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  • Every CAH is different!!
  • Began project with 10 CAHs
  • Self-identified Supervisors or Managers were grouped together as “Management”
    Those working as senior-level officers in the organization were grouped together as “Administration”
    Every other respondent (eg. Radiology, Occ. Health, dietary, maintenance, social services, etc) were categorized as “Auxiliary”
  • n=182
  • While performing their job
  • While performing their job
  • Staff were asked to identify what training would be most useful in performing their jobs on a daily basis.
  • What did they think their co-workers needed most?.
  • What did they think their co-workers needed most?.
  • N=51
  • How do these priorities align with your BSC?
    Example: Continuing education essential for staff retention, one of the core measures.
    Radiology CEU needs are highest
    Certifications: ACLS, PALS, CPR, Serve Safe
    Priority areas: Critical care/Code response; trauma; psychiatric care; pediatrics; pharmacology
    SB 235-requiring RNs to obtain 30 hours CEUs q 2 yrs. Passed in Senate; now in House Prof. Licensure Committee
  • How do the executive priorities align with your BSC?
    Examples:
    Staff education systems should improve various measures: staff & pt. satisfaction, pt. safety, etc
    Organizational change & accountability will evolve as BSC is cascaded down your organization. Culture will be unified as you communicate the vision.
    Policies & procedures: updated, in digital format; standardizing protocols
    NM development--fiscal responsibility & accountability; redefine concept of performance for their depts. Help them understand how their dept. contributes to overall strategy. Help move them toward a business orientation.
    Transition to technology-part of change mgmt
    Productivity improvement-work redesigns; managing sick time/benefits; reimbursements
    Staff Recruitment-RNs, OT, PT, ultrasound, pharmacy, nuclear medicine difficult to recruit
    Staff Retention-Building loyalty, teamwork
    New staff orientation & preceptorship programs-compensation; pay equity
    Succession Planning-part of recruitment/retention strategy; fiscal planning
  • PENNTAP: PA Technology Assistance Program
    Examples: Software for tracking competencies, orientation, staff education
  • Contact information located on this website
  • Instrument is a deliverable of the project. Needs to be tested.
    Develop strategic plan to leverage PSU resources to address rural hospital workforce needs
    * Support relationships between PSU, WIBs & rural hospitals
    **Build Industry Partnerships
    **Capitalize on Incumbent Worker Training Grants
  • Instrument is a deliverable of the project. Needs to be tested.
  • porh.psu.edu

    1. 1. 1 Assessing the Workforce Development Needs of Pennsylvania’s Critical Access Hospitals QuickTime™ and a TIFF (Uncompressed) decompressor are needed to see this picture. April 27, 2006 The Penn Stater Conference Center State College, PA Janetta DeOnna, Project Dir.
    2. 2. 2 Acknowledgments  Special thanks to:  Larry Baronner, CAH Coordinator  Kim Germino, RN, Project Coordinator  Dr. Tobin Lopes, Data Analyst  Wei Wang, Data Analyst Asst.  Christina Gettins & Wendy Moyer, PENNTAP  Site Coordinators & Hosts Funding through Medicare Rural Hospital Flex Program, PORH, PA Dept. Health, Bureau of Health Planning
    3. 3. 3 Presentation Outline  Project Background & Purpose  Data Collection Methodology  Findings  Preliminary Recommendations & Discussion  Next Steps
    4. 4. 4 “When you’ve seen one Critical Access Hospital, you’ve seen one Critical Access Hospital”. Larry Baronner, 2005 Snowflake Approach
    5. 5. 5 Background & Purpose  Project Goal: To identify current and projected workforce development needs of CAHs  Rationale:  Opportunities to aggregate training dollars  Resources may be identified & shared  Best practices may emerge  Project Timeline: 7/1/05-6/30/06
    6. 6. 6 Background & Purpose Key Questions: 1. What information do CAHs need to raise the competencies of current staff? 2. How does middle management fit into the strategic plan of the organizations? 3. How do CAHs invest in human capital to improve their internal processes?
