#ACCCNOC: Innovation + Leadership

Innovation was the major theme on the second day of the Association of Community Cancer Centers (ACCC) 40^th National Oncology Conference, as members of the multidisciplinary cancer care team shared groundbreaking ideas for pushing the envelope in delivering comprehensive cancer care. The day began with an address from ACCC President Olalekan Ajayi, PharmD, MBA, chief operating officer for Highlands Oncology Group, PA, “At this meeting, we are delivering sessions focused specifically on workforce development. Whether you have an interest in recruiting and retaining a pipeline of oncology workers or you are looking for ways to identify and bring up new and diverse leaders,” Dr. Ajayi said. “This meeting has the strategies you need to succeed.”

Dr. Ajayi went on to introduce the opening keynote speaker of the day, Ted A. James, MD, MHCM, FACS, medical director and vice chair of Beth Israel Deaconess Medical Center, New York, NY. Dr. James delivered an insightful session on driving innovation and excellence in cancer care. “We can't deliver cancer care the same way we have always done. Times are changing. It is the age of information, convenience, and control,” Dr. James said as he began his session. “Change is hard, and I believe it's because it requires energy and action, and it also takes a lot of effort from a leader to effect change."

According to Dr. James, the significant challenges facing the oncology community (ie, dissatisfaction, dysfunction, and burnout) can only be tackled through inventive leadership. “What is the difference between a leader and manager? A manager is someone that maintains the status quo, but a leader is someone who changes the status quo, and that is what we need in the present cancer care space,” he explained. “The world is very different now, so we must start thinking differently. If we as leaders don’t keep up with the innovations, we are going to fall behind.” One-way leaders at cancer programs and practices can achieve this is by inspiring their workforce. “To generate intrinsic motivation and creative problem solving from our team members, you need to provide 3 things: autonomy, resources and training, and purpose,” Dr. James said. “People need to be aligned with something bigger than themselves.”

In conclusion, Dr. James shared a framework that leaders at healthcare organizations can leverage to effectively lead their staff and deliver next-generation care. In his words:

• Individuals who are highly committed but have low capacity or skills are your enthusiasts. What do leaders do for these individuals? Coaching, training, mentorship, and active feedback.
• Those who are highly committed and have a high capacity are our champions. As leaders, we need to engage these individuals. We need to hold them up and champion them.
• Individuals who are not committed but have high potential are our skeptics. As leaders we need to listen and influence these individuals. We need to ask what issues and/or challenges we can help them with. 
• Obstructors are individuals with low commitment and capacity. As leaders we need to hold these people accountable. If we do not address their issues, they will obstruct positive change.

“With innovation, anything is possible. The best way to prepare for the future is to create it.”

The rest of the morning sessions were centered around the 2023 ACCC Innovator Award winners. “I hope this year’s winners will inspire you to reach new heights and empower you to effect positive change for your patients and organizations,” Dr. Ajayi said. In their sessions, this year’s winners provided attendees information on identifying and implementing creative solutions to common challenges, including lessons learned, and tools that they can take home and use in their cancer program or practice. More information on this year’s ACCC Innovator Award winners can be found on the ACCC website. The sessions that followed offered excellent learning opportunities for attendees. Below are key highlights from various sessions: 

Leadership Sustainment and Engagement During Challenging Times

Launched in 2020, the Tennessee Oncology Leadership Academy aims to build a culture of collaborative and agile leaders by offering 4 distinct pathways: aspiring leader, emerging leader, elevating leader, and excelling leader. To date the Academy has enrolled 157 team members, seen a 96% retention rate, and promoted 13 graduates. The key to the Academy’s success is the transition of its instructors into coaches for those who graduate from the program.

Steve Kennedy, senior vice president of human resources at Tennessee Oncology explains how the program measures success: "So, what kind of ROI [return on investment] has Tennessee Oncology seen from this investment in its leaders? From the 150+ leaders who went through this program, we have only lost 6 leaders. One left to start her own business, and another left to work as a stay-at-home mother. This lack of turnover in our leaders reduced the turnover of our first-line supervisors, improving the overall retention rate of our practice."

