Balancing Competing Needs in Healthcare Upskilling: Policies, Challenges, and Recommendations

Introduction

Healthcare facilities are the same as business entities, aiming to maximize profits while minimizing costs except for the government-sponsored healthcare facilities. There is a possibility of competing needs in healthcare facilities whereby employees fight for their interests while the management targets meeting company goals. The main stakeholders in healthcare are the workforce, patients, and management, and all often have their own needs (Holt et al., 2017). Leaders have a role in solving the organization's conflicts through policies that enable the proper utilization of resources. Since they have to operate on a going concern concept, healthcare institutions need to handle available resources with care. The organizations focus on making profits; employees demand higher salaries and regular training while patients expect quality service, including the latest technologies, all conflicting interests. The paper aims to evaluate the contradictory interests and policies within my organization concerning upskilling stressors.

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The Two Competing Needs Impacting Upskilling in My Healthcare Institution

The first need that impacts upskilling as a stressor in my organization is that patients need quality services that incorporate the latest technologies for optimal outcomes but at affordable costs. Patients are the main stakeholders in any healthcare facility, and they expect the very best service and results. They are never concerned with the costs of acquiring emerging technologies or hiring qualified staff and experts. It is upon the healthcare organization to ensure the patients are satisfied and contented. While in the healthcare facility, patients expect to be served by a qualified and experienced doctor, nurse, therapist, pharmacist, or any other healthcare staff.

An example is a cancer patient who visits the facility with the expectation of receiving the latest cancer chemotherapy. It could be Doxil's use, which is approved by the Food and Drug Administration (FDA) for treating breast cancer patients (Mngqibisa et al., 2017). The nurse will need upskilling to reach the expectations; however, it is not worrying for the patient.

The other competing need in my healthcare institution is to minimize expenses and increase profits. The desire to cut costs has a direct impact on upskilling, which consumes a lot of funds. As my facility is private and not financed by taxpayers' money, it must make profits for it to continue operating. Upskilling is an expense to the entity and reduces profits; therefore, the management would wish to minimize the retraining and upgrading costs to have higher earnings (Bilkey et al., 2019). The organization has to weigh whether to retain employees who are not updated on current nursing practices or incur costs to upskill them.

Relevant Policy in My Organization that Influence Upskilling

My institution's six-year strategic plan has a policy that requires the allocation of some funds for educational scholarships and training fees for employees with long-term contracts and who have served for more than five years. It is only employees who are loyal and expected to remain in the organization qualify for the scholarship. However, the funds' allocation depends on the profits recorded at the end of the financial year. The beneficiaries should have served the institution for more than five years and shown to be productive. The policy is beneficial to institutions on upskilling matters as qualified workers are trained and acquire the latest medical and nursing skills. Last year a graduate nurse benefited from the program and was trained to be a nurse informaticist after the organization installed an electronic system of record keeping. Also, two more nurses working in the ICU wing form the list of the scholarship program's latest beneficiaries. They were trained on how to operate a new machine to conduct renal replacement therapies in the ICU.

Policy Critique

Both the positive and negative sides can view the policy. On the positive side, the approach is beneficial to the organization and the healthcare employees. The employees benefit by acquiring new skills and knowledge, which makes them competitive in their specifications. The organizations earn from the program by having a competitive edge over other healthcare facilities that do not have up-to-date nurses, doctors, or other updated healthcare workers. The policy's main limitation is that it depends on earnings, so if the organization performs poorly, there will be no allocations. The program can only be successful if the organization is recording good performances.

Ethically, it is not appropriate for workers to wait for five years to get a chance to upgrade their skills. It means that an employee will remain incompetent for five years before being trained on new nursing practices. Health workers need to upgrade their skills as soon as possible to serve the patients better and deliver quality service. It is not fair for the organization or the workers to wait for five years to qualify for the scholarships to upskill. If a new employee is supposed to use new machines or follow the latest protocols, the organization will challenge to train them because of working less than five years in the facility. It would be unfair to ask healthcare workers below five years of service to cater for their upskilling expenses.

