Embracing Change

Readers of Tuesday's Clarion-Ledger front page couldn't have missed what the paper considered to be the day's top news.

The headline in the print edition read: "UMMC axes nursing slots."

The lead paragraph went on to say UMMC "has laid off 10 nurse educators and four others in the latest downsizing."

The earlier "downsizing" was actually three years ago, so I'm not sure the time interval justifies use of the term "latest."  Also, as the story explained, the 2012 staff reduction was much larger, involving 115 positions. 

My purpose here is not to quibble with the newspaper about how it played this story.  Instead, I want to discuss how we think and talk about those occasions when, for a variety of reasons, we feel compelled to realign our staffing to meet changing realities.

First, I want to say that our leadership group never loses sight of the fact that the employees impacted by these decisions are good people and valued team members.  We never make these decisions lightly or without compassion for those involved.  And we make every effort to assist those whose jobs are eliminated to transition into other roles when that's possible.

These occurrences go by different names - job cuts, layoffs, downsizing, reductions in force.  Each carries a different connotation, but there can be important distinctions.  

The relatively large reduction in the workforce of 2012 was in direct response to local economic factors.  We simply needed to reduce our staffing costs to meet an unexpected shortfall in revenues.  The positions affected ranged across the organization.

Fortunately, staff reductions like these, and of that magnitude, have been few and far between in our history.  Indeed, as I've mentioned several times recently, we are in a stronger financial position now than we have been in many years.

The more recent cuts are an example of our institution adapting to a changing business environment.  The fact is, we are constantly reshaping our workforce in response to changes in technology, consumer preferences, regulations, reimbursement policies, operational needs and many other influences.  

Some of this reshaping, as was the case last week, results in decisions to eliminate staff positions.  After several months of evaluation, we determined that work being performed by our at-large nurse educators could be done, or in some cases, was being done, by unit-based staff.

Equally important in this decision, however, is that the activities of nurse educators - as with almost anyone involved in education - have changed dramatically with the advent of online content and digital distribution channels.  Tablets and smartphones, Facebook and YouTube - technologies and tools that didn't exist just a few years ago - have transformed the way we teach and learn.  They've made vast amounts of content more widely available, bringing greater efficiency to the process.

This trend is an example of disruptive innovation - the way new technologies or paradigms displace existing ways of doing things.  

We don't have to look far to find examples of disruptive innovation.  How about telemedicine?  How about distance education?  The genomic revolution in research and patient care.  The paradigm shift from volume-based care to value-based care in health-care reimbursement.

We are awash in disruptive innovation. And it's only going to spread. And it's only going to accelerate.  

And that means we will constantly be making adjustments in our workforce, and in other ways, to adapt to this changing environment.  In most cases that will be achieved through in-service education and retraining.  In a few cases it will mean reductions in staff because we have become more efficient, or because the skills that were once needed to achieve our goals are no longer needed.

The good news is that disruptive innovation creates opportunity, and with that opportunity comes new roles and responsibilities.  From the examples I cited above, we have committed to becoming, and in some cases already are, leaders of the wave of innovation engulfing academic medicine.

Will there be some painful adjustments along the way? Yes. Will the news media from time to time carry more stories about UMMC "downsizing?"  Probably. 

But they will also carry stories about the growth of our telehealth services and our online education programs, about our discoveries of genes that control brain function and our leadership in clinical quality.

When you read those and other stories, you will know that we are meeting the challenge of an ever-changing world, on our path to A Healthier Mississippi.