Post-pandemic staff shortages remain an issue for many healthcare leaders, but it takes a special level of flexibility to balance the needs of patients with those dedicated staff who continue to show up, day after day.
Dave Jenkins is executive director of market operations at North Carolina’s Cone Health, as well as an adjunct faculty member in health administration at Winston-Salem State University. As the focus of this episode of the MGMA Member Spotlight podcast, Jenkins shares his insights into behavioral health, ongoing education and making tough staffing choices in a post-pandemic world.
Jenkins says his role within Cone Health, which now features five hospitals, three outpatient surgery centers, 10 urgent care centers and more than 120 physician practices, plus a retirement community, involves infinite flexibility. But, as he says, that’s what he signed up for.
“I’d be wary of any healthcare leader that can accurately describe a typical day – I feel like that’s kind of why we get into this field,” Jenkins says. “No two days are alike. I have to balance the needs of what’s going on in the hospitals, what’s going on in our outpatient clinics, and ensuring that we’re in tune with the overall health system operation.”
Collaborative care in behavioral health
To that end, Jenkins says he focuses on continual strategic planning, examining market trends and business within the organization’s various programs and practices. Since the COVID-19 pandemic, Jenkins has worked hard to both restore and enhance resources, especially in Cone Health’s behavioral health services.
“The demand for mental health services was really exacerbated by the pandemic, and the nature of our work has changed significantly. How can we do more tele-psychiatry, more integrative health, more collaborative care? A lot of our time and energy is spent optimizing what resources we have to meet community needs, knowing that the demands far exceed our capacity right now.”
Jenkins recognizes that working in behavioral health requires a different approach than other specialties, and he appreciates the physicians, therapists, nurses and techs who have been willing to step out of their comfort zone to work with the patient population.
And while integrative care models have been around for decades, Jenkins says he continues to push for additional training and resources to see more mental health issues addressed at a primary care level, rather than being constantly referred out to his overwhelmed specialists.
“If we’re able to do more at the primary care level with collaborative care, then that frees up capacity for my psychiatrist to work with those that have the most difficult needs,” he says.
Making hard choices during staff shortages
Like other healthcare leaders, Jenkins has had to make some tough decisions when staff shortages began to impact the potential quality of care. Rather than overwhelming his remaining staff, Jenkins has frequently directed Cone Health’s facilities not to fill to capacity.
“It means being willing to make those tough decisions, because sometimes that will go in contrast with the demands of the organization. But you really also have to think about what’s right for the patient. You don’t want patients to be in a situation that’s unsafe because there’s insufficient staffing.”
Jenkins has worked strategically with partners to provide outside assistance in the form of agency staffing and temps. While that helps bridge the gaps, he recognizes it’s not a sustainable solution, and he encourages his teams to actively recruit, at all times.
“The single most important thing that you can do to prevent staff feeling overwhelmed is to have full staff, to have the right ratios,” he emphasizes. “We really try to emphasize that with our team, and be transparent with them and let them know what recruiting and retention looks like. Then they’re usually more accepting of those boundaries.”
Life-long learning is core to healthcare leadership
On top of his duties with Cone Health, Jenkins spends as much time as possible working as an adjunct instructor, assisting managers like himself to learn more and expand their careers through Winston-Salem State’s MHA program.
“I just enjoy the experience and really enjoy being around the students, and all I’ve learned from them,” he recalls. “For me, teaching is a learning opportunity, because so many of them are either career changers or they are wanting to progress their careers and they are bringing knowledge and experience to the classroom. I tap into that for my own personal growth, so it’s a symbiotic relationship, I guess.”
While working with students, Jenkins emphasizes making the right decisions on their priorities. With so many factors out of their hands in a leadership role, they need to learn what they can control, and how to make the most of that.
“You can control your growth plan and development. You can control networking. You can control learning more about your organization and the industry and your specialty,” he says. “I have seen the leaders who recognize that, and it puts you in a much better position to respond and react.”
Continuous on-the-job education, Jenkins says, remains core to success and growth in healthcare. Without a flexible, inquisitive and adaptable approach, he questions how many managers continue to function.
“You never stop learning. If you don’t, or you can’t, then you’re in the wrong place. If you’re not a lifelong learner, this is not the industry for you.”
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