Evaluating International Healthcare Staffing Strategies

Evaluating International Healthcare Staffing Strategies

Advantages and Disadvantages of Hiring Internationally Trained Healthcare Professionals

In our midsize regional hospital, which is wrestling with chronic shortages in many units, hiring healthcare professionals trained outside the United States presents both opportunities and challenges. The main advantage would be the potential to rapidly address critical staffing gaps. Leveraging the global talent pool will allow the organization to fill key roles more rapidly, thus minimizing the potential for burnout among staff, optimizing care ratios for patients, and continuing services provided.

International healthcare professionals bring with them a variety of experiences, cultural competencies, and fresh perspectives that can enhance the organization’s capacity to care for an increasingly diverse patient population. The global training and practice backgrounds of international health professionals can introduce new, innovative ways of approaching the delivery of care and solving challenges (Austin & Gregory, 2024; Walton-Roberts, 2019). Sometimes, it may even be less expensive to employ people who have trained overseas since the reduced training and education costs in some countries can translate to competitive salary expectations against hard-to-fill specialist posts being recruited domestically.

This approach does not come without its challenges. In essence, healthcare delivery is dependent upon effective communication and intercultural understanding between providers and their patients. In this regard, language problems, lack of awareness about the local culture and norms in healthcare, and differences in communication style could all too easily affect the quality of care or patient satisfaction if not appropriately handled (Miyata, 2023; Roth et al., 2021). Verification of foreign credentials, obtaining state licensure, and ascertaining the equivalency of training may be complex, time-consuming, and expensive, along with prolonged onboarding, putting a higher burden on organizational resources.

The internationally-trained professional faces some challenges in the context of fitting into already existing medical teams and locals’ preference for the healthcare system and practice. This could have higher turnover rates if not carefully managed through robust orientation and support programs (Miyata, 2023; Roth et al., 2021). There are also ethical considerations around “brain drain” from developing countries that may already face healthcare worker shortages, requiring careful consideration of the organization’s practices with regard to recruitment so as not to contribute to global health inequities.

Fit with Hospital Mission and Competitive Advantage

Our mission in the hospital is to provide the highest possible level of care that is culturally appropriate to the varied segments of the regional community. As internationally-trained professionals add to the hospital’s cultural competency and language capabilities, it aligns with the mission. The organization should, however, not compromise on the quality standards and patient expectations by putting up a candidate who can deliver quality care. Finally, from a competitive standpoint, if the organization can integrate international talent successfully, it can differentiate itself in this market through more diverse care teams and potentially expanded language services, making the needed services especially valuable as the patient population becomes increasingly diverse (Austin & Gregory, 2024).

Fit With Current Patient Population and Medical Teams

The patient demographics have diversified over the past years, especially in an area with growing immigrant and refugee populations. Internationally trained healthcare workers who belong to these patient groups by culture or language can aid in improving communication, cultural sensitivity, and patient trust (Austin & Gregory, 2024). Integration into existing medical teams will be another matter, however. Where diverse viewpoints can spur innovation, differences in training styles and clinical practices can grate against each other for a time. Effective onboarding, mentorship, and team-building would assume much more importance to foster cohesion and leverage the benefits of diverse teams.

Ongoing Training Requirements

Any internationally-trained staff will likely need further training and support in several areas: U.S. healthcare system orientation, local clinical protocols, and best practices, electronic health record systems and standards of documentation, cultural competence for the local patient population, and ongoing language support and development of communication skills. The organization must be willing and committed to invest in comprehensive orientation programming and continuous professional development so these staff members can practice to their full capability.

Ethical and Legal Concerns

The critical issues that have to be faced will be nondiscriminatory hiring, verification of credentials, investigation of gaps in training, compliance with visa laws, foreign workers’ employment laws, protection against exploitation or unfair treatment of international staff, and resolution of cultural practices that conflict with U.S. medical ethics (Immigration Advice Service, 2022; Thompson, 2022). Robust policies, legal counsel, and oversight by the ethics committee will be required to navigate such complex issues.

