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There’s already anecdotal proof of its importance
In science fiction, there is an oft-repeated theme of machines rising up and taking the place of humans, leading to a battle pitting technology against life. But ask hospital executives and even frontline health care workers what technology could mean to them in the future and most will respond positively. The potential for increased efficiency, less paperwork, and more time for direct patient care could only be appealing to them.
It’s not some distant pipe dream. The future is now, or at least very nearly now, and the impact on the workplace and work force will be tremendous, according to a new survey, The Fusion of Technology and Work Force, published by VHA of Irving, TX, this spring. "The technology an organization selects, and the way in which it is diffused, impacts recruitment, retention, productivity, and culture," the report states, noting that part of what has kept nursing school enrollment down is the perception that health care is "a low technology, high paperwork environment." The report goes on to say, "Across professional disciplines, shortages of nonphysician health care workers are exacerbated by the perception of health care as conservative, bureaucratic, and uninterested in innovation."
It will take more to attract skilled workers than pay and benefits, the report continues. "These costly short-term strategies do not address the working conditions that often drive health care workers out of the field. VHA research indicates that any successful long-term solution to the work force challenge will involve a fundamental change in the nature of the health care work. This must include the integration of technology."
It’s not like there isn’t technology out there that hospitals can integrate to make the workplace more efficient and more positive. (For a sampling of some and their impact on the work force, see chart.) For example, the report states, "technologies such as digital imaging can:
"At the same time, these systems require:
That means work and getting hospitals to adopt technologies requires a commitment to some temporary disruption in work patterns."
While there can be some initial pains involved in implementing technology, the report notes that it can be critical in "overcoming some of the perceived downfalls of working in health care and aid in the recruitment, retention, and motivation of qualified staff."
A secondary issue for now
While the report points to obvious impacts that technology has on the recruitment and retention of staff, there is nothing — at least not yet — that shows a definitive link between having technology and finding and keeping good people, or not having it and having work force problems, says Chuck Bohlen, director of the VHA’s Center for Research and Innovation in Charlotte, NC. "We don’t want technology to be viewed as a way to lay people off or cancel vacancies," he says. "But there are certainly people out there who believe that if you take technology away, people would be extremely unhappy. So it is a retention issue. It makes work easier and more attractive to those who have seen both the old processes and the new."
As new generations of young people enter the work force, however, it could become a definite recruitment plus or minus, Bohlen says. "There are students who come out of their clinical training expecting a hospital to be as high-tech as their school. And they will probably be disappointed," he says, noting with amusement that some students just "don’t use paper and pencil, they only know how to keyboard. They come to a hospital with paper and pencil charting and just don’t know what to do."
On the other hand, some schools have a more traditional clinical education, taught by faculty who aren’t as computer literate and choose to teach the way they were taught. "Those students may come to wired hospitals with electronic charting and computerized physician order entry, and they just don’t have the skills necessary for those workplaces."
For hospitals, technology issues must be on the radar now, Bohlen warns. "We talk about the Barbara and Brittany generations: Barbara has never used a computer in nursing care, and you’re asking her to use it. She may be intimidated. Brittany will hit the work force in a year or two, and she’s going to have technological expectations. You are going to have to figure out how to deal with both generations."
There has yet to be any research looking at the impact of technology on recruitment and retention. Indeed, most organizations only have anecdotal information about its impact on those issues. For instance, the report cites Sacred Heart Medical Center in Spokane, WA. According to Robert Hester, RN, a nursing department analyst there, technology is a fact of life for recruiting and retention already, and many who were initially uncomfortable with new technologies when they were implemented would now refuse to go back to paper-based systems.
At DCH Health System in Tuscaloosa, AL, nurses who left to become traveling nurses for better pay are coming back after finding the old ways still prevalent outside DCH, says Kim J. Ligon, chief information officer at the four-hospital system in central Alabama. "One of our old nurse managers who worked on improving our documentation system left and discovered how advanced we were in terms of technology," she says. "Her comments have others rethinking early retirement."
There is other evidence that technology affects recruitment and retention at DCH, too, Ligon says. For instance, new physicians are very enamored with the computerized physician order entry program that the system is rolling out. "The student nurses like it, too," she says. It doesn’t hurt that the University of Alabama and its Capstone School of Nursing uses the same documentation system. "That means if they come to work here, they don’t have to learn something new."
Recently, Capstone offered a refresher course for nurses reentering the work force. "Nurses came from all over the Southeast," Ligon recalls. "We did a presentation on our documentation system and the technology we use. After that, some of the participants decided that in returning to nursing, they would stay here, rather than go back to their own cities to look for jobs."
Still, while she says that technology will make more and more difference in finding and keeping good staff, right now it’s "on the periphery. You choose a technology for one reason; but then a light bulb goes off, and you realize it will be great for another reason, like recruitment."
Part of what makes technology work at DCH is the input that frontline workers have in technology issues. "The nursing staff here aren’t shy of telling information systems what they need," Ligon says. "And we listen. We also are conservative rolling things out. We don’t just buy something because it is the latest and greatest technology. We do it only for practical functions and sound business reasons," she says, noting that many in the technology field become enamored "of the cool stuff out there. But it may not make the work lives of our staff any better. Just because, it is new doesn’t mean we have to buy it. If you work like that, you end up with a staff that are gun-shy about what new technology or computer system they have to learn today."
Editor’s Note: For more information on the VHA report, The Fusion of Technology and Work Force, visit the VHA web site at www.vha.com. The entire report is available to VHA members, although it will be made public later this year.