IHS Takes Serious Steps to Bolster Workforce and Improve Care

IHS partners with NIH and tribes to implement steps to improve the quality of health care.


IHS director Mary Smith recently issued an update on what’s been happening since the recent launch of “an aggressive strategy to improve the quality of care in the Great Plains area and across the country.”

The past 10 years have seen a new focus on quality improvement, she said, and IHS is working to enhance that with, for example, a system wide mock survey initiative at all 27 IHS hospitals to assess compliance with the Centers for Medicare & Medicaid Services (CMS) Conditions of Participation and readiness for reaccreditation.

Related: IHS and CMS Partner for Patient Safety Improvements

The IHS continues to face significant workforce challenges, including a chronic shortage of quality health care providers (HCPs), according to Smith. To that end, more than 2 dozen Commissioned Corps clinicians have been deployed to temporary placements in the Great Plains area hospitals with CMS findings. To attract more HCPs, the National Institutes of Health has been helping IHS recruit more nurses into its clinical program; IHS is also revising position descriptions, using more comprehensive recruitment plans, raising pay, and instituting relocation pay for GS-12 and lower clinical positions and lower grades. IHS is also implementing a “stronger” search committee process and advertising vacancies more widely.

Another change is the expansion of tribal participation in filling vacant area director positions. Members of a tribe from each area will, for the first time, play a role at the outset of the hiring process, Smith said.

Related: Dangerous Staff Shortages in the IHS

The strategy also emphasizes bringing in health care quality expertise. This initiative began with the launch of a Hospital Engagement Network (HEN 2.0), which allows IHS hospitals to share strategies on how to reduce avoidable readmissions and hospital-acquired conditions.

The last priority area is to strengthen relationships with local and regional partners, like health care systems, colleges, and direct service hospitals. “Some of the most helpful expertise and the most effective leadership is right in the Tribal communities we work with every day,” Smith said. The “government-to-government relationship with Tribes is the foundation of our work at IHS.”

Related: IHS Pilots Improved Version of Health Records

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