'Important part of our glue': The healthcare staff executives often overlook

Front-line managers and supervisors are a critical part of the future of healthcare yet are often overlooked by executive leaders, Tamra Minnier, MSN, RN, chief quality and operational excellence officer at Pittsburgh-based UPMC, told Becker's.

In the wake of the "Great Resignation" and with health systems seeing increasing retirement rates, much of the great historical knowledge in healthcare has been lost, Ms. Minnier said, adding that newer members of the field are the ones left behind, and some of them had less hands-on experience during training due to the pandemic. 

The responsibility of staff engagement is squarely on the shoulders of front-line leaders, she said: "I don't think we talk about that enough. Nor do we talk about the leadership knowledge that has been lost through the frequent leadership changes across healthcare."

Ms. Minnier said not a day goes by without a leadership change being portrayed in the news, "Yet we know if we're going to deliver the highest quality of care and best outcomes, we need to see our staff turnover begin to settle down."

One of the first steps is stabilizing the front-line leadership team in all sections, including clinicians, nursing, supervisors, housekeeping supervisors, cath labs and imaging and pharmacies. 

"They are an important part of our glue. How are you as a leader taking care of those people? How are you supporting them? How are you helping them build confidence in the skills to face headwinds today? And if we don't do that, I truly worry about the future of healthcare leadership," she said. "The front-line leaders, managers and supervisors need to become a focus of our intention as senior leaders."

To boost leaders' knowledge, UPMC began holding clinician-only development sessions that start with the basics of the field. 

"We talk about what we think the clinician is, what we think the important things are and the why behind the things we're doing," Ms. Minnier said. "The conversations during those forums have been nothing short of spectacular. For example, there's a difference between being accountable 24/7 and available 24/7, but during the pandemic those lines got blurred. When you're a new leader, you don't know the rules. We talked with our clinician groups to clarify they are not required to be available 24/7; they can cover for each other. They did not know that at the time. People make a lot of assumptions about what they can or cannot do in various leadership roles, so it is incumbent upon the leaders to bring young leaders along and allow them to be successful."

Front-line leaders are struggling with burnout, stress and, in some cases, frustration with not knowing how they are supposed to do the job, which can lead to turnover. 

UPMC is also launching an informal network for new leaders that gives them someone to call at the end of a bad day.

"There's a joke in healthcare about how the first thing you do when you get into the car at the end of the day is call somebody. It's a commonly known thing in healthcare and a major de-stressor, but who do you call if your senior leader has retired or moved on?" Ms. Minnier said. "We are trying to build an informal network for our leaders to have someone to talk to to fill that gap in a different way."

To improve the workplace for front-line leaders, Ms. Minnier advises executives to hold direct and personal forums with front-line supervisors. 

"Please do that in the next month," she said. "Start that conversation. And if you're an insightful leader and you pay attention, you're going to hear things that maybe will surprise you. It's very easy to become disconnected with their voice and what their frustrations are."

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