The biggest staffing lessons Mercy learned in 2023

Granting nurses more flexibility was worth it at the end of the day for Mercy. 

Dara Webb, vice president of women and children's patient services at Chesterfield, Mo.-based Mercy, sat down with Becker's to discuss how the system innovated to better serve its nurses in 2023 and her strategy and predictions for 2024. 

Ms. Webb is speaking on "What C-Suites Serious about Health Equity and Value-Based Care Need Next," at Becker's 14th Annual Meeting, April 8-11 in Chicago. 

Question: What was the biggest lesson you learned in 2023? 

Dara Webb: The biggest lesson I have learned is around staffing and how to innovate in the staffing space. Not only our physicians, but our nurses are requiring that we think about this in a holistic way. How do we innovate in having more gig coworkers, remote coworkers — what does that look like? For example, we now have a fully remote, virtual RN triage team. For those nurses in a different space in their career who did not want to be at the bedside, we were able to retain them in triage. 

We're thinking more innovatively. Physicians were a little bothered by removing the nurses from inside the clinic, but I think at the end of the day, this is worth it. Our nurses want to have this flexibility. 

Q: You're speaking about health equity and value-based care in April. What are you doing around health equity right now, and what are you looking forward to implementing in the future? 

DW: We are doing a lot of great work, and I do think that we have a lot of areas of improvement. We have four OB social workers dedicated just to our OB clinics, and we have two community health workers. Were able to touch every single clinic that is employed by Mercy with a social worker or a CHW, and I am very proud of that. It's a regional team. We reach as far south as Washington, Mo., Jefferson, Mo., and as far north as Troy. We've kept a regional approach to those economies of scale, so we go beyond just the St. Louis area. We have a large portfolio in some of these rural areas. 

Where we have an opportunity is developing a maternal health equity program manager. With that program manager, the hope is to really engage with community organizations, because we can't do this work by ourselves. Really engaging with community organizations so Mercy can be at the table — if that's working with other CHW programs, midwife programs, advocacy programs, milk bank programs, you name it — that person will ensure that we're engaging with other communities. This individual will also ensure that we're thinking about trauma-informed care from an internal perspective. How do we ensure that we have the type of training, so as families that are delivering here or, or thinking about delivering here, have a culturally competent environment. 

Q: What do your value-based care initiatives look like? 

DW: Most of our value-based contracts are in the primary care space, but we do have some value-based contracts with Medicaid, and some of our commercial lives. Those value-based contracts are around pediatric patients and maternal care. So some of those quality measures are: Are you getting prenatal care, HPV vaccinations? What are our C-section rates? 

I will tell you it's not just a Mercy thing, I think it's a health system thing — most of the value-based dollars are in Medicare Advantage. I think healthcare executives need to challenge ourselves, because we know there are value-based improvements we can make with commercial lives. We know that there are things we can do with Medicaid. How do we use those best practices in the infrastructure that we build around primary care for 65+, for our OB patients, and for our pediatric patients. 

What's one bold prediction you have for 2024? 

DW: I really think hospitals need to lean into hospitals at home. I think that's going to be more and more where hospitals need to look at programming, partnerships or building their own. You don't have enough beds, you don't have enough staff. How do you have patients in the right care and the right place? 

[Also] really incentivizing patients and caregivers. What kind of training and/or money can we give people so they feel they know what to do with their loved ones at home because they don't need to be [hospitalized] and they can get their care. 

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