What They’re Watching: Julie Sande, Ketchikan Pioneer Home

Julie Sande is the Administrator at Ketchikan Pioneer Home. She joins us in this edition of “What They’re Watching” to discuss retaining rural workforce and quality of care.


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“One area that we’re really struggling with at the pioneer homes is recruitment and retention. So, as we struggle to continue to try to find health care workers in a very challenging and competitive environment, I think the opportunities for a managed care organization to potentially use community health aides or workers, provide training and opportunities to keep some of those individuals in their own communities, and still provide a level of oversight and care for them without having to transition to a larger community, where the health care might be much more expensive. Instead, be able to see that delivered in the villages or in the remote camps or communities and allow the patient to be where they’re most comfortable and also be able to deliver the care in a much more efficient and economic manner.

I come from several different perspectives. But one is, you know, I grew up out in a logging camp and so I will always have that very rural piece in terms of how I’m interpreting information. I have a real clear idea of what it looks like when you are in a community and the only way to have life-saving opportunities or care would be by a float plane or a boat out. I look through health care a lot of times in that lens. At the same time, having been on the governing board for our hospital for many years and having worked in health care for more than twenty years, I can also clearly see Alaska’s challenges in terms of logistics and just the travel [which] make it so that it’s very difficult to provide health care in a way that is affordable for the state and then us individually. And so, I think we might have to take a look at whether or not it’s appropriate for each of our communities to have all of the newest and the best. And I think that there’s a lot more opportunities for coordination between both health care organizations and also the community, so that we just won’t have the opportunity, maybe, to have all of the different service lines available in each hospital or each community, but instead what ways can we partner with one another, so that it’s mutually beneficial, but then also it’s the best thing for the patient.”