Pipeline Partners: Developing Training and Recruitment Programs for the Oncology Workforce

To address workforce challenges head on, Inova Schar Cancer Institute has partnered with institutions of higher learning to establish a clinical research internship program for the future development of workers in clinical research, medical dosimetry, medical physics, and phlebotomy, among others. The session highlighted how to build relationships with educational partners in local communities and across the country to develop an oncology pipeline of future candidates for critical job roles.

One such partnership example discussed was the University of Wisconsin – La Crosse. Laura Matthews, MBA, MPH, vice president and administrator at Inova Schar Cancer Institute noted, “Geography does not have to be a barrier to building partnerships with universities and medical schools." Upon completion of the internship program, students earn a master’s degree in medical dosimetry and are eligible to sit for the board exam.

In addition to the internship program, the cancer institute seeks to provide flexibility to staff already employed. Natalie Brawner, MHA, senior director of the cancer service line shared, "Flexibility goes a long way. Another way we are looking to retain our nurses is to look at new staffing models. We are currently exploring new scheduling options like three 12-hour days and four 10-hour days."

Recruiting Strategies: Looking Under the Hood of the Employment Process

Debbie Rimmele, BSN, RN, OCN, CPC, nurse retention specialist at Loyola University Medical Center shared some insight with attendees about the recruitment and hiring process. She stated, "We need to rethink how we are recruiting people. And we need to understand how social media is impacting what our applicants think about our cancer program."

There are many internal processes that need to go smoothly to offer potential employees the best experience. Rimmele suggested allowing an applicant to interview other members of the team, tour the workspace, and take place in a shadow opportunity. And to be as transparent as possible with the applicant to let them know the next steps in the hiring process.

Rimmele offered some strategies to avoid the human resources hiring abyss: “Build a relationship with your HR [human resources] partner; review expectations to be included in the job posting; review and update your posting requirements regularly; and establish a protocol for applicants that you do not want to hire.”

The Competition of Compensation and Benefits: Keeping Up

Organizations must look at the full value proposition for employees to recruit and retain good staff. To do this, organizations need to look inward regarding how well you are communicating to staff about other investments and benefits beyond salary and paid time off. Tia Foster, project director at Northwestern Medicine offered some advice on next steps for attendees including, “Listening to your employees and what's important to them; implementing strategies to improve the well-being of your employees; communicating to staff how important they are to the institution; and repeat: if a strategy is not working, go back and fix the issue(s) and try again.”

The ABCs of Retention: Employee Recognition and Appreciation, Manager Support, Wellness and Workforce Resiliency, and Job Flexibility

Today’s workforce wants to work for organizations who care about the totality of their lives. In many organizations, technology has created a blended life and work style, in a 24/7 model as we continuously stay connected, yet work/life balance and wellness have never been more important to staff. This session focused on finding ways to support all areas of employee life and well-being.

Tiffani Darling, director of the office of wellbeing at Northwestern Medicine shared simple tools to measure burnout among employees. Darling stated, “If your program doesn't have a formal way to measure burnout, consider asking this simple question: How full is your tank?" “Data shows that when staff report that their opportunities to do what they do best every day goes down, burnout rates go up.”

Begin by taking the time to understand the needs of your staff through tailored surveys or focus groups. Think creatively about what your organization can do for its employees in areas like financial coordination, housing resources, access to transportation, and healthy living, such as food and exercise.

Leadership Visibility and Hardwiring the Employee Relationship

Being an organization where everyone wants to work is about the leaders who everyone wants to work for and with. Successful leaders are visible, personable, and know the roles and understand the needs of their staff. Jason Fleming, MD, FACS, chair and program lead of gastrointestinal oncology at the Moffitt Cancer Center noted the following, "your teams are not your organizational chart."

According to Dr. Fleming, empathetic leaders know when to listen intently and when to speak. He believes that embodying this spirit will improve the retention of key team members and deepen the bond among staff throughout an organization.