Advancing Measurement & Accountability
Federal, state, and local governments can influence health systems and organizations by directly measuring well-being, developing organizational metrics for worker and learner well-being and turnover, and establishing health and public safety workforce analysis and planning bodies.
Note: Research examining the most effective policies is often limited. Where there is evidence, we try to provide it. In many cases, we provide spotlights of federal, state, or local policies and programs that can be adopted or adapted in other places.
Measure Well-Being
Federal, state, and local governments can directly collect and/or require measurement of health and public safety worker burnout, moral injury, and well-being for the purposes of tracking, feedback, directing resources, and payment.
Resources
In 2022, the Partners for Nurse Staffing, a collaborative of five national organizations, convened a Nurse Staffing Think Tank to identify recommendations to address the nurse staffing crisis. Recommendations included:
- Clinician experience as a criterion in the CMS Hospital Value-Based Purchasing program (mirroring patient experience).
- Create a CMS Condition of Participation that requires organizations to regularly assess/measure the health of the work environment and demonstrate evidence of continual improvement.
The NAM National Plan for Health Workforce Well-Being prioritizes investing in measurement, assessment, strategies, and research and identifies federal, state, and local governments as critical actors. The plan recommends:
- Establishing and supporting a national epidemiologic tracking program to measure health worker and learner well-being, distress, and burnout with mandated funding
Spotlight
HRSA’s Health Center Well-Being Initiative conducted a workforce well-being survey across nearly 1,500 HRSA-supported health centers. Data will be used to inform program and policy development and training and technical assistance efforts. Each participating health center will also receive a dashboard of its survey data. Technical assistance resources and the survey instruments are available on the website.
Establish Health & Public Safety Workforce Analysis and Planning Bodies
The U.S. Surgeon General’s Advisory recommended a “coordinated, whole-of-government approach to adequately prepare public health, health care systems, and health workers for future public health emergencies,” including supporting a National Health Care Workforce Commission to identify appropriate federal levers to stabilize the workforce factors that drive health worker burnout.
Resources
The National Health Care Workforce Commission was established under the Affordable Care Act as a nonpartisan independent agency charged with reviewing health care workforce supply and demand and making recommendations to Congress and the Administration on national health care workforce priorities, goals, and policies.
The National Governors Association spotlights a number of state health workforce analysis, planning, and investment initiatives in California, Colorado, Missouri, Oklahoma, Wyoming, and Rhode Island. Examples, include:
- California established an Assistant Deputy Secretary of Healthcare Workforce position and the California Health Workforce Education and Training Council in statute in 2022.
- Colorado launched a dashboard to track progress toward health workforce “Wildly Important Goals.”
- Missouri convened a Taskforce on Healthcare Workforce Development that crafted a report on Strengthening the Workforce Pipeline: Recommendations for Public Health & Healthcare in Missouri that resulted in the establishment of the Public Health & Healthcare Workforce Advisory Taskforce.
Spotlight
The Utah Medical Education Council (UMEC) was established in 1997 to conduct health workforce research, advise on Utah’s health care training needs, and influence graduate medical education (GME) financing policies. For example, UMEC managed a Medicare demonstration project from 2000 to 2010 in which the state received and distributed Medicare direct GME funds according to the Council’s research on workforce needs.
