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Workforce issues dominate conversation at annual hospital leadership summit 

Improving Pennsylvania’s health care workforce pipeline and the tools available to lessen the problem continue to be at the top of mind for the state’s health system leadership. 

The state’s hospital leaders met this week in Harrisburg for the Hospital Association of Pennsylvania’s Annual Leadership Summit. 

The summit marked the first time that the association’s members have sat together to discuss what they are doing since the last summit in 2019, said Andy Carter, Hospital Association of Pennsylvania (HAP) president and CEO. 

The summit spanned two days, with many of its topics centering around the workforce shortage, something Carter said is impacting all health care systems across the state in some way. 

“It is profound– we have high vacancy rates, and our hospitals are full,” he said, adding that the systems have been particularly focused on addressing shortages among nurses. “We cherish the work nurses do and we met to continue to identify strategies to retain existing nurses and create a pipeline for new nurses.” 

The Wolf Administration announced in March that it would be allocating $225 million to support Pennsylvania’s health care workforce needs of hospitals and behavioral health providers as part of Act 2 of 2022, signed into law in January. 

Summit speakers touched on a number of strategies that systems will need to look at as they tackle the problem of health care workforce shortages.  

Carter said the association and its membership are grateful for the funds but that providers now need to look toward long-term solutions. 

Solutions discussed at the summit included improving compensation among staff and in particular, understanding different generational needs among the nurse population. 

“Some are looking for a really good retirement plan because they are 55, others are looking for loan forgiveness because they are 22 and fresh out of an expensive nursing program,” said Carter. “They are working harder to customize for different needs and to organize shifts with a much keener eye to the preferences of the nursing professionals and other clinicians.” 

Carter also highlighted the workforce pipeline, noting that hospitals recognize that they will need to be creative in how they improve the pipeline by increasing access to more faculty and bettering nursing education programs. 

Behavioral Health 

Among workforce issues across hospitals, one of the more pressing issues lies in behavioral health, according to Carter. 

Some of HAP’s member hospitals are so strapped for behavioral health professionals that at any given time a hospital can have dozens of patients in its emergency department that no longer need emergency care but are suffering an acute mental health crisis. 

“These folks need specialized treatment in an inpatient or outpatient facility but there is no capacity,” said Carter. “They have to stay with us and that constrains our capacity. Right now we are essentially providing boarding services for them.” 

This month, HAP wrote on behalf of its more than 235 member organizations to the state’s elected leaders, asking them to approve an increase of state funding for county mental health programs by at least $28 million and facilitate placement in post-acute care settings by including an additional $13 million to county mental health funding. 

The letter also asked elected officials to require that Medicaid payment rates properly reflect the cost of complex cases, longer stays and resource-intensive treatments. 

Penn State Health adds physician leader for cancer services 

Dr. Marc Rovito. PHOTO/PROVIDED

Penn State Health appointed Dr. Marc Rovito to vice president and physician leader for cancer services, a newly created position that’s part of the health system’s effort to deliver coordinated cancer care across its hospitals and outpatient locations.

He and Ethel Randall, administrative vice president of the cancer service line, will make decisions about capital investments in equipment and facilities, recruitment and retention of staff, and deployment of cancer care resources throughout Penn State Health’s service area. 

Rovito was most recently St. Joseph Medical Center’s interim vice president of medical affairs, joining the hospital in 2011.

He has served as St. Joseph Cancer Center medical director and cancer liaison physician, leading accreditation initiatives for the cancer care programs and overseeing a $5.5 million addition to the cancer center. 

“Marc is well positioned to lead this exciting transformation of our clinical cancer care processes given his combined experience in academic, community and private practice settings,” Dr. Peter Dillon, executive vice president and chief clinical officer of Penn State Health, said in a release. 

Board certified in medical oncology, Rovito is an assistant professor in the Department of Medicine’s Division of Hematology and Oncology at Penn State College of Medicine and Penn State Cancer Institute. 

Amid COVID-19 surges, PA hospitals ask for help 

The Wolf administration is organizing with the Federal Emergency Management Agency (FEMA), to launch a number of regional support sites for both hospitals and long-term care facilities and strike teams to support hospitals facing staffing shortages. 

