Here's some good data from an ACHE Congress seminar (March 10-13th):
Takeaway Points:* Reciprocal permeability of globalization (movement back and forth of dollars and people - staff and patients)"
* "collective impact seems to be getting more intense by the year"* "see hospitals responding in more of a bottom-up approach as opposed to there being a centralized function in hospitals - maybe we need corporate strategies for dealing with the global environment - monitor the environment for changes that are significant in the world."
* "It's happening to us..." no information on flow of dollars/personnel in terms of consultants moving back and forth - US based firms and staff establishing bases abroad.
Quote of the day: "Healthcare is a little bit late to the table in thinking about this."
MEDICAL TOURISM/Travel to Care - should have been a session in this presentation.
From the Audience:
* Hospitals going public in India. India, Saudi Arabia are having docs go back and start hospitals and recruit fellow doctors to RETURN (Boomerang Providers).
* Cleveland Clinic has 1B budget to come up with overseas revenue streams (businesses go where the growth is...they can see markets developing and opportunity for gain).The Old Standards are Still Hanging Around:
* Treating patients with limited English proficiency is still a big deal - about 18% of US population speaks language other than English at home. 80% of hospitals surveyed report they encountered LEP patients at least monthly. 97% large hospitals (300 beds), 64% small hospitals (under 100 beds)- ALL affected (some regional variations, teaching hospitals more likely 98 % vs. 75% other hospitals).* Move beyond anecdotes to measurement (metrics).
* Why the global labor market (movement of docs, nurses, consultants, etc)?
Migratory Health Worker Stats:
* Phillipines is largest 'exporter' of trained nurses - 30%* "foreign educated nurses tend to work more and work harder" "doing the work that we don't really want to do"
* integration of global workforce is happening beyond the periphery of traditional border states - California 29% are foreign-trained - NY, NJ, Fla approx. 24%* remittances ($ sent home from employees abroad) are significant source of 'international aid'
* States with most IMGs practicing = 40% in NJ, just under 40% in NY, 35% in Fla, state median is 17%)
* Top 3 IMG specialities- internal medicine (36%), psychiatry!?(31.4%), anesthesiology (29%)
Home Organizational Applications:
Do study based on exit interviews/new hire interviews...why do nurses leave other hospitals and why do they COME work at our hospital? Do nurses migrate internationally (externally) for the same reasons they migrate nationally (internally)? Ask nurses why they leave...answers may include:
* "the nursing shortage in the US will be around for awhile- don't be in a rush to go" - from former Phillippines hospital administrator - 7,000 islands - average tenure 3 to 6 mos at tertiary care centers...1 year if you're lucky - fair amount of Philipino docs who are converting to nursing to practice/work in the US - larger effects on Phillippino culture - nurses acting as welfare agents, rest of family may not work
1. Decreased staff satisfaction (shocker)
From the Audience - Creative Potential Solutions (They Need an IDEO Session...):
Meaty summary but there are some very good lessons hidden amongst the data. Are you tracking international medical professionals at your organization?