Johnese Spisso on the CEO Coalition's Efforts to Improve Healthcare Worker Safety

The COVID-19 pandemic has shined a light on the physical and emotional risks healthcare workers face in addition to systemic inequities present prior to the health crisis.

In an effort to spark a national movement for change, a coalition of health system CEOs has devised and signed a Declaration of Principles setting new safety standards for these workers. The Coalition consists of 10 health system CEOs from across the country committed to improving safety, well-being and equity for all who work in the healthcare field.

The Declaration expands the definition of safety to cover psychological and emotional well-being, states equity and anti-racism are core components of safety, and works to ensure safety by eliminating physical and verbal workplace violence, according to a recent CEO Coalition statement.

To learn more about the Coalition’s formation and how it devised these principles, Chief Healthcare Executive™ (CHE) spoke with Johnese Spisso, MPA, president of UCLA Health and CEO of UCLA Hospital System. Spisso is a co-founder of the CEO Coalition and also co-wrote the Declaration.

CHE: Can you discuss how the CEO Coalition came together? Has the group worked on initiatives in the past?

Spisso: Well, certainly this past year has brought a lot of new issues forward in healthcare and as our role as employers for an incredibly dedicated and talented workforce in healthcare. The coalition was founded by 10 healthcare system CEOs from across the country. The founding healthcare systems are diverse in both the background, the region, and types of hospitals they lead. It represents academic medical centers, not-for-profit hospitals, and safety net facilities. The group of CEOs convened because we all shared a common commitment that we really cared deeply about the safety of our team members and wanted to help spark a movement to set new standards of safety for the nation. We recognize that the COVID-19 pandemic was amplifying and bringing visibility to safety issues for team members. It also particularly amplified the physical and emotional risks healthcare team members face, as well as systemic inequities. It gave us an opportunity to look at issues through a new lens and think about how we could bring all of this talent and energy together and create a movement that would be impactful.

CHE: The Declaration of Principles covers some areas that were workplace concerns before the pandemic—such as protecting healthcare workers from violence. Is the Coalition drawing on efforts that were in motion before COVID-19 to improve the health and safety of the workforce?

Spisso: The Declaration of Principles was drafted and refined based on feedback from in-depth interviews and convening with the executives and CEOs over the course of three months in the early part of 2021. We relied on research and strived to understand what core principles underline team members' ability to feel and be safe at work, even prior to the COVID-19 pandemic—because a lot of these issues were there in the past. The CEO Coalition, we have the goal of turning that Declaration of Principles into action by collaborating with healthcare institutions to conduct research and identify a set of evidence-based practices and measures that help support the Declaration of Principles. So, there's still a lot of work to do.

CHE: The Principles discuss investments in technology to reduce mental and physical burdens for staff. This sounds like it could include everything from reducing time in front of screens to equipment to help move/transfer larger patients. What is the breadth of investment envisioned?

CHE: Are best practices emerging to deal with staff burnout? If so, what are they?

Spisso: Yes, and we certainly have seen burnout and fatigue throughout this pandemic, and it's come in waves. I think starting out, not only were our staff worried about their own safety, they were also worried about the safety of their families when they were coming into work, and then taking care of patients and going back home, particularly early in the pandemic when we didn't have all the information that we needed about COVID-19. We've tried to make sure we can continue to support their health and well-being and their families' health and well-being as we navigate through the pandemic and provide that direct frontline care. We've tried to do a lot of wraparound services to support the staff going the extra mile for us. I think a lot of institutions have done this with support for meals, support for groceries, support for housing, support for childcare. We've also, here at UCLA health, we've run a variety of virtual and online wellness programs like mindfulness meditation, yoga, as well as reaching out and calling our staff and seeing how they're doing, particularly those who were working in our COVID-19 units.

CHE: We had a recent commentary submitted that said one challenge of ensuring adequate staff is the lack of slots in nursing education programs. Has this problem come up at UCLA Health?

CHE: How will the Coalition measure the success of implementing the Principles?

Spisso: That's a really important point. I think, as we bring forward new work to make sure it is having the impact that is desired, and I think that as we look at the CEO coalition, we'll be successful if healthcare team members' safety, as defined in the Declaration of Principles, is measurably improved within one to two years. Our vision is to build momentum by gaining the support of CEOs across the country to help demonstrate the importance of the issue, and specifically around those three pillars that we've defined for our healthcare system nationally. Those are the emotional and psychological safety, the health justice, and the physical safety. We also hope then, that we can use that work and those measured improvements to influence health policy, funding, and culture to create a safer experience for all who work in healthcare, and to keep our healthcare workforce on the job longer in their careers.