At a recent industry conference, I watched a pair of presenters show some fairly eye-opening statistics about workforce retention. The studies they cited weren’t health care-specific, but they did demonstrate that conventional wisdom about hiring — specifically, that years of experience and education correlate with strong job performance and retention — is wrong.
In fact, they said, you’d get better results by picking candidates by coin flips than basing your decision on how long an applicant has spent in the industry.
The statistics were solid, published by a pair of researchers from established universities. But the outcry from the audience, primarily consisting of long-term care administrators, was almost instant: That just can’t be right, the voices said. I don’t care what those numbers say — I’m taking the certified nursing assistant with 20 years’ experience over the rookie every time.
As a baseball fan, the argument was all too familiar.
The game has undergone a statistical revolution over the last two decades, with front offices relying on metrics — like wins above replacement, batting average on balls in play, and walks plus hits per inning — that would be unrecognizable to former fans who tuned out years ago.
There’s proof that a newfound attention to data has bred success in the major leagues. The Oakland Athletics famously rode their “Moneyball” tactics to multiple playoff appearances nearly 20 years ago now, and the Houston Astros used a bullpen scientifically built on making batters swing and miss on off-speed pitches to help them win a world championship in 2017.
Teams regularly employ dramatic infield shifts to place their defensive players in the likeliest path of each batter’s ball, regardless of where those players have traditionally set up shop. Batters pay attention to the angles their swings take, tweaking them to produce the arc that will routinely generate home runs. And just this season, tired of seeing pitchers repeatedly walk star slugger Bryce Harper, the Washington Nationals started batting him leadoff — basically daring opponents to either give him something to hit or risk starting the game with a runner on first.
In short, what was once heresy 30 years ago — having your second baseman play short right field or having anyone other than a slight speedster bat leadoff — has now become baseball orthodoxy.
It’s time the skilled nursing industry embraces that same spirit of data-based experimentation.
There are voices in the world of baseball who click their tongues at the newfangled statistics and insist that managing by gut instinct is the only way to succeed. But their ranks are fading away, and for good reason: Not only did the Astros’ embrace of analytics bring them a World Series title last year, but their opponents — the National League champion Los Angeles Dodgers — boasted an impressive data department led by former financial analysts and an MIT graduate.
The change was slow and gradual — “Moneyball” was published in 2003 — and not every team is fully on board, with some old-timers still scoffing at the computer-based approach. But the revolution is here, playing out on baseball diamonds across the country and propelling the savvy organizations to success.
The same embrace of data can save skilled nursing. Not every metric will be relevant, and not every organization that adopts a data-first approach will ride the wave directly to the top of their given markets.
But there’s no way that operators can survive changing reimbursements, surging demand, and a difficult labor market without the willingness to get on board with whatever new insight they can harness. And as my experience at the conference shows, smart organizations can’t just release packets of data showing why a certain strategy should work — or even just send their chief clinical officers to conference after conference in which top thinkers emphasize the importance of data.
Leaders need to make sure that attitude trickles down to the very bottom of every organization, from the CEO to the support staff at each facility. They need to show everyone, from frontline caregivers to administrators to the families of the people who live in their facilities, how the data they use to woo Medicare Advantage providers and other referral partners directly affects care and positive outcomes.
When big thinkers extol the power of data at industry events, they should be preaching to a choir full of caregivers who are already true believers. Otherwise, operators will be stuck in a never-ending loop of attending conferences that emphasize the importance of data while their residents and employees never reap any concrete benefits.
And the skilled nursing industry will continue to lose to superior opponents that long ago put the Moneyball method to work for them.
Written by Alex Spanko