Attracting and retaining the right staff with Deborah Wesley, RN, BN, MSN, MHA, CEO, Addison County Home Health and Hospice

In this episode of the Post-Acute POV, our host Eric Grunden, Chief Customer Officer, is joined by Deborah Wesley, RN, BN, MSN, MHA, CEO, Addison County Home Health and Hospice, to have a conversation on attracting and retaining the right staff across post-acute care.

Join Deborah and Eric as they discuss the impact the pandemic and vaccination mandates have had on recruiting staff, the specific qualities her team looks for in candidates, the importance of displaying empathy to retain employees, and how Addison County Home Health and Hospice uses their EHR as a strategic piece of their recruitment plan. Listen to their discussion.

Topics discussed during today’s episode:

1. [01:15 – 02:53]: Deborah provides an introduction on herself and the history and mission of Addison County Home Health and Hospice.
2. [03:32 – 04:43]: Second, Deborah comments on 2021 being called “The Great Resignation” and the impact that the pandemic has had on attracting and retaining the right staff.
3. [4:56 – 9:09]: Third, Deborah describes how COVID vaccine mandates have impacted neighboring home health organizations and how Addison County Home Health and Hospice was able to reach a status of 100% vaccination.
4. [9:45 – 11:26]: Deborah then explains how her organization uses their EHR as a strategic piece of their recruitment plan and the emphasis they place on work-life balance.
5. [11:48 – 13:09]: Next, Deborah discusses what her team looks for when recruiting to maintain their positive culture and the importance of being open to challenges and change.
6. [13:30 – 14:46]: Deborah shares how, as their EHR continues to evolve, they are provided with more opportunities to engage their staff by encouraging them to learn new aspects of the software like voice-to-text and developing individualized care plans.
7. [15:21 – 16:32]: Next, Deborah describes how she and her team have displayed empathy with their staff during the pandemic by maintaining an open-door policy, lending a listening ear, and recognizing the stressors employees may be facing at work and in their personal lives.
8. [17:00 – 18:46]: Deborah and Eric conclude the conversation by discussing fresh ways to support work-life balance. She shares the concept of “Coffee and jammies,” which encourages employees to log in each morning and create a plan for their workday to avoid feeling rushed out the door.

Resources

• Find out more about Addison County Home Health and Hospice: https://www.achhh.org/
• Listen to more episodes of the Post-Acute POV

Transcript

Speaker 1

Hi, and welcome to the Post-acute Point of View, our discussion hub for healthcare technology in the out of hospital space. Here we talk about the latest news and views on trends and innovation that can impact the way post-acute care providers work. And we take a look at how technology can make in today’s changing healthcare landscape in both home-based and facility-based care organizations and the lives of the people they serve. Today, we hear from Eric Grunden, Chief Customer Officer and his special guest. Let’s dive in.

Eric Grunden

Well, hello. This is Eric Grunden in Chief Customer officer at Matrix Care. I want to thank you for joining us today for another episode of the Post-acute Point of View. Today, we have a very special guest, Deborah Wesley, CEO of Addison County Home Health and Hospice, here to discuss a really important subject, one that we’re all seeing today, and that is about attracting and retaining the right staff.

Eric Grunden

So without further ado, we’re going to get started. First of all, Deborah, thank you for joining us. Thank you for taking time to have this conversation. We’d always like to start with a little bit of an origin story. So we’d love to hear about Addison County and specifically what led you to Addison County in your career?

Deborah Wesley

Sure, Addison County, Vermont is a unique little place nestled in the Green Mountains of Vermont. Addison County Home Health and Hospice has been a nonprofit community VNA for 50 plus years. We celebrated our 50th anniversary just before the pandemic. It is a community based driven, nonprofit VNA that really takes care of its community. Home health, hospice, our Medicaid waiver program, our maternal child health program, it really supports our community through the full continuum, as well as many community services such as flu clinics. Now it’s COVID clinics, COVID testing sites, and supporting our community partners.

