Lunch Session

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Lunch Session Moving Up! Career Ladders for
Allied Health
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Employee Career Investmentpresentation
toAllied Health Regional Skills Solutions
Summit

• Joanne Pokaski, Director of Workforce Development
• Beth Israel Deaconess Medical Center
• July 15, 2008

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Beth Israel Deaconess Medical Center

• Teaching hospital affiliated with Harvard Medical
  School
• 8500 employees, 6500 FTEs
• One of 14 teaching hospitals in Boston area
• 13 of employment in Boston is in hospitals

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Problems we are facing

• Serious labor shortages in allied health
  positions.
• Aging workforce nearing retirement age.
• Barriers to employee advancement from within
• Very specific education and credentialing
  requirements in health care
• Limited slots available in 2-year and 4-year
  educational programs
• Most programs are full-time and not compatible
  with full-time work/family obligations
• Shortage of credentialed diverse candidates

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A Strategy that Reflects Our Values

• Focus on occupations facing skill shortages
• Provide employees opportunities to move to
  higher-skilled, higher-paying jobs
• Allow employees to gain career advancing skills
  while working to support themselves and their
  families
• Make classes convenient for work schedules
  on-site where possible, little or no cost
• Ensure there are no dead end jobs
• Increase diversity within higher-skilled/better
  compensated professions

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Demographics by Occupation, BIDMC
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Where did we start?

• Senior VP of Human Resources was hired in 2003,
• One day retreat of key decision makers in
  hospital. Result decision to hire someone to
  lead the initiative.
• Director of Workforce Development position
  created, filled in September 2004.
• Three areas of workforce development focus
• Skill shortage pipelines
• Career advancement support for incumbent workers
• Community hiring adults and youth

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Building a Pipeline ProgramStep One Information
Gathering

• For each position considered
• salary
• Educational/certification/licensing requirements
• vacancies, vacancy rate
• Total FTEs budgeted
• On a scale of 1 to 10, how serious is your
  vacancy problem?
• Number hired last year, new grads vs. experienced
• students doing clinical - hired vs. hosted.
• Career ladder options, future trends

• What were the areas that people thought made
  sense for a skill shortage pipeline at BIDMC?
• What was being done at other institutions?

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Nursing Pipeline Program

• Vacancy rate was just under 5, had been 15 at
  its worst.
• Sufficient scale to absorb graduates, with over
  1000 RN FTEs.
• A great deal of interest among employees most
  applicants had taken many pre-requisite courses
  on their own.
• Nursing leadership was willing to partner with
  us.
• A non-profit approached us about applying for a
  grant with other hospitals. Would minimize our
  costs, ease our workload.

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A.D.N. vs. B.S.N.

• 2 of 4 hospitals asked chose to participate.
• We consulted with our nursing leadership.
• We moved forward with an A.D.N. program because
• We were hiring some A.D.N.s.
• If youre looking for diverse nurses, you need to
  have more than one route to get there. We wanted
  our employees to have the opportunity to get to
  RN.
• We would support our grads to pursue an RN to BSN
  degree upon graduation.

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Nursing Pipeline Program

• Launched in April 2005
• 5 semester FT program ? 7 semester part time
  program
• Community college courses purchased by hospitals
• Courses on-site after work, on-line, labs on
  Saturdays at community college. Clinical at
  employer.
• BIDMC sponsored 8 of 16 student slots using
  tuition reimbursement and loan forgiveness.

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Program Model Nursing Cohort 1
Year 1
Year 2
Year 3
Year 4
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Program Model Nursing Cohort 2
13-18 people
50 people
Year 1 2007
Year 2
Year 3 2009
Year 4
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Surgical Technologists

• Allied health professionals in role previously
  held by scrub nurses in OR.
• 28 vacancy rate (12.5 / 44.5)
• Short-term strategies
• Converted ST FTEs to RNs,
• Hired travelers,
• Paid overtime.

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Surgical Technology Pipeline Program

• Cohort 1 Launched in July 2005
• BIDMC (8), 2 other partner hospitals (3)
• 2 semester full time program ? 4 semester part
  time program
• Final 2 semesters, students did 24 hr/week
  clinical
• Employees stayed in current role with reduced
  hours
• Kept income close to whole with a stipend
• Kept benefits whole
• Tuition, fees, books, and stipend paid by
  employers as a loan to be forgiven after 2
  years in new role.
• Results

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Cohort 2

• We partnered with more hospitals, scaled back
  numbers funded 4, with 2 alternates.
• BIDMC added interviews to selection process,
  emphasized need for commitment to program,
  physical nature of job
• No courses on-line at beginning
• Added a semester to ease academic burden
• Results

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Surg Tech Program Future

• Current vacancy rate 0.
• Cohort model not working.
• Switch to selection of individuals after
  completion of some pre-requisites.
• Individuals to be sponsored through a community
  college program.

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Research Administrators

• Professionals responsible for administrative
  operations of research grants and contracts.
• 15 vacancy (5/33) in area where growth expected
• Constant turnover from poaching.

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Research Administrator Pipeline Program

• Research and WD partnered to create an in-house
  program.
• Competitive selection process led by WD
• Outreach, information, application and budget
  exercise, interviews with hiring managers.
• 8 week after-work training led by Research.
• Mastery of material ? eligibility for hire.
• 3 cohorts have led to 12 hires.

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Our Vision for the Future
Sustain current pipeline programs
Build additional pipelines
Expand the scale and impact of all our pipeline
programs
Provide support to those who are a year or two
out from being ready to start
Focus of Boston Foundation Investment
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How do we expand the scale and impact of our
pipeline programs?