    7. 7. 7 Background & Purpose Site visits conducted 10/05-2/06: 1. Barnes Kasson Hospital 2. Bucktail Medical Center 3. Corry Memorial Hospital 4. Endless Mountain Health System 5. Fulton Co. Medical Center 6. Jersey Shore Hospital 7. Meyersdale Medical Center 8. Muncy Valley Hospital 9. Troy Community Hospital 10.Tyrone Hospital
    8. 8. 8 Data Collection Methodology  Literature review  Development of data collection tools 1. Interview Guide-Staff 2. Interview Guide-Administrators 3. Survey-All Staff 4. List of potential data for review 5. PENNTAP: Technology Assessment Tool
    9. 9. 9 Data Collection Methodology  Pre-Visit Planning  Established communication w Onsite Coordinator & scheduled site visit  Distributed employee letter & survey  Compile secondary data for review  Arranged interviews  Onsite  Collected surveys  Conducted interviews  Reviewed secondary data
    10. 10. 10 Findings  Survey (n=1015)  Demographics  Critical Training Needs  Training Preferences  Staff Interviews (n=182)  Administrative Interviews (n=51)
    11. 11. 11 Survey Results
    12. 12. 12 Demographics The majority of survey respondents (87%) were female. CAH Workforce Gender (n=1015) Female 87% Male 13%
    13. 13. 13 Demographics About one-fifth of the workforce is at retirement age, and another one-third is between 45-54 yrs of age. CAH Workforce Age (n=1015) 18-24 yrs 4% 25-34 yrs 16% 35-44 yrs 24% 45-54 yrs 32% 55 yrs or over 21% No Response 3% 18-24 yrs 25-34 yrs 35-44 yrs 45-54 yrs 55 yrs or over No Response
    14. 14. 14 Demographics There is clear evidence of an aging workforce. Aging Trend of CAH Workforce 0 100 200 300 400 18-24 yrs 25-34 yrs 35-44 yrs 45-54 yrs 55 yrs or over N=1015
    15. 15. 15 Demographics The majority of respondents were educated at the HS or Voc- Tech level. Education Level of CAH Workforce (n=1015) 130 4 34 129 250 448 0 100 200 300 400 500 Other Doctorate Master's Bachelor's Associate's HS/Voc Tech
    16. 16. 16 Demographics Almost two-thirds of respondents were employed in auxiliary positions. CAH Workforce by Job Category (n=1015) 240 43 57 47 620 0 200 400 600 800 R N /L P N N u rse A id e M a n a g e m e n t A d m in istra tio n A u x ilia ry
    17. 17. 17 Demographics The workforce is skewed toward a heavier composition of seasoned employees, with 59% having 6 or > yrs. of employment at their institution. CAH Workforce by Yrs of Employment (n=1015) < 1 yr 10% 1-5 yrs 31% 6-10 yrs 17% 11+ years
    18. 18. 18 Demographics Over half of respondents (51%) have 11 yrs or > of experience in their current job. CAH Workforce by Yrs of Experience Current Job 48 239 197 518 0 100 200 300 400 500 600 < 1 yr 1-5 yrs 6-10 yrs 11+ yrs
    19. 19. 19 Critical Training Needs-All Staff Critical Training Needs – All Personnel (n=1015) #Hospitals Computer/Software Training eg Excel, Word, Web Searches, Job-Specific Software 10 Updates Related To Technical Knowledge, Skill, Equipment & Procedures 10 Continuing Education/Certifications (eg ACLS, PALS, CPR, Serve Safe) 10 Critical Care/Code Response 10 Pharmacology Updates 10 Assessment, Diagnosis & Care Plans, esp. Trauma, Psychiatric, Pediatrics 10 Billing, Medical Terminology & Coding 9
    20. 20. 20 Critical Training Needs-All Staff Critical Training Needs – All Personnel (n=1015) #Hospitals Interpersonal Skills/Manager Skill Development 7 Dietary/Special Diets/Diabetes Education 6 Laws And Regulations 5 Communication W/ Staff Across Depts. And Patients 4 Working With Budgets/Interpreting Reports 4 Disaster Preparedness/Terrorism Response/Security 4
    21. 21. 21 Preferred Length of Training Most employees prefer training to be limited to one day or less & are willing to travel 2 hours (1-way). 192 58 86 127 35789 62 96 232 334 175 91 275 152 92 275 208 140 81 64 508 57 46 40 108 Least Preferred Most Preferred One-week institute Three-day workshop Two-day workshop One-day workshop Half-day or less
    22. 22. 22 Preferred Method Training Delivery Most employees prefer classroom-based training. 51 23 100 122 609 183 110 167 191 178 232 132 191 124 131 156 114 218 189 122260 132 197 133 106 Least Preferred Most Preferred Workbook with audio or video tape Combination-classroom & web-based Web-based Project-based Classroom
    23. 23. 23 Staff Interviews