Deborah Wesley

So it is an anchor in our community. It is really a community center. We’ve had an employee that just retired that actually worked here for 42 of our 50 plus years, so it is amazing and she has just decided to retire to enjoy her grandchildren.

Deborah Wesle

Addison County Home Health and Hospice is a really unique place. I joined here September of 2017, worked in Connecticut in home health and hospice developing home care agencies and hospices for 30 years, decided to move a little further north to be close to my kids as they had graduated and decided to settle up in this area. And as I looked around, I was really humbled by the commitment to mission that this organization had and was really excited to be part of it.

Deborah Wesley

It has been an agency that is undergone incredible transformation since 2017, and I am humbled daily to be part of a team that actually gets to do their mission every day.

Eric Grunden

That’s outstanding, 50 years. Congratulations, happy anniversary.

Deborah Wesley

Yeah, it’s pretty cool. It’s a committed organization that truly does get to walk its mission.

Eric Grunden

That’s wonderful. That’s wonderful. Well, let’s jump into our topic today. It’s a big one. Every industry across the world might be experiencing this as well. And that’s a focus on attracting and retaining the right staff. I’ve heard 2021 referred to as the great resignation or the big quit, and that’s basically the trend of employees voluntarily leaving their jobs in response to the pandemic. And I’d love to start by getting your thoughts on what you’re seeing in our country today as it pertains to this mass resignation and people changing jobs.

Deborah Wesle

Sure, and we are very fortunate here at Addison County that we’ve not had witnessed to similar adventure that has gone on across the country. I can recall since I’ve been in nursing, and that is 35 years, that there has been a healthcare shortage, and it’s predicted to get worse. The average age of a nurse is in their fifties, and it is not a profession. We’ve not done a great job of protecting our young and mentoring along, and we are a dying breed, and that is a scary thought right now.

Deborah Wesley

I think the pandemic brought it to the light. I think it pushed it out into the front. On top of that, we have fatigue, we have exhaustion, and we have many different opinions about how we should take care of ourselves and our communities.

Deborah Wesley

And I think the vaccination stories have caused a lot of challenges as well, and people are just tired, tired of providing healthcare every day. There’s childcare problems. It’s just really complicated what we do, so I think retaining employees is the most important thought process that organizations have to have. We have to keep who we have. We have to take care of our employees, and we have to be able to attract new employees. If we have an organization that is committed to our employees, I believe the rest follows.

Eric Grunden

Such a great way to start. You touched on a couple of things, the pandemic, mandates, have you seen specifically there at Addison County, an increased turnover due to those things, and what are you doing specifically to address it in your community?

Deborah Wesley

It is a unique question for us. I can tell you that many surrounding organization and agencies throughout New England are truly challenged by the mandates and the requirements for vaccinations. We’ve gone out to many of our community organizations to help them get the employees that want to be vaccinated vaccinated.

Deborah Wesley

We have not faced those challenges. Early on in the pandemic, we decided as an organization, as this pandemic was cresting two years ago, who could imagine, we sat down as an entire organization, every aid, every PCA, every office employee, every nurse, every therapist, and every clinician, and every administrative personnel. And we gathered and said, “We’re on the edge of something it’s coming. We don’t know what, and we don’t know how long.”

Deborah Wesley

And this was before payroll protection. We don’t know it’s coming. We had 34 days of payroll in the bank, and now we have more. And I’m proud of this team for continuing to weather through, but we did not know.

Deborah Wesley

So as a team, every level of this organization got together. And as I sat there and began the talk, I said, “I want everybody to know, we will stand as one. We will weather this is one. I will find the PPE for us as one. We will all wear the same PPE, and we will all get paid until there is no money to pay. And at that point we will start whittling salaries from the top down, so that our most vulnerable employees will always get paid.”

