Arespacochaga
Absolutely. All right. So let me wrap up with the question about what advice would you give to leaders who are looking to address organizational well-being, who may be thinking, there's too much, there's too much I've got to do to make this, to change our culture, to move our work. What are some of the things that you tried that really helped?

00;06;15;29 - 00;06;49;23
Brandie Manuel
I think starting small and really recognizing that you're probably already doing some of the things already. So things like rounding on your team, rounding with purpose, starting with some of the tools that they teach in team steps, which I am just I've seen the evidence, but I've also seen it work for us. So spending some time getting to know the people if you don't already, getting to know the people that you work with, getting to hear what matters most to them, it may surprise you and spend more time being out and experiencing what it is that they're seeing every day.

00;06;49;25 - 00;06;59;24
Elisa Arespacochaga
Brandi, thank you so much for both the work that you do and the care you're taking of your team. I think it's a wonderful opportunity, and I know you're continuing to spread it to the next generation.

00;06;59;26 - 00;07;01;12
Brandie Manuel
Thank you for having me.

00;07;01;14 - 00;07;09;24
Tom Haederle
Thanks for listening to Advancing Health. Please subscribe and write us five stars on Apple Podcasts, Spotify, or wherever you get your podcasts.