Ariel Avgar, Associate Professor of Labor Relations, Law, and History

                                                Cornell ILR School

The U.S. healthcare system is in an ongoing state of crisis. Like systems in other developed countries, healthcare organizations are struggling to confront multiple and competing pressures that have made it increasingly difficult to advance the worthy but allusive goal of delivering safe, high quality, consistent, affordable, and accessible patient care. Choose the metric—mortality rates, hospital readmissions, medical and medications errors, hospital acquired infections, or patient satisfaction—and there is much to be concerned about. Put simply, the U.S. healthcare system is underperforming by almost any clinical measure used. In this talk I will set forth the argument that a comprehensive and sustainable fix to healthcare will only emerge once policy makers and organizational leaders turn their attention to healthcare workers, the manner in which they are employed, and the conditions under which they work. At the heart of the healthcare system’s shortcomings, according to this argument, is a broken employment relations model, one that is not aligned with the delivery of high quality, affordable, and accessible care. Employment relations factors, I maintain, are central drivers of almost all quality of care, clinical integration, patient access, and financial outcomes that stand at the heart of a well-functioning and high performing healthcare system. It is these factors that affect healthcare organizations’ very ability to confront the many serious challenges they face.