The main strength of the policy is that it confers benefits to patients and the healthcare staff. The employees get a chance to upgrade their skills without incurring their costs, and the patients benefit by receiving the updated treatment, which is safe and affordable. The overall outcome is a happy and motivated workforce and a high patient satisfaction level. In the long term, staff turnover will be reduced significantly, and productivity will increase among the workers; hence the organization will save resources used in advertising, recruiting, and interviewing new employees (Waights et al., 2018). The satisfaction of the patients will enable the institution to have a good reputation and a high rating. Besides, there will be referrals from the patients, attracting more customers for the organization who need quality healthcare.

The most challenging part of the policy is limited resources. It is hard to implement the policy during periods of harsh economic conditions as it depends on an organization's profitability. It becomes challenging because workers may not define how the organization is profitable. The management can deny the qualified workforce a chance for upskilling because the organization has been performing poorly. It is upon the senior managers' wish to decide the amount to be set aside after the end year for educational scholarships. When and what amount to allocate for the policy will have to be made in the boardroom upon evaluating other priorities of the institution.

Policy Change Recommendations to Balance the Competing Needs of Resources, Workers, and Patients

Partnerships with Foundations and Donors

Resources are the main obstacle for the upskilling program in the organization. One good policy to solve the scarcity of resources could be looking for partnerships with willing foundations and donors. They will provide the funds needed to finance the scholarships for the healthcare workers. External funding releases pressure put on the organization's resources and can solve other needs. An example of a foundation for partnership is the Bill and Melinda Gates Foundation, which funds healthcare programs (Kulimbua, 2018).

In-house Training

The other potential policy recommendation is training the employees while in the hospitals instead of outside the premises. Sending workers away for upskilling programs consumes more resources than on-the-job training (Persson et al., 2018). It would be beneficial to enable the training session to be carried inside the facility to allow the employees to continue performing their duties. It would be feasible when the employees are acquiring new skills while at the same time providing their services in the facility. The recommendation is economical.

One of the ethical deficiencies of current policies is that employees do not receive payments whenever they are on study vacation. It is improper not to pay workers who are undergoing training for the benefit of the organization. The act causes financial distress among the healthcare staff, enhancing their knowledge and skills since they have their own financial needs. Upskilling is a part of the organization's initiative to regularly re-strategize due to the fast-changing healthcare environment and advancements (Di Wu et al., 2017). Therefore, the employees deserve payment while under the upskilling programs.

References

Bilkey, G. A., Burns, B. L., Coles, E. P., Mahede, T., Baynam, G., & Nowak, K. J. (2019). Optimizing precision medicine for public health. Frontiers in public health, 7, 42. https://www.frontiersin.org/articles/10.3389/fpubh.2019.00042/

Di Wu, M. S., Xue, H. Y., & Wong, H. L. (2017). Nanomedicine applications in the treatment of breast cancer: current state of the art. International journal of nanomedicine, 12, 5879. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5566389/

Holt-Lunstad, J., Robles, T. F., & Sbarra, D. A. (2017). Advancing social connection as a public health priority in the United States. American Psychologist, 72(6), 517. https://psycnet.apa.org/buy/2017-36583-002

Kulimbua, J. (2018). Evaluation of Community Health Workers' Upskilling Training in Maternal and Newborn Care at Mount Hagen in Western Highlands Province, Papua New Guinea. Pacific Journal Reproductive Health, 1(7). http://pacificjournalreproductivehealth.psrh.org.nz/index.php/pjrh/article/view/147

Mngqibisa, R., Muzigaba, M., Ncama, B. P., Pillay, S., & Nadesan-Reddy, N. (2017). Upskilling nursing students and nurse practitioners to initiate and manage patients on ART: An outcome evaluation of the UKZN NIMART course. African Journal of Health Professions Education, 9(3), 153-158. https://www.ajol.info/index.php/ajhpe/article/view/163681

Persson, M., Anastassov, Y., Khater, R., Spataru, R., Nobile, F., Skuladottir, H., ... & Rumsey, N. (2018). Cutting edge training: upskilling health professionals in psychological care for patients undergoing appearance-altering procedures. Journal of Aesthetic Nursing, 7(10), 522-529. https://www.magonlinelibrary.com/doi/10.12968/joan.2018.7.10.522

Waights, V., Bamidis, P., & Almeida, R. (2018). Technologies for care–the imperative for upskilling carers. http://oro.open.ac.uk/55287/