Frontline Healthcare EmployeeCareer Advancement

Joanne Pokaski, Director of Workforce DevelopmentBeth Israel Deaconess Medical Center

October 3, 2013

Beth Israel Deaconess Medical Center

• Boston teaching hospital affiliated with Harvard Medical School

• 8000 employees, 6100 FTEs• 649 patient beds• One of 14 teaching hospitals in Boston area• 19% of employment in Boston is in healthcare• 15% of employment in Boston is in hospitals

Before (2004)

Nursing ScholarshipsNursing Continuing Ed

Tuition Reimbursement

ESOL, Career Exploration, Basic math,

science

.

Before (2004)

Nursing ScholarshipsNursing Continuing Ed

Tuition Reimbursement

ESOL, Career Exploration, Basic math,

science

RN vacancies at 5%,Had reached 15%

Overseen by a non-profitserving multiple sites. No connection to a career advancement strategy.

$$$ seen primarily as a benefit program.

Surgical Technologists•Allied health professionals in Operating Room.•Required: 1 year college certificate program•28% vacancy rate (12.5 / 44.5)•Short-term strategies:

– Converted ST FTEs to RNs, – Hired travelers, – Paid overtime.

Medical Laboratory Technicians• Perform tests on body fluid and

tissue samples and analyze results in the Pathology lab.

• Associate Degree and certification required. (Bachelor’s preferred)

• 15% vacancy rate (24/159) • 14% of current workforce aged 60+• Short-term strategies:

– Frequent market adjustments– Overtime (15K hours/year at BIDMC)– Do without

Problems We Were Facing

Labor Market• Significant shortages in

allied health professions.• Specific education and

credentialing requirements limiting pool.

• Limited knowledge of occupations by general public.

• Lack of diversity among credentialed candidates

Employees• Diverse, loyal• Understand career

opportunities• Most training programs are

full time and far away• Limited slots available• Programs are expensive

with limited support• Employees felt “stuck.”

Our Solution: Pipeline programs

• Focus on occupations where we are challenged in hiring.

• Competitively select employees for training– Academic readiness, current job performance, skill set

• Training– Part-time so that employees can work full time– On-site at hospital after work hours– Little to no cost for employees– Clinical training on site

• Guaranteed job at the end of successful completion

Patient Care Technicians

Nursing assistants in an acute care setting.

Starting salary: $27,500Decision by nursing to

hire more career PCTs to stabilize workforce.

Local C.N.A. training programs focused on long-term care, not acute care.

Patient Care Technician Program

Marketing• Target: food and

environmental services workers

• Brochures, staff meetings, information sessions

Selection• Academic

Assessment• Job

performance• Interview

Classes• 2 nights a week

for 6 weeks. Weekend skills labs.

• Taught by a nurse paid by hospital.

3-week Practicum• Left their jobs• Paid as PCT

aides on nursing payroll

• Hands on training• Fail = go back to

old job

Guaranteed Job

Program ResultsCohort 1 Cohort 2

Applicants 23 34Selected 9 10Entered Clinical 8 10Graduated/Placed 8 (June 2008) 10 (June 2010)

Retained 1 year 8 (100%) 9 (90%)

Retained 2 years 7 (87.5%) 7 (70%)Avg Starting Salary $12.45 $13.44Avg New Salary $13.47 $13.96Increase 8% 4%

Pipeline Programs

RN to BSN MLT to Med Tech

Research Administrator

RN Med Lab Tech Surgical Tech

Patient Care Tech

Registration Specialist Pharmacy Tech Medical Coder

Bachelor’s Degree or higher

College CertificateOr Associate Degree

Post HSIn-houseTraining

Pipeline Programs

RN to BSN MLT to Med Tech

Research Administrator

RN Med Lab Tech Surgical Tech

Patient Care Tech

Registration Specialist Pharmacy Tech Medical Coder

Bachelor’s Degree or higher

College CertificateOr Associate Degree

Post HSIn-houseTraining

Pre-college Needs of 35 Who Tested for BIDMC RN Program:

25

17

9

18

4

6

0 5 10 15 20 25 30 35

Intermediate Algebra

Introductory Algebra

Basic Math

College Writing

Intro to Language

Reading

Reading Pre-college Algebra

Basic Math

Pre-college English

Biology Anatomy & Physiology Chemistry Microbiology

Required Program Level

Pipelines

Histotech

Med Lab Tech

Surgical Technologist

Nursing Rad Tech Nuc Med Tech

Respiratory Therapy

Other

What is attractive about this program for an employee?

• Convenient advice about changing careers• No commitment required at beginning• Can start slowly • Can “take a break” to pursue other priorities• No cost to employee• Courses held at convenient times, locations• Year 1 goal: 75 participants. Actual: 212.• Because we have pipeline programs, people

understand why they need academic skills.

Employer Role

• It is in the employer’s interest to take a strong role.

• Incumbent employees see these programs as employer’s programs, not someone else’s.

• Employers are in the best position to mediate between program providers, employee participants, and hiring managers.

Employer Role: Choosing to Participate

• Understand the program• Set scale and conditions of participation• Identify priority areas• Articulate reasons for participation• Determine and pay costs.

– Tuition reimbursement benefit, operating funds, grants, individual donors.

• In-kind contributions: staff, classrooms, clinical rotation spaces and preceptors

Employer Role: Participant Selection

• Who is eligible to participate?• How will you get the word out to employees?• How will you choose who will be sponsored?

– Current employee performance, academics, interviews, essays.

• How do you support employees who are not chosen?

Employer Role: Participant Support

• Provide clear expectations in writing at beginning• Program oversight

– assuring clear communication to employees, – Assuring program is high quality– being available to troubleshoot for employees with third

parties.• Advocate for employee with current, future hiring

managers.

Employer Role: Building Trust with Hiring Department

• Assure department commitment to project and to hiring graduates.

• Engage hiring managers in selection.• Communicate with hiring department as

students near clinical rotations, graduation.• Partner with departments on conditions of hire

and transfer to role.

Employer Role: Institutional Sustainability

• Engage hospital leadership in your programs. You need at least one high-level champion.

• Highlight positive outcomes, personal stories.– Graduations, newsletter articles, press releases.

• Acknowledge your hospital partners.• Ask for program feedback during and after

cycle. Make changes to improve programs.• Only take on what you can manage and

sustain.

Factors For Success

• High-level champions– SVP of HR– CEO– COO

• Dedicated staff inside employer

• Hiring department that sees the potential benefits

• Clear communication of roles and expectations

• Understanding that not all who start a program will finish

• Really good screening of applicants

• Employee support

Why do this?

• Greater understanding of hiring needs

• Better problem solving skills for dealing with changing labor needs in health care

• Reduce turnover of new hires

• More diversity along the career spectrum

• Become employer of choice

• Cost of doing nothing• Reduce vacancies• Reduce overtime• Increase employee

morale and retention• Build a culture of

opportunity