July 29, 2021

In-person or remote work? For health care organizations, both.

Daily Briefing

    Now, as many people eye a return to the workplace after working remotely for the past year and a half, leaders are faced with the choice of either operating like they did pre-Covid, or implementing a hybrid workplace model. Radio Advisory's Rachel Woods sits down with Advisory Board's Miriam Sznycer-Taub and Alex Polyak to discuss how leaders can make a hybrid workplace function effectively.

    Read a lightly edited excerpt from the interview below and download the episode for the full conversation.

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    Rachel Woods: I'm going to go ahead and make the assumption that for most organizations across the health care ecosystem, some portion of their workforce is going to be working in person at least some of the time. When it comes to that in-person space, how should we think about changes to the actual physical environment that they are working in?

    Miriam Sznycer-Taub: So pre-pandemic, we saw this move away from individual offices to cubicles, to open office spaces. You saw that across a lot of industries and health care was no exception. Even physicians moved away from having their own offices to kind of an open office set up.

    And that was honestly not great during Covid, right? It actually made the push to get everybody home even more urgent, because it was very difficult to keep people six feet away when your desks are only three feet away. So I think there's going to be a rethinking of, what office space should really look like and, again, how health care organizations specifically should use their space.

    And then beyond that, I think there are some really kind of specific needs that provider organizations are going to have, particularly as they're thinking about more virtual visits being done, where you have a clinician in a health care facility, who's doing a virtual visit with a patient, they can't do that from a big open office space.

    For one, it's not a great experience for a patient if someone walks behind, there's also a lot of HIPAA issues. It's not a great environment for a clinician. And so I think that we're really going to have to think about how do we use our spaces to both be for in-person visits, as well as this new virtual visit world that we're in?

    Woods: And to your point, not to think about administrative and clinical space separately because in some cases they will actually be mixed.

    Sznycer-Taub: Yeah. I think the line is going to get even more blurred between those spaces. And again, it's going to force executives to really think what they need their space for.

    Woods: So this is not a moment where every organization is going to be able to build from scratch. Frankly, even if they had the money to do that, that would be a huge upheaval after a year and a half of extreme change. So what recommendations practically speaking, do you have for folks who are going to be retrofitting existing spaces to this new reality?

    Sznycer-Taub: I think it's important to just think about the space that you're asking clinicians to take a virtual visit in. I think virtual visits, while they feel like they're all about the technology, they actually have a facility impact. They have a facility implication to them. Is the room that the clinician is in, does it have a good background so that there's nothing distracting.

    Do you have a setup where this clinician can look at the patient, look at the camera, but also be able to see their EHR so they can look at whatever they need about the patient without the patient feeling like they're not paying attention. Do you have a room that is closed off, that is fairly soundproof, that has good acoustics so that the sound experience is good?

    For some organizations they're going to decide they want to retrofit space, they want to create a telehealth pod. I think others are going to say, "Hey, can we use this office as our telehealth space?"

    What do we maybe even need to do within an exam room? If we're going to use an exam room for a virtual visit, what changes might we need to make to make sure that it's a good experience? Because you know where that clinician is sitting, even though the patient isn't sitting in the room with them, it's still an important part of the virtual visit experience. And I think it can make or break that connection with the patient.

    Woods: We've been sort of skirting around a question that I think is on our listeners' minds. We've been talking about the fact that these decisions are going to impact the entire health care ecosystem. And we've sort of been talking about a mix of administrators, of staff, of clinicians, but I can't help but think that there is going to be a part of the workforce. And it's probably the clinical workforce that doesn't honestly have a choice here and is going to have to come back to or continue to work in person.

    And that has to be tricky for leaders who are right now talking about all of the benefits that come with working remotely. Frankly, the benefits that we've been talking about in this discussion, how does a health care leader actually grapple and come to terms with those kinds of two opposing thoughts?

    Alex Polyak: Now this question makes me chuckle just a bit, because it reminds me of sort of the open secret in health care that we're relatively good at recognizing changes that are on the horizon absolutely awful at estimating when we'll have to grapple with them.

    And I answer that, absolutely. I do not think, certainly not for the foreseeable future, that we will get to a place where we don't need clinicians be at least part-time in person. But what I would really encourage everyone to think about is the fact that almost every clinician will likely much sooner than we expect be working or flexing across both a virtual and an in-person environment.

    I've spoken to so many CMOs who said telehealth was something we knew we would one day have, but certainly we were putting it off five years from now, 10 years from now, but—when they had to—they made it work within six months. And the same is true, to a lesser degree, for virtual nursing.

    And so I say quite honestly, I think within the next 10 years, there will hardly be any nurse or physician who does not have perhaps even at least one day a week working virtually. Or if it's not one day a week, think about it this way: We know that nurses are in all likelihood going to be flexing across different units. And one of those units is going to be virtual telehealth. So it might be that for six months, you work on the ward for six months after you work virtually. And this is actually phenomenal for retention, especially for older workers who simply can't deal with the physical loads of the job.

    So of course, and I will note, we don't necessarily have the solutions for environmental service workers. They in all likelihood will continue to have to come in in person. But I would just encourage executives to really think about, is the horizon perhaps closer to us than we've anticipated when it comes to flexing clinicians across both virtual and in-person.

    Woods: And let's be honest, we're talking about a strategic way to be thinking about this, a strategic way to be thinking about a benefit to the workforce. So I guess my push to our listeners would be remote work is one benefit, and if you know that you're not going to be able to give that to your entire workforce evenly, then you have to start thinking about the other benefits, the other kinds of flexibilities that you can give.

    Well, Alex, Miriam, this is one of those hairy topics where there are not best practices, but I do want to give each of you a moment to kind of speak directly to our audience and give them an action item. When it comes to returning to in-person work, what's the one takeaway that you want to leave our listeners with?

    Sznycer-Taub: We spent a lot of time pre-pandemic making health care facilities really patient-friendly and patient-centric and that was so important and we should keep doing that. But I think this is a really good opportunity to think about how do you make your health care facility staff centric too?

    So what are the things you can do to make the in-person experience for staff better, whether that's thinking about the options they have for getting healthy, nutritious, fast meals, is it making sure they have appropriate respite spaces? Is it making sure that they have a good workplace, that they can set their things? And I think this is the time to rethink your space and think about how do you create that really good physical environment for your staff who are coming into your facility.

    Woods: Alex, what about you?

    Polyak: It might not be satisfying, but this is a journey. The cubicle was invented in the 1960s. The idea of an open floor plan in the late 1990s. We don't know what this is going to look like in 10 years, 20 years from now.

    And that may not be satisfying but unless we are able to be flexible about our strategic expectations of what the workplace will look like five, 10, 15 years from now, we're just going to be shooting ourselves in the foot repeatedly. And it's not going to be the type of wound that some clinicians are going to be able to fix just like that.

    Learn more: Manager's guide to leading remotely through Covid-19

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    Covid-19 has introduced unprecedented challenges for managers who may now be managing a remote team or a team adapting to ever-changing circumstances amidst the pandemic. This toolkit is for leaders who need new tools to keep their team productive, engaged, and aligned.

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