Vissers: Pay, working conditions critical to staff retention

BOULDER — Boulder Community Health, like health care organizations throughout the country, is looking at compensation systems to help retain and recruit workers in short supply during the pandemic, but it has to go further; it has to improve working conditions in order to have long-term impact.

Dr. Robert Vissers, CEO, is well aware of the stressors impacting the BCH workforce. He’s a former emergency-room physician.

“We’re doing several things, some short term and others longer term,” he told BizWest in an interview about numerous topics, including the shortage of health care professionals such as nurses. “What we’re doing right now is to make changes to our compensation both to stay competitive in this marketplace locally and nationally, particularly for nursing staff, but also to reward them for the amazing sacrifices that they’ve made. I’m also an emergency physician, and this has been the most difficult year I’ve experienced. We’ve asked a lot of our professional staff.”

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BCH, which normally provides annual pay increases each April, moved that up this year and has provided 4% pay increases effective now at the end of the year. The minimum wage paid to any employee is $17 per hour, he said.

“And with these changes, are we market competitive within individual areas?” he asked. Answering the question means looking at specific jobs within the company network to see if BCH has kept up.

In all, Vissers said that BCH is spending $5 million “out of cycle” on payroll.

To help combat shortages of nurses, many organizations have used traveling nurses — temporary employees who frequently earn significantly more than existing employees. Vissers said he is well aware of the irritation that this engenders from employees. 

“All of us are having to bring in outside labor and contract labor. Historically, we haven’t had to use a lot. Our preference is to spend those dollars on our employees and recruiting permanent employees,” he said. “This wage arms race is not good for patients and nurses themselves. We’d much rather invest those in our current staff.”

Vissers said he is aware that an increase in compensation only goes so far. It doesn’t address what he called the “moral distress” and fatigue that staff faces. Moral distress can be defined as the emotional state that results from being asked to do things different from what a nurse or other professional thinks ought to be the ethical correct action.

An example might be having to do computer work when the on-the-floor patient needs are so great, as they have been during the pandemic.

“The compensation doesn’t address the fatigue and moral distress that staff is facing. Employee wellness will be the focus in the coming year — how can we further invest in the wellness and resilience of the current staff as we navigate this difficult time when the end doesn’t seem anywhere close. … It’s no longer going to be enough to bring in pizza for the night staff. We need to double down.” 

Vissers said the Boulder community has stepped up and shown support for health care workers. “We have never seen such support for our nursing staff. Despite the challenges that we’ve faced, patient satisfaction has never been higher. More importantly the recognition [of what health care workers do] has never been higher in our community.”

When the public is asked how the organization should spend its foundation dollars, “overwhelmingly the answer was ‘support your staff, work on wellness of your current employees.’ Our focus next year will be how we make sure our employees are taken care of.” 

Vissers said he wants to work toward “making sure nurses and others work at the top of their licenses. Make sure they’re doing things they trained for and not sitting behind a computer. Let them be the professionals they are.” That means bringing in support staff to do some of these other jobs and creating efficiencies in the system. 

“If I can reduce the amount of time someone spends in the ER by half, that reduces the amount of time that nurse has to spend with that one patient,” he said.

To do that, BCH may have to hire more certified nursing assistants to take some of the routine workload off of nurses, which in turn means that BCH, along with every other hospital along the Front Range, must find ways to help colleges train more CNAs.

“In the 26 years I’ve been in health care, we’ve always struggled with shortages of docs, nurses or CNAs. Are there other technicians out there who could help. Can we bring in paramedics, for example. It’s not just the capacity of schools to bring in caregivers, but we have to make it compelling for people to join the industry. Make sure we address their personal needs, personal wellness. We have to create a job and a job market that is appealing.” 

“Once someone spends time at BCH, it isn’t hard to convince them that this is a great place to work.”

Behavioral health in community

BCH, like most hospitals in the region, is seeing a greater demand for mental health or behavioral health services, “whether it’s adolescents or the isolated elderly or those having to care for family at home,” Vissers said. 

“BCH has made a significant investment in the Della Cava Pavilion. We recently announced IOP [intensive outpatient care]. The IOP will provide care during “that difficult and fragile time” when a behavioral health patient leaves an inpatient unit and transitions back to regular life. Those patients, instead of occupying a bed in an inpatient setting, will visit the hospital daily to receive assistance while living at home, he said.

Independence

When asked about BCH’s independence — the hospital is the only facility in the region outside of hospital groups — Vissers was resolute. “The reason we’ve placed such emphasis [on independence] is that it keeps care local, it keeps quality high. It allows us to be flexible and keep costs down.

Still, the organization will partner with other entities when it makes sense for patient care. He cited partnerships with medical clinics in the community and three surgery centers in which BCH has 50% share. It also has partnered with UCHealth in Broomfield on an inpatient rehabilitation center. 

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