    24. 24. 24 Biggest Challenges- Staff Biggest Challenges – Staff (n=182) #Hospitals Poor communication across all levels of the institution (eg between depts., with patients & their families, staff and administrative personnel) 10 Staffing Shortages 10 Lack of training & the challenge of remaining clinical competent/learning computers skills 7 Aging equipment/lack of equipment 6 Managing difficult people & pts 6
    25. 25. 25 Biggest Challenges- Staff Biggest Challenges – Staff (n=182) #Hospitals Frustration with computer systems 6 Lack of knowledge about coding, billing, insurance 5 Lack of administrative & supervisory support 3
    26. 26. 26 Most Requested Training- Staff Most Requested Training – Staff (n=182) #Hospitals Computer skill development 9 Regular updates in AOE 8 Interpersonal skill development/communication/team bldg 7 Management/Leadership skill development 7 Coding/Medical Terminology/Billing 6
    27. 27. 27 Beneficial to Co-Workers Staff Training Needed by Co-Workers – Staff (n=182) #Hospitals Communication, interpersonal & organizational skills 10 Computer skills-basics 9 Regular updates-procedures, techniques, equipment, certifications 6 Team building-respect, understanding across depts, cross- training 6 Management/Leadership for Supervisors 5
    28. 28. 28 Beneficial to Co-Workers Staff Training Needed by Co-Workers – Staff (n=182) #Hospitals Time management/multi-tasking 5 Better orientation of new nurses 5 Central supply training for new staff 3
    29. 29. 29 Skills Needed in Future- Staff Skills Needed in Near Future – Staff (n=182) #Hospitals Regular updates in AOE 10 Computer skills-basics 9 Management/Supervisory skill 7 Communication Skills (eg conflict mgmt) 7 Medical terminology/coding 6 Time mgmt/multi-tasking 4
    30. 30. 30 Barriers to Competence- Staff Barriers-Current & Anticipated (n=182) #Hospitals Inadequate funding for education & professional development 10 Time (family obligations & staff shortages) 10 Timing & location of training 6 Competition among staff re: who should attend 4 Lack of organizational commitment to education 4 Staff refusal to participate in professional development or comply w/ legal mandates 4
    31. 31. 31 “Barrier Busters”-Staff Suggestions for Overcoming Barriers (n=182) #Hospitals Online courses, computer training, subscriptions to web-based sources of information AOE; teleconferences 9 Workshops held onsite or nearby 9 Off-shift training 8 Increased availability & use of per diem staff; cross-train staff to cover other areas 6 Financial aid support 5 Shadowing other sites 5
    32. 32. 32 Administrative Interviews
    33. 33. 33 Most Chronic Challenges-Admin Most Chronic Challenges-Admin (n=51) #Hospitals Keeping staff current & competent; certifications current 8 Staff resistance to change; generational differences 8 Nurse recruitment & retention; aging workforce/need for succession planning & career pathing 8 Shrinking volumes; increased competition; need to improve productivity 8 Need for supervisory training; develop middle mgrs; coaching & mentoring 7
    34. 34. 34 Most Chronic Challenges-Admin Most Chronic Challenges-Admin (n=51) #Hospitals Need for better organizational policies & consistent enforcement of policies, incl. standardization of charges for procedures & supplies 6 Lack of communication between & within depts 6 Managing organizational change; creating culture that entices new employees to stay 6 Need for full-time educator/educational system; new employee orientation; how to educate pts.; professional development & empowerment 6
    35. 35. 35 Most Chronic Challenges-Admin Most Chronic Challenges-Admin (n=51) #Hospitals Noncompliance w/ regulations & failure to enforce accountability; apathy 5 Staffing shortages 4 Need for increased use of technology & computer training for staff 4 Recruiting skilled staff in OT, PT, ultrasound, pharmacy, nuclear medicine 4 Time constraints & lack of admin support to implement, evaluate & sustain process improvements 3
    36. 36. 36 Most Urgent Needs-Admin Most Urgent Needs -Admin (n=51) #Hospitals Keeping staff current & competent, incl. certifications 8 Staff education-how to organize, develop & fund education, locate & utilize free/low cost resources; identify best practices 7 Transitioning staff from paper to computerization 7 Need for leadership, manager & team leader training, incl. fiscal competence 7 Moving aging personnel toward accepting change/culture change 5