Deborah Wesley

And that together as an organization, we made a commitment, and we stood strong. We had some employees that needed to take some time off because their kids couldn’t get to school. And we developed jobs, even our nurses and therapists that had to work remotely, we developed jobs to keep them working, to keep them on the payroll and to keep everybody moving.

Deborah Wesley

Our nursing aid, therapy aid, and PCA visits declined, but we kept people at the salary they were at before the pandemic started. And that bonded this team to move forward together. We really stood together. We talked about it and as we weathered through and changes happened, we made decisions as a team and talked about what was important.

Deborah Wesley

So when the vaccines rolled out, we made sure that every single employee here that was frontline, and everybody’s considered frontline because we were standing on it together, got vaccinated together. And then we realized that it was so important that we vaccinate and support our community, our team rolled up their sleeves and began giving vaccines and boosters to home-bound patients. At that time it was vaccines, and they did that because that was part of this mission.

Deborah Wesley

So vaccines became a central part of our conversation as something as a mission minded, nonprofit VNA regardless of your personal view and opinion. And we were really clear, nothing here is personal. Nothing is your personal opinions. Nobody brings their personal views to the table. We all come for the common good. It is our community and our vulnerable patients there at home. And we did not have, we had one person due to a serious medical was unable to be vaccinated. And at this point they are now complete. So we were at a hundred percent vaccination status. So we didn’t have to take that on. And I believe a lot of that had to do with the fact that we made this an early conscious conversation.

Deborah Wesley

We continued to have conversations eventually by Zoom and in small groups, but by Zoom about what did we need to do so that every level of the organization sat at that table with what they felt was an equal share.

Deborah Wesley

And it’s a lot to bring 102 people together and to have a conversation. But we did that through multiple platforms so that everybody felt heard. We entered into the testing phase, and one of the things, we had to test each and every employee every week, and what we did was I sat down every week with every employee and participated in their testing with them and took the time to talk about their fears and their anxieties through this pandemic.

Deborah Wesley

So when we rolled through to vaccination time, we were all on the same page. We all knew how each other felt, and we decided that we were all going to be vaccinated to support our patients, put our personal opinions aside.

Deborah Wesley

So we didn’t face those challenges, but we have sister organizations throughout New England that have really suffered tremendous losses. And it has really challenged the mission to be able to care for patients for those organizations. And it is a difficult time, but we put it to our employees as it is their mission to do this, and we were able to move it forward.

Eric Grunden

That’s outstanding. It’s such a refreshing story, wonderful story, and it says so much about the culture. It sounds like your leadership and the team there is building at Addison because that’s a unique story. Very powerful that I think many can learn from.

Eric Grunden

You talked about the culture. You talked about the commitments. You talked about standing next to your team and ensuring everyone had a job and was going to get paid. I have to assume that that leads to great recruiting and people that want to be a part of this organization. Talk to me little bit about how you’re handling recruiting today. It sounds like you’re able to keep a lot of staff, so you may not be doing a ton of recruiting, but anything specific or unique that you do to attract the right staff.

Deborah Wesley

Absolutely, recruiting has always been a huge challenge. When I arrived, we did have significant vacancies, and we had turnover and sometimes that needs to happen. What we learned is as we really looked at our practices and our efficiencies outside this pandemic and before, what we were doing, everything we did with our systems and our processes, we looked at the parties involved and how did we make it? We integrated all of the pieces and to step back a bit, we utilized our EHR as a strategic piece of our recruitment plan. We utilized the systems and the processes and the technology and the interoperability, and we saw that as a tremendous piece of how we were going to recruit and retain staff.

Deborah Wesley

We wanted to ensure that our staff could feel safe during the pandemic. But prior to that, it was work life balance. It was not spending hours on the computer. So the systems and the processes and the interoperability we had became critical to recruiting staff.

Deborah Wesle

And as we traveled through our staffing patterns and we really about a year before the pandemic leveled off where we didn’t have a lot of vacancies. We did have some turnover, and that was great. An example of this, we put an ad out, but it really didn’t stay. We had a nurse from our hospice team retire and that notice was on a Monday, and on Thursday we had that filled. It was word of mouth of our employees that filled the positions. And this person had been waiting for a vacancy. And that excited me.