The initiative includes the launching of regional support sites, allowing hospitals struggling to meet inpatient demands to transfer patients to hospitals within a designated location with increased capacity. 

Hospitals will also be identified to receive staffing support through the state Department of Health, which could include physicians, respiratory therapists and registered nurses.  

“I am committed to seeing the healthcare community through these difficult times,” said Gov. Tom Wolf. “We’re organizing these support sites and strike teams in response to calls for help from the healthcare community. I will do everything in my power to continue supporting the healthcare heroes that have supported all of us since day one of this pandemic.” 

As of Sunday, Jan. 2, the daily average number of COVID-19 cases in Pennsylvania was 18,344. The number of people currently hospitalized with the virus on Monday, Jan. 3 was 22.6% higher than it was on Dec. 27, according to the state Department of Health. 

On Jan. 3, a 23-person support team of physicians, nurses and respiratory care practitioners was deployed to WellSpan Health’s York hospital through FEMA, one of two strike teams approved for the state so far, with a second sent to Scranton Regional Hospital. 

The support, requested by Gov. Tom Wolf, was sent to help York-based WellSpan Health as daily COVID-19 hospitalizations across eight hospitals doubled from less than 250 patients to over 450 over a six-week period. 

The team is expected to be helping for approximately 30 days with the chance of increasing that time if necessary. FEMA’s assistance allows the system to redeploy its staff to other areas of the system if needed, said Dr. Roxanna Gapstur, president and CEO of WellSpan Health. 

“We have seen several improvements. It’s quite obvious that this team of professionals are experts in their field,” said Gapstur. “We have been moving the staff around from site to site as needed. It is really helpful to have the strike team here at York but it’s helpful for the rest of the system as well.” 

At Penn Medicine Lancaster General Hospital, those numbers have equated to 101 unvaccinated COVID-19 positive inpatients out of 128 and 18 unvaccinated patients in critical care out of 21. 

Within Penn State Health, the Hershey-based system has had 193 adult COVID-19 hospitalizations as of January 5 with 42 in critical care and 26 on a ventilator. 

“The demand on health care facilities, on hospitals and our emergency rooms has been incredibly high in the last few weeks and we continue to see increasing volumes in the demand for health care,” said Dr. Peter Dillon, executive vice president and chief clinical officer at Penn State Health. 

Currently about 20% of Penn State Health’s patient population at its hospitals is COVID-19 positive but caring for that population takes up to 80% of the system’s resources and energy, said Deborah Addo, executive vice president and COO at Penn State Health. 

Penn State Health leadership, along with other health care leaders in the region, recently spoke to the governor about what will help health systems through the most recent surge. 

“It isn’t what we just need in our hospitals, it’s what we need in our post-acute hospitals like behavioral health and pediatrics,” said Addo. “What we are seeing in acute care hospitals, is that [COVID-19 is clogging the entire system’s] ability to get patients in or discharge them into another level of care.” 

Harrisburg University to grow IT program through partnership with IT apprenticeship program

A new partnership between Harrisburg University and an Arizona-based IT apprenticeship program is expected to build a pipeline of eligible students into the university’s Information Systems and Information Technologies program.

The university announced on Friday that it will partner with Woz Enterprises, an organization that offers apprenticeship programs to address a widening gap in technology careers in the country.

Through the new partnership, HU will grant apprentices of Woz Enterprises pre-acceptance to pursue a Bachelor’s degree through the university’s Information Systems and Information Technologies (ISIT) program.

Individuals who hold an associate degree and complete a pre-apprentice program through Woz will also be eligible to enroll in the ISIT program.

“We are pleased to partner with Woz Enterprise to provide this opportunity to individuals who are pursuing a career in technology,” said Dr. Eric Darr, president of Harrisburg University. “The agreement gives individuals the ability to enroll in our affordable, world-class ISIT program.”

Woz Enterprise, a division of WozU and founded by Apple co-founder Steve Wozniak, acts as a supplement to an associate degree and teaches students courses like Application Development .Net, Application Development Java and End-User Computing.

Students in the Woz Apprenticeship program receive college credits toward the HU ISIT program and get on-the-job experience in the tech industry, said Chris Coleman, president of Woz U.

Coleman added that educators can no longer say that technology careers are the future and should instead realize that companies need talent in the present.