    37. 37. 37 Most Urgent Needs-Admin Most Urgent Needs -Admin (n=51) #Hospitals Better methods of orienting new staff, incl. new supervisor orientation & preceptorship programs 5 Better staffing to increase availability of preceptors/mentors, decrease reliance on per diem staff 4 Getting policies & procedures in place; standardizing protocols; updating & digitalizing manuals 4 Improving productivity; providing the right mix of service; managing over- utilization of sick time; equity in pay scale; reimbursements 4
    38. 38. 38 Most Urgent Needs-Admin Most Urgent Needs -Admin (n=51) #Hospitals Interpersonal skills training eg. Customer sevice; conflict mgmt; time mgmt; business etiquette; team building; critical thinking; empowerment; life long learning 3 Maintaining organizational viability; lack of physical space/aging facility 2
    39. 39. 39 Looking Ahead-Admin Concerns in Near Future -Admin (n=51) #Hospitals Ability to remain competitive, define niche 10 Staff retirement; succession planning for aging workforce/retirement costs; retention strategies 9 How to keep staff current across lifespan 9 Recruiting/Retention; improving hiring practices; decreasing use of agency nurses; improving new employee orientation 8 Improved communication across organization/culture change 7
    40. 40. 40 Looking Ahead-Admin Concerns in Near Future -Admin (n=51) #Hospitals Having adequate space, equipment & viable structure to keep doors open 7 Nurse Manager training, professional development & accountability, incl. fiscal responsibility 7 Transitioning staff to computerization; managing change effort 7 Using technology to improve educational content & provide alternative delivery modalities 6 Improved policies & accountability to bring facility & staff into compliance; implement BSC; strategic planning 6
    41. 41. 41 Preliminary Recommendations  Align with BSC  Staff T&D Priorities  Executive Priorities  Technology Priorities
    42. 42. 42 Align with the Balanced Scorecard Considerations:  What stage are you at in terms of developing your strategy map?  What type of culture, skills, training & technology are you going to develop to support your processes?
    43. 43. 43 A Balanced Scorecard Perspective;  Finance  Financial Capital  Community & Patient Satisfaction  Social Capital  Clinical & Business Processes  Organizational Capital  Learning & Growth – Staff & Medical Staff  Human Capital
    44. 44. 44 Staff T&D Priorities Staff Priorities 0 2 4 6 8 10 12 CEUs/Certifications Manager Development ComputerTraining RoutineUpdates AOE Interpersonal Communication Leader/Preceptorship NewEmployee Orientation Coding/Billing TeamBuilding TimeManagement STAFF
    45. 45. 45 Executive Priorities 0 2 4 6 8 10 12 StaffEducation- Competencies Organizational Change P& Ps/Accountability NurseMgrDev Technology Training Productivity Improvement StaffRecruitment StaffRetention Orientation& Preceptorship Succession Planning
    46. 46. 46 Technology Priorities Utilize free consultation with PENNTAP specialist to:  Secure videoconferencing capabilities  Develop comprehensive plan for integrating technology/transitioning to EMRs, etc.  Identify funding sources/resources eg CERMUSA, CareerLinks  Develop Staff T&D plan for computer training  Provide technical recommendations re: software, etc.  Expand web utilization  Conduct mock survey
    47. 47. 47 PENNTAP Healthcare Specialists http://www.penntap.psu.edu Eastern PA:  Christina Gettins Central PA:  Wendy Moyers Western PA:  Greg Snyder
    48. 48. 48 Next Steps…  Test survey instrument  Thematic Innovation Award-PSU Outreach  $14,517; No specific timeline  Purpose: Develop strategic plan to align Outreach resources with rural hospital workforce development needs  Partnership with Office of Economic & Workforce Dev., PORH & PSU Outreach Marketing
    49. 49. 49 Next Steps… Q&A
    50. 50. 50 THANK YOU! Janetta DeOnna, Project Director PSU Office of Economic & Workforce Development 118B Keller Bldg University Park, PA 16802 Ph: 814.863.6717 Email: jxg141@psu.edu

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