Deborah Wesle

It was our staff that are excited about what they do and how we support them and offer that work life balance and empower them to do their job and give the tools to do it and to be able to have that balance in their life and to know that their leaders will walk alongside them with this and support them.

Eric Grunde

Yeah, that’s outstanding. I think we touched on you recruiting staff and what you’re building and how quickly you were able to get some staff filled. What do you look for when you’re hiring? It sounds like you have a great culture that you’ve built up over time. That seems like everyone seems to be leaning forward into that. So what are the personality traits or the characteristics that you’re looking forward to bring someone into the organization?

Deborah Wesle

I think initially when I came here, what we were looking for was, it wasn’t necessary people that were willing to agree and just go with the flow. We were looking for those that were willing to be open to change and challenge.

Deborah Wesley

As we took on our EHR, and it evolved, our staff are front and center about making decisions about the technology. They’re front and center about participating in beta trials. We want people willing to step outside their comfort zone. Those people, if everybody agreed with me, I’d be bored. So when we really looked at this evolution, we looked at those people that were willing to stake their claim.

Deborah Wesley

Nothing is more wonderful than a staff meeting when we have a lot of different inputs and opinions. So people that are willing to state, not complain. Complaining doesn’t work. It’s stating their needs and stating what is best for the mission, not what best for themselves, but best for our mission. There is that balance.

Deborah Wesle

And I really, HR and I really talk about the fact that we no longer recruit. Our team recruits. As I had said, we had a vacancy come up, and that was officially posted on a Monday. We had interviewed and hired on Thursday, so it was the team that went out. They are looking for people who want to work with them, and on a daily basis, they talk about what it’s like to work here. And we encourage people to come and shadow. So we do not have a single clinical vacancy at this time. We always can use per diems, but we have no permanent positions that are open and have a waiting list for that. So it’s kind of unique.

Eric Grunde

That is very unique in today’s world and outstanding. Let’s, switch gears a little bit. You touched on a few of these topics, work life balance and others. When we talk about retaining employees, it sounds like you have a great staff. Have there been new programs or have you had to do things differently in light of the pandemic, in light of the market that we’re in to retain employees?

Deborah Wesle

Yeah. We are always looking for new opportunities. Our therapy department has had some retirees and some turnovers, and we’ve expanded to do some outpatient, physical and occupational speech therapy. So we’ve looked to increase that team, and we’ve been able to do that successfully.

Deborah Wesle

And that’s one of the things that’s having these exciting new things and encouraging people to join and be part of that. And literally, what are we going to do? I give them a blank piece of paper. What are we going to do? How are we going to do this? There’s no box to define that. How do you see this program? Here’s the rules, here’s the regulations.

Deborah Wesley

So I think that’s an exciting opportunity for people to be part of something and feel like they’re building something. We make sure that as our EHR continues to evolve, and it is always on cutting edge of trying to be the most innovative and trying to be as interoperable as possible. We encourage our staff to participate in trials, to participate in building of programs. Voice to text, we had people testing it all over the place to see if they were comfortable with it. Developing individualized care plans, a lot of different things within the system, they’ve participated, and it gives them a belonging and a connection they’ve built it. They feel as if they own a piece of it and having a stake in that really retain people and help them stay connected.

Eric Grunden

Outstanding, outstanding. I was reading a recent study by Ernst & Young, and they talk about 54% of workers in this market that we’re currently in are leaving their jobs because their boss wasn’t empathetic to the struggles either that they were having at work, 49% even said that their employers were unsympathetic to their personal lives.

Eric Grunden

We work in an industry that really requires empathy and sympathy in what you do every day in the post-acute providers. Do you feel like you’re doing enough to show employees that same empathy and sympathy that you require that they show of patients?

