SWEDISH PHYSICIAN ENTERPRISE CMO, JAMES MARTIN, MD
A Progress Note for Providers: The Provider Survey Results
We concluded our provider survey in late October, and we have had some time to review and digest the results (interspersed with vaccination planning and pandemic response work, to name a few other important concerns). In November, I relayed some of the information learned about stress, wellness and burnout, and included the many resources then available for everyone to access for assistance. Now I would like to provide you with a fuller picture of the results of the survey.
Here is a summary deck of the survey responses. In addition, your leaders have been provided this deck as well as with recommendations that include discussing the results with their groups, and working to gather even more information to help inform the work we need to be doing on your behalf.
In true physician form, I would like to present this to you as an APSO note (Assessment/Plan/Subjective/Objective).
Assessment (A):
The survey rolled out shortly after major announcements regarding major changes that impacted the roles of many providers. This may have had some impact on the responses.
Levels of stress, anxiety and depression in providers at Swedish are similar to national averages, yet awareness of and/or interest in access to supporting mental health services seems to be lower than nationally. Of concern, the risk of self-harm seems to be slightly higher at Swedish.
Staffing is the number one problem in our clinics, and the number one solution to improving overall satisfaction and work load management.
There is a concerning number of providers who do not feel valued by nor aligned with Swedish leadership. It follows that providers at Swedish are less enthusiastic about the organization’s future, less likely to stay, and less likely to recommend it as a great place to work and practice. We need to do a better job of demonstrating how we value everyone at Swedish, and ensuring they understand we are aligned with them and the work they do.
Plan (P):
- Stress and well-being: We need to encourage and promote “help seeking behaviors.” We need to reach out to our most at risk, connect with them, and help them get the support they need. We need to continue to grow, promote and advertise our strong portfolio of wellness resources. We have already begun much of this work, and will continue it in earnest.
- Staffing and workloads: The market for medical assistants, LPNs and RNs has dried up in Puget Sound (estimate 30% reduction in market due to COVID). We have removed all barriers to hiring, and have opened the floodgates to the use of our third-party staffing agency (who is also having a challenge filling roles). We are aggressively moving forward with the centralization of all services that don’t need to be done in our clinics (i.e., referral processing and management, medication prior authorizations, and prescription refills); we are mobilizing online and centralized scheduling resources to reduce phone volumes. We are expanding our apprenticeship program, and developing a “medical assistant–registered” role to help support our clinics. We are also exploring centralized nurse triage services to help support our clinics 24/7.
- Alignment and feeling valued: We value our providers immensely; they are the life-blood of Swedish, yet a significant number of them don’t see it that way. All of our plans for staffing and well-being will be for naught unless we understand what we need to do to make our providers feel valued and aligned. We can make assumptions as to what that means; better still, we should simply ask our providers the following three questions:
- What actions and behaviors do you need to see from Swedish and your leaders that would make you feel that alignment exists? Be specific – descriptions are not enough.
- What actions would demonstrate to you that you were valued?
- What would give you confidence for the future?
Subjective/Objective (S/O):
Below are some of the key data points from the responses. (The survey respondents were “providers” – physicians (broken out into primary and specialty care), APCs and other allied health providers.)
Stress and Well-Being
- At Swedish, providers reported slightly more stress than the national benchmark.
- At Swedish, providers reported slightly less depression than the national benchmark.
- At Swedish, providers reported slightly less anxiety and depression related to COVID-19, but reported an increase in workload due to COVID -19 compared to national benchmarks.
- Nationally, providers reported some symptoms of burnout, from occasional to constant. At Swedish, the numbers were slightly higher overall, though primary care and APCs reported it more frequently at 64% and 62%, respectively.
- As previously communicated to you, thoughts of taking one’s life were reported as slightly more common at Swedish than as nationally. Primary care had the highest response rate at 6.4%. The national benchmark is 4%.
- Personal access to mental health services was felt to be less helpful for mental health concerns by Swedish providers than as nationally.
Workload and Overall Satisfaction
- The number one factor to improve satisfaction, sustainable practice and patient care was improved staffing. In fact, the entire Puget Sound region reported this as number one as well. As a system, this factor was the lowest reported. Swedish, and Puget Sound in general, is an outlier for staffing challenges.
- Streamlined workflows and alignment of professional values with clinical leadership were the second and third most commonly reported factors that would improve overall satisfaction.
Alignment and Engagement
- As a system, 60% of respondents had confidence in the future of PSJH. Confidence levels at Swedish ranged from 35% (primary care) to 50% (specialty care). APCs and other allied health providers were in between.
- Feeling valued: Nationally, respondents reported feeling moderately or greatly valued (47%); at Swedish, this ranged from 28% to 41%.
- Providers at Swedish are less likely to stay at Swedish and recommend Swedish as a place to work when compared to other Providence regions. The difference is greatest with primary care and APCs.