• Increase completion rates
• More employees who understand the commitment
  necessary for college courses/clinical rotations
• More tutoring and counseling support
• More career support from managers

Get the best pool of applicants for each cohort

• More knowledge among employees about the
  existence of these options
• More employees meeting minimum academic
  requirements for programs

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How do we provide support to those not ready
to start a program?

• Create a pre-pipeline program with a career plan
  for those not ready for college courses
• Hold pre-college courses on site

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Employee Career Initiative

• Career counselor available to all employees
• College placement test prep
• College placement testing
• Pre-college courses available on site at no
  charge
• Basic science courses available on site at no
  charge
• More information for interested employees

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Elements of Counseling
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3
7
Reviewing transcripts and Accuplacer scores
Assessing readiness
Monitoring Performance and connecting with tutor
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Choosing the right career
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4
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Creating an employee plan
Setting the right pace
Discussing transition to pipeline program
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Assessing current life/work constraints
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Pre-college Needs of 35 Who Tested for BIDMC RN 2
Program
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Surgical Technologist
Nuc Med Tech
Nursing
Rad Tech
Med Lab Tech
Respiratory Therapy
Histotech
Other
Pipelines
Required Program Level
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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.
• This summer 79 employees are enrolled in classes.

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Medical Laboratory Technicians

• Perform tests on samples of body fluids and
  tissues and analyze results.
• Associate Degree and certification required.

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Medical Technologists and Medical Laboratory
Technicians

• Short-term strategies
• Strong preference for MTs
• Frequent requests for market adjustments
• Overtime
• Do without

• BIDMC
• 15 vacancy rate (24/159)
• Aging workforce

Age range of BIDMC Med Techs
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MA Workforce Competitiveness Trust Fund

• 6 vacancy rate in MA
• Only 6 programs in state
• Only program in Boston area is 5 years full time.
  Number of graduates has decreased over time.
• Partnership
• BIDMC, Childrens Hospital, New England Baptist
  Hospital, Bunker Hill Community College.
• Applied for and received 500,000 grant.
• Work to create and accredit a Medical Lab
  Technician Associate Degree program.

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Med Lab Tech Program

• Screen, select and sponsor employees in program.
• First 6 semesters courses after work, labs on
  Saturdays.
• Final 6 months lab practicum on site at
  hospital. Employee is hired into Med Lab Tech
  Aide role during this portion, maintains salary,
  benefits.
• Upon graduation and passing certification exam,
  is hired into MLT role.
• Graduates have the opportunity to become MTs over
  time.

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Patient Care Technicians

• Nursing assistants in an acute care setting.
• Decision by nursing to hire more career PCTs to
  stabilize workforce.
• Local C.N.A. training programs focused on
  long-term care, not acute care.

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Patient Care Tech Pipeline Program

• In-house program. Target population hotel
  service workers, patient observers, patient
  transporters.
• 6 weeks class two nights a week after work and
  five skill practice sessions.
• Upon successful completion, leave job and move
  into PCT Aide role at current salary. 3 weeks
  full-time hands on training under a nurse
  educator.
• Upon successful completion, move to PCT role on a
  unit.
• Results

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Employer Role

• It is in employer interest to take a strong role.
• Incumbent employees see these programs as
  employers programs, not someone elses.
• Employers are in the best position to mediate
  between program providers, employee participants,
  and hiring managers.
• Employers have a lot of leverage in the workforce
  development system.

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Employer Role Choosing to Participate

• Understanding the program
• Scale and conditions of participation
• Identification of 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.

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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?

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Employer Role Participant Support

• Provide clear expectations in writing at
  beginning
• Program oversight
• assuring clear communication to employees,
• high quality instructors,
• being available to troubleshoot for employees
  with third parties.
• Advocate for employee with current, future hiring
  managers.
• Timely intervention on student behalf
• Reiterating what student must do to pass class,
  clinical
• Finding tutors, other supports when necessary

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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.
• Communicate with hiring department and current
  department as students near graduation.
• Work with hiring department to trouble-shoot
  problems when they arise.
• Partner with departments on conditions of hire
  and transfer to role.

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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 in-hospital partners.
• Ask for program feedback during and after cycle.
  Make changes to improve programs.
• Only take on what you can manage and sustain.

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What are the Benefits of Participation?
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The Cost of Doing Nothing

• Increased demand on staff to pick up overtime and
  extra shifts
• Patient safety issues
• Decrease in staff morale, increase in
  professional burnout
• Challenges to patient care (e.g. timely lab
  results)
• Very competitive hiring environment increases
  turnover and overly inflates compensation costs
• Lower bar for employee performance
• Difficulty in achieving growth in strategic
  service lines
• Necessity of employing expensive tactics such as
  travelers

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Benefits to Hiring Department

• Reduced vacancies
• New hires
• Better fit with hospital culture
• Reduced orientation time
• Lower turnover rates
• Helps hiring department do business differently
• Old thinking people learn elsewhere, then we
  hire them. If we cant find people, our salaries
  are too low.
• New thinking we need to pay attention to the
  labor market. We need to be open to training our
  own employees.
• More diverse new hires.

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Benefits to Hospital

• Increased employee morale fewer stuck
  employees.
• Culture change within hospital.
• Increased employee loyalty.
• Increased desirability as an employer.
• More diversity across jobs.

• Return on Investment
• Overtime savings
• Savings from not hiring travelers
• Savings in recruitment costs
• Reduction in hospital turnover

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Benefits for Employees

• Opportunity
• for additional education
• to increase skills, confidence
• to increase income
• to be hired into their dream job
• to have more impact on patient care
• to mentor other employees

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Questions?