“Getting training and an education in information systems, information technology and computer sciences allows individuals to enter an industry that offers job security and competitive salaries,” he said. “Working and gaining valuable experience in a relevant tech field, while simultaneously earning a degree also makes it a cost-effective proposition for students.”

Once students complete the necessary courses, they are well-prepared for both the technical and non-technical courses at Harrisburg University, said Dr. Beverly Magda, associate provost at HU.

“Industry has a strong need for a workforce with technical skills and knowledge, but they also need a workforce that have the strategic thinking, ethics knowledge and business skills,” Magda said. “This is why the ISIT program is a good fit for WozU students.”

Construction sites restart this month in a new environment

Contractors practice social distancing as they work on the new Gardener Theater at the Lancaster County Day School in Manheim Township, Lancaster County. The theater, designed by Murray Associates Architects, is planned to be finished in Jan. 2021. PHOTO PROVIDED

The incoming Gardner Theater at Lancaster County Day School in Manheim Township, Lancaster County, was well into construction when the COVID-19 pandemic caused the state to put a hold on all non-essential construction sites.

Because the project was structurally unsound to leave as it was, contractors received a waiver from the county to work on the project until it was at a safe place to stop.

For the project’s designers, Harrisburg-based Murray Associates Architects, The Gardner Theater was one of few physical projects that continued into the quarantine.

Non-essential construction sites reopened across the state at the beginning of the month. The past two months had proven difficult for many companies in the industry, who either lost projects due to clients in struggling industries or were unable to provide maintenance services to businesses for fear of COVID-19 spread.

As an architectural firm, Murray Associates had plenty of work to stay busy as staff focused on continuing relationships with clients and designing projects, said Benedict Dubbs, the firm’s owner.

“We had several projects we were moving forward with on design and we had plenty of things to do on those projects,” Dubbs said, noting that his firm continued planning with contractors in anticipation for a reopening of construction sites.

Other companies, like Harrisburg-based heating contractor HB McClure, were more reliant on the go-ahead from the state to begin construction projects.

HB McClure and its 453 employees offer everything from heating, air conditioning and electrical services to homeowners and businesses across the midstate.

While the company did get the go ahead to continue work as an essential business, HB McClure’s leaders still found themselves furloughing 60% of the company’s staff until construction could begin again.

Adam Smith, vice president  of commercial service at HB McClure, said that the company was able to continue offering services on its heating and cooling systems to try to make up for the lost revenue from construction site closures, but many businesses were unwilling to allow staff into their buildings those in March and April.

“While we were considered an essential business, it was more of a challenge of having our customers, even ones that were open, to allow us into their facilities,” Smith said. “We had a backlog of over 100 customers that we would have offered routine preventative maintenance to that didn’t want us in their facilities due to COVID.”

The toll of the COVID-19 pandemic has been felt in every industry and caused many clients to put a pause on their projects for the foreseeable future.

Murray Associates Architects, which works primarily with retail, higher education and preparatory schools, has already seen this with a number of clients that have yet to return to projects.

Dubbs said that both his clients in retail and in higher education are waiting for the dust to settle before jumping back into projects they planned earlier this year.

“Our clients are boutique stores and that scale of retail,” he said. “Those folks are scared to look because it’s a very different landscape than it was weeks ago.”

Colleges have a similar problem, said Dubbs, who noted that many construction sites on college campuses are on hold as the schools evaluate how their campuses could change as they focus more on online schooling.

HB McClure is getting its staff back to construction sites, but limitations on staff due to social distancing regulations could offer a significant impact on when projects are completed.

“We hear that some schedules won’t be pushed or won’t be moved but we aren’t deep into the move to fully understand the impact this will have on productivity,” Jim Saussaman, president of HB McClure said.

Changes in scheduling are par for the course for the staff at HB McClure, but one thing Saussaman said was difficult to plan for was the emotional toll for staff doing maintenance on heating and cooling systems in high-risk locations like hospitals.

While many clients have been good about warning the company about potential outbreaks at their facilities, Smith said the company needs to be sure its staff isn’t at risk.

“Some have notified us right away but some haven’t notified us as quickly as we would like that they had positive cases in their facilities,” he said. “We ask if there have been employees with symptoms that they have procedures in place.”