Deborah Wesle

I really think that we do here. I think that is a very significant culture shift. And I’ll be honest, we did not always have that here. We weren’t always engaged, but it is very important.

Deborah Wesley

Part of our leadership team, we care about each other. We care about our employees. I strategically did not place my office off into an administrative aisle. My office is burrowed down deep into the clinical side of our office with my door always open. And there isn’t a day that there’s an aid, a PCA, an RN that stops by that may just want to have a conversation.

Deborah Wesley

Through the pandemic, there were a lot of stressors that our staff faced and personal stressors as well as work stressors. And it’s important to be there. I can’t solve people’s problems, and that’s really not my role, but to empower people and to listen and sometimes having another set of ears or being available to help strategize.

Deborah Wesley

And our leadership team has been there. And historically, if people had been in jobs where I do not feel heard. If people feel heard, it’s not about getting what they want, it’s about being heard and being respected. And I think that is core elements of our leadership program.

Eric Grunden

That’s a great reminder of what leadership truly is. As we wrap up here, you’ve said it a couple of times, work life balance. I know I talk about it with my team. We’ve got more people working from home. How do you find that work life balance, especially over the last couple of years. You have examples or is there advice that you can give other caregivers of what you’ve implemented at Addison County there of how you’ve given your team either the space or the opportunity to really have a work life balance?

Deborah Wesley

Absolutely. It’s really important. I think before we moved on to our EHR, there was a real inequity of work life balance. There was just so much redundancy of paperwork. People were so far behind they would go on forever. As we moved into our EHR, and we began to understand and really adopt its efficiencies and interoperability, we really pushed for that work life balance.

Deborah Wesley

And I changed it to coffee jammies. I encourage people to turn on their iPad and start their day with a cup of coffee at home and in their jammies to begin to plan their day and organize themselves without having to rush themselves out the door, but to take a few minutes. And to end their day at home.

Deborah Wesle

We’ve got so much of technology within our EHR. We actually monitor our staff to make sure, so if we have staff that are documenting late at nights or constantly on the system or their visits are documented after the fact, and all of our employees must meet productivity standards, so this is not giving people the few hours during the day. Everybody has to meet the same standards as their peers. If they’re unable to meet those, then we really drill down and look at what are those issues? Is it more training, more education, more support, organizational skills. We really try to offer all of those. And then we work with people to ensure that when their day is done, their day is done.

Deborah Wesley

We have a lot of methods of communication on our iPad. We have secure texting. We have email. We have methods of communicating through our EHR, and we encourage people at the end of the day, you are not on call. You turn it off. If I need to find you, I know how to reach you, but we do not do that. We don’t encourage messages being sent regarding patients or any care after five o’clock or before eight o’clock. And we really put limits on how much we send even to each other during the day because we want to reduce that fatigue. And we really encourage that balance with everyone.

Eric Grunde

That’s outstanding. That’s outstanding. I think I am immediately going to implement coffee jammies within my division here at Matrix Care. I love that. I love that so much.

Eric Grunden

Well, Deborah, I have thoroughly enjoyed our conversation. I commend you and the rest of the team at Addison County for all that you’re doing in your community and the leadership that you’ve shown and the culture that you’re building there. And I thank you for spending a few minutes with us today sharing that.

Eric Grunden

And with that, I want to thank everyone for joining us for another episode of the Post-Acute Point of View. Again, we had a great topic today with attracting and retaining staff. A very special thank you to Deborah for sharing your insight and being with us today. So with that, I would like to thank you and wish you all a great day.

Speaker 1

That concludes the latest episode of the Post-Acute Point of View from Matrix Care. We have a lot of guests and topics coming up that you won’t want to miss, so be sure to subscribe. If you’ve enjoyed today’s podcast, and if you have a topic you’d like us to discuss, leave us a review. To learn more about Matrix Care and our solutions and services, visit matrixcare.com. You can also follow us on LinkedIn, Twitter, and Facebook. Thank you for listening, be well, and we’ll see you next time.