Possible Retention Challenges

On the other hand, retention may become a problem due to cultural adjustment, professional isolation or lack of advancement opportunities, visa restrictions or desires to move overseas, and burnout from additional stressors of working in a foreign system (Zulfiqar et al., 2023). In light of these risks, the organization should have targeted retention strategies, including mentorship programs, clear career advancement pathways, cultural integration assistance, and ways to build a sense of community among international staff.

Opinion on Advantages versus Disadvantages

Weighing the risks against the benefits, I believe that for our organization, the benefits associated with internationally-trained health professionals outweigh the risks if the organization can put in place sound support systems and plans for integration (Austin & Gregory, 2024; Walton-Roberts, 2019). It would be hard to justify not doing so with a critical staffing shortage and prospecting the benefits of improved cultural competency and increased diversity. This can happen only through proper screening and selection of candidates compatible with the hospital’s quality standards and organizational culture, multi-facet onboarding, training, and follow-up support programs; an inclusive environment respectful of diversity of thought; acting ethically in the process of responsible recruitment; and keeping a keen eye on outcome and feedback for constant adjustments. If the organization can apply a thoughtful, well-planned approach, it can leverage the benefits of international hiring, mitigate associated risks, and meet the challenges.

Implications of Healthcare Globalization on Quality Improvement

There is a remarkable depth and importance in quality improvement measures and performance policies that globalization of health staffing has on organizations (Raza et al., 2020). Our organization will have to enhance its quality metrics to include cultural competence and language-concordant care. Quality improvement efforts should focus on clear communication practices and strategies that surmount language barriers. Great emphasis should be on the assurance of consistency in adhering to evidence-based protocols through rigorous training and monitoring, especially with varied training backgrounds. The organization now has a chance to learn good practices from other countries in quality improvement processes and adopt the same. Thus, innovation can result by incorporating the same in our quality improvement initiatives. The organization further needs to customize patient satisfaction surveys and feedback processes to account for the experiences of patients with backgrounds and cultures abroad. The quality standard with a diversified education background might have to be maintained through more frequent and rigorous competence assessment.

These changes will necessitate changes in the organization’s policies and procedures for performance. Therefore, the organization must develop rigorous specifications for the training of staff in cultural competence, require periodic assessment of language proficiency for those employees who have patient contact, develop relevant specifications on how the diversity of the workforce will be integrated with the organization’s quality improvement efforts, upgrade processes for event reporting and root cause analysis, to ensure the identification of any cultural or communication issues, and develop mentorship opportunities to pair internationally hired staff with experienced staff.

Model for Employee Retention

While reviewing models that could guide the organization’s efforts to retain the best workforce in diverse healthcare settings, the ANCC Magnet Recognition Program® readily stands out as one of the possible frameworks for our organization (American Nurses Credentialing Center, 2019). Anchored mainly on nursing excellence, most of its principles can be integrated into our broader healthcare workforce. It emphasizes transformational leadership, structural empowerment, exemplary professional practice, new knowledge and innovations, and empirical outcomes.

This would then be adapted to our context by designing leadership training programs that underline inclusive practices, mentorship, and career advancement opportunities for international staff, cross-cultural teams that drive innovation in care delivery, and instituting robust feedback mechanisms that enable continual improvement in integration efforts. By so doing, the organization can create an environment that will attract, retain, and develop a diverse workforce.

Internal and External Environments for Strategic Planning

Effective communication is another principal factor in the implementation and maintenance of our international staffing strategy. Concerning internal communication, transparency will be paramount by openly communicating to all staff the reasons, objectives, and anticipated challenges of the international hiring initiative (Chirwa & Boikanyo, 2022). Cultural sensitivity training on how to work in diverse teams effectively and support colleagues from other parts of the world will be imperative for existing staff. The organization needs to establish frequent forums that provide opportunities for employees to voice concerns, successes, and suggestions on the integration of international professionals. Subsequently, positive experiences and contributions of international staff can receive due prominence, leading to enhanced acceptance and appreciation.

Externally, engagement with local community leaders must be proactive to address concerns and emphasize the value of a diverse workforce. This would create trust and understanding with the patients through the dissemination of educational materials about the qualifications and value of internationally-trained healthcare professionals (Chirwa & Boikanyo, 2022). The organization should develop a communications strategy to address media or public inquiries that may arise regarding its international hiring practices. Diversity and international professionals must form part of the top lines in the recruitment messaging. In so doing, a clear, consistent, and culturally sensitive model of communication will earn our strategy commitment from staff, patients, and the community. This approach holds the key to fully unlocking the potential that lies in the diversity of the globally representative workforce to improve our quality of care and organizational effectiveness.

