Fellowship Openings

Developing a New Staffing Management Model to Improve Patient Care

Project: Developing a New Staffing Management Model to Improve Patient Care

Agency: Los Angeles County Department of Health Services

Location: Los Angeles County, CA


The Los Angeles County Department of Health Services (DHS) is the second largest municipal healthcare system in the nation. It has an annual operating budget of $4.3 billion, it employs more than 22,000 people who work in in varied capacities to serve 670,000 unique patients a year, most of whom are low income. As a result, any changes to the County’s healthcare system can have a profound effect on the health and well-being of millions of people.

DHS is constantly seeking opportunities to improve the quality and efficiency of its patient services through evaluating the quality and effectiveness of its healthcare workforce. One focus of such efforts is return-to-work staffing management, which oversees the process of helping disabled employees obtain reasonable accommodations to do their jobs. In recent years, the return-to-work system has become loosely tracked and is in need of a standardized, streamlined model. The goal of the new model will be to ensure legal requirements to employees are being met while providing adequate staffing resources to frontline health facilities that serve the most vulnerable LA County residents.

DHS is seeking to take the lead in addressing these challenges. DHS has recently hired a new risk manager who is navigating the challenges of its return-to-work staffing model, now wants to focus on addressing those challenges, which include: a far-flung network of facilities, each of which has its own clinical focus, cultures and needs; inconsistent procedures and policies; need for improved centralized tracking and oversight and developing the momentum necessary to make a large organizational change in policy and practice.

In order to align agency resources with employee needs toward achieving better patient care and outcomes, DHS wants to institute an innovative new return-to-work staffing management model. To support this work, it will partner with FUSE Corps to host an executive fellow for one year who will analyze the department’s current return-to-work system and design and implement a new model in coordination with the Department of Human Resources that will achieve greater efficiencies and effectiveness. Key to this work will be securing the participation of all stakeholders. The fellow will thus help DHS, and the County overall, enhance and expand services to residents while maximizing resources.


The following provides a general overview of the proposed fellowship project. This project summary and the potential deliverables that follow will be collaboratively revisited by the host agency, the fellow, and FUSE staff during the first few months of the fellowship, after which a revised scope of work will be developed and agreed upon by the FUSE Fellow and the host agency.

Starting in October 2019, it is proposed that the FUSE Fellow will begin by meeting with DHS executives, using collegiality and a sense of shared enthusiasm for the mission to build effective working relationships. The fellow will also become familiar with the agency and its workforce and undergo training with HR to gain an excellent grasp of the agency’s return-to-work policies and processes in the context of the County’s overall objectives. Leveraging emotional intelligence and a talent for building trust, the fellow will embark on a campaign to visit and learn about every DHS facility, seeking to understand the specific culture, perspectives, and needs of each one.

The fellow, employing a strong work drive, independence, and a facility for workflow model and data analysis, will begin assessing return-to-work staff management procedures at DHS and how well they meet the needs of the agency as well as employees. An ability to examine systems at the granular level while maintaining a sense of the big picture will be vital in completing a detailed appraisal of challenges and opportunities for streamlining processes, increasing consistency and efficiency, and enhancing patient care.

Relying on superb project management expertise and applying inventiveness, the fellow will then devise new approaches to the return-to-work system, keeping DHS management apprised and seeking input as necessary. A deep understanding of process balanced with remarkable people skills will help the Fellow design a new staffing management model as it pertains to return-to-work that achieves greater efficiencies, systemwide tracking, and better outcomes for the agencies and its employees. In gaining acceptance of this new model, the fellow must continue to rely on soft skills to oversee the significant change management involved, keeping in mind the challenges that may be posed by varied stakeholders and seeking to mediate agreement among them. Openness and persuasive abilities will be key.

During the fellowship year, the fellow will begin executing necessary changes while creating the new systemwide model; by its conclusion, the fellow will have implemented that new model. With this work, the fellow will help DHS improve its return-to-work processes and deliver better patient care while ensuring equitable treatment of employees. Ultimately, this will further assist Los Angeles County in transforming its systems to transform the lives of Angelenos.

  • Become familiar with DHS practices, objectives and stakeholders— Meet with DHS executives and County partners, build relationships, and undergo training to fully understand return-to-work legal requirements, procedures, and health-care setting specifics. Acquaint self with County objectives and the opportunity of DHS to further them. Research best practices in return-to-work staffing management. Begin meeting with managers at each DHS facility and build their trust, seeking insights on their respective viewpoints, needs, and culture.
  • Conduct a detailed assessment of current processes and challenges — Analyze existing return-to-work approaches in the context of legal requirements, agency needs and employee concerns. Determine their costs to the system and how well they meet their purpose. Find areas of inefficiencies and other challenges. Closely examine myriad details, appraising their effectiveness across DHS facilities, and place in context of the larger return-to-work system at DHS and what the agency hopes to achieve. Look for opportunities to make better use of DHS resources, including more long-term solutions that will streamline processes and deliver better patient care, while doing the right thing for employees.
  • Design and implement a new staffing model — Brainstorm new approaches to return-to-work and find creative ways to address operational weaknesses. Furthering relationships with stakeholders including those at individual DHS facilities and external entities such as labor unions, begin executing changes that can be integrated into current practices, ensuring sensitivity to differing perspectives and employee expectations, and working to create buy-in. Develop an overall return-to-work staffing management model that addresses DHS objectives and gain DHS and County approval. Implement new model, expending necessary effort on all aspects of change management. Create a systemwide tracking system and construct mechanisms for review and ongoing responsiveness to budgetary considerations and County goals to ensure the model’s long-term sustainability.


  • Elizabeth (Liz) Jacobi, Chief People Officer, Los Angeles County Department of Health Services
  • Catherine (Catie) Mathers, Risk Manager, Los Angeles County Department of Health Services


  • At least 15 years of professional experience in a relevant field, particularly with a strong background in project management, workflow and data analysis and change management. Healthcare experience helpful but not necessary.
  • Superior critical thinking and analytical skills.
  • Ability to synthesize complex information into clear and concise recommendations.
  • Ability to relate to a wide variety of diverse audiences with strong emotional intelligence and empathy.
  • Excellent stakeholder engagement skills and the ability to use facilitative leadership techniques to coordinate stakeholder activities.
  • Self-motivated, goal-oriented, entrepreneurial leader who can also be an independent worker.
  • Persistent in obtaining information and creatively resourceful in identifying solutions to complex problems.
  • Ability to create direction and movement within potentially ambiguous environments.
  • Exceptional written and verbal communication skills with an ease in public presentations.
  • Understands the need for solutions to support all people in a community regardless of race, religion, gender, immigration status, or ethnicity.