Conclusion

In summary, while there are huge challenges in hiring internationally-trained health professionals, there is also immense potential to address our staffing needs and increase our capacity to serve our diverse community. Therefore, the organization can take this approach to serve its patients even better and increase its strength by weighing the pros and cons of the plan, providing strong support and integration strategies, and working for clear communication and quality improvement. However, looking ahead, how well the organization will continue to assess and adapt our strategies best bodes for future success in this global healthcare scene.

References

American Nurses Credentialing Center. (2019). Magnet model – Creating a magnet culture. American Nurses Association. https://www.nursingworld.org/organizational-programs/magnet/magnet-model/

Austin, Z., & Gregory, P. A. (2024). Enhancing the integration of internationally educated health professionals in the healthcare workforce: Implications for regulators. Journal of Nursing Regulation, 15(1), 24–32. https://doi.org/10.1016/s2155-8256(24)00026-7

Chirwa, M., & Boikanyo, D. H. (2022). The role of effective communication in successful strategy implementation. Acta Commercii, 22(1), 1–13. https://doi.org/10.4102/ac.v22i1.1020

Immigration Advice Service. (2022, December 19). Problems faced by employers when they hire foreign workers. Immigration Advice Service. https://iasservices.org.uk/what-are-the-problems-faced-by-employers-when-they-hire-foreign-workers/

Miyata, C. (2023). Challenges and career consequences of internationally educated nurses: Empirical research qualitative. Nursing Open, 10(11). https://doi.org/10.1002/nop2.1977

Raza, M., Afzal, M. I., & Elahi, M. A. (2020). Assessing the sustainability of public health in the era of globalization. Arabian Journal of Geosciences, 13(19). https://doi.org/10.1007/s12517-020-06009-y

Roth, C., Berger, S., Krug, K., Mahler, C., & Wensing, M. (2021). Internationally trained nurses and host nurses’ perceptions of safety culture, work-life balance, burnout, and job demand during workplace integration: a cross-sectional study. BMC Nursing, 20(1). https://doi.org/10.1186/s12912-021-00581-8

Thompson, M. (2022). 9 The ethical recruitment of internationally educated nurses? An examination of the devaluing of nursing in the Philippines, a sending region. Global Migration, Gender, and Health Professional Credentials, 187–208. https://doi.org/10.3138/9781487531744-012

Walton-Roberts, M. (2019). Occupational (im)mobility in the global care economy: The case of foreign-trained nurses in the Canadian context. Journal of Ethnic and Migration Studies, 46(16), 3441–3456. https://doi.org/10.1080/1369183x.2019.1592397

Zulfiqar, S. H., Ryan, N., Berkery, E., Odonnell, C., Purtil, H., & O’Malley, B. (2023). Talent management of international nurses in healthcare settings: A systematic review. PLOS ONE, 18(11), e0293828. https://doi.org/10.1371/journal.pone.0293828

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We’ll write everything from scratch

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This Individual Project (IP) builds upon your work in all previous units.

The fifth and final area of focus as director of operations asks you to think about the future. You discussed in your second report how chronic staff shortages are impacting operations in at least two units. The senior executive team wants you to outline how the hospital might augment its medical staffing by hiring health professionals trained outside of the United States.

Your Outline for the Future report will include the following:

• Discuss the advantages and disadvantages of hiring healthcare professionals trained outside of the United States. Include in your discussion issues such as the following:
  • The hospital’s mission and competitive advantage
  • The fit with the types of patients the hospital serves
  • The fit with current medical teams
  • Ongoing training requirements
  • Ethical and legal concerns
  • Possible retention challenges
• Provide your opinion on whether the advantages outweigh the disadvantages, and give specific reasons for your position.
• Evaluate the implications of healthcare globalization on quality improvement measures and their implication regarding performance policies and procedures.
• Review the literature and other resources to find a model similar to your hospital’s improvement strategies for retaining employees.
• Discuss internal and external environments that are meant to inform the strategic planning process focusing on communication.

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