Children's Hospital of Orange County

Transcription

1 Training Proposal for: Children's Hospital of Orange County Agreement Number: ET Panel Meeting of: May 26, 2011 ETP Regional Office: San Diego Analyst: K. Campion PROJECT PROFILE Contract Type: Healthcare Initiative Industry Sector(s): Healthcare Counties Served: Orange Repeat Contractor: Yes No Union(s): Yes No Priority Industry: Yes No No. of Employees in CA: 2,061 No. of Employees Worldwide: 2,061 Turnover Rate % Manager/ Supervisor % 20% 0% FUNDING DETAIL The Healthcare Initiative is funded under WIA 15%; no core program funding is used. Program Costs Substantial Contribution Total ETP Funding In-Kind Contribution $399,600 $0 $399,600 $595,200 ETP Single (02/16/11) 1 of 4

2 Children's Hospital of Orange County May 26, 2011 ET TRAINING PLAN TABLE Job No. Job Description (by Contract Type) Type of Training Estimated No. of Trainees Range of Hours Class / CBT Lab Average Cost per Trainee Post- Retention Wage 1 Medical Skills Training MS Clinical with Preceptor; MS Didactic; Continuous Improvement; Computer Skills Weighted Avg: 300 $5,400 $32.00 Minimum Wage (Benchmark) by County: $15.37 per hour for Orange County Health Benefits: Yes No This is employer share of cost for healthcare premiums medical, dental, vision. Used to meet the Post-Retention Wage?: Yes No Maybe Although employer provides health benefits, they are not being used to meet Post-Retention Wage. Wage Range by Occupation New Graduate RNs Occupation Title Wage Range *There is no wage range for this occupation INTRODUCTION In this proposal, Children s Hospital of Orange County (CHOC), a non-profit California corporation, seeks $399,600 in funding for nurse retraining. CHOC and its affiliate, Children s Hospital of Orange County at Mission (CHOC at Mission), are hospital facilities that specialize exclusively in medical care for children in the areas of intensive care, oncology, neonatal, cardiology, surgical, neuroscience, medical transport services, and more. CHOC is the parent hospital to CHOC at Mission. CHOC s main facility, located in Orange, is a 238-bed, acute-care hospital serving the children of Orange County. It has 1,961 full-time employees, of whom 483 are RNs. CHOC at Mission is located on the fifth floor only of Mission Hospital in Mission Viejo. This is considered a hospital within a hospital because only those employees who work on the fifth floor are CHOC at Mission employees. This floor is designated as the pediatric wing and it has 48-beds, 118 full-time employees, of whom 84 are RNs. This proposal targets training for new graduate RNs at both the main CHOC facility and CHOC at Mission. In this case, CHOC will hold the ETP Agreement, and CHOC at Mission will participate under the same contract. The maximum funding for this proposal is no more than $400,000, the cap approved by the Panel for a Multiple-Employer Contract. ETP Single (02/16/11) 2 of 4

3 Children's Hospital of Orange County May 26, 2011 ET Healthcare Initiative This proposal will be funded under a new Healthcare Initiative using federal Governor s Discretionary 15% Workforce Investment Act Funds (WIA 15%), in partnership with the Employment Development Department. Since these are federal funds, there is no out-of-state competition requirement and the ETP Minimum Wage is being used as a benchmark. As with other alternative-fund programs, there is no substantial contribution requirement. Given the need for intensive training of newgraduate nurses, that population will be allowed up to 300 hours per-trainee. In addition, Healthcare Initiative guidelines allow a minimum of 8 hours for all trainees. Otherwise, core program performance standards apply, although modifications are possible. The Healthcare Initiative incorporates features of Medical Skills Training (MST) from the core program; and builds on the success of Non-Profit Nursing Skills Training funded with WIA 15% and American Recovery and Reinvestment Act in Fiscal Year Under the Healthcare Initiative, MST Clinical with Preceptor training and Didactic training will be reimbursed at the blended rate for nurse upgrade training, $22 per hour. Standard classroom training will be reimbursed at the priority reimbursement rate, $18 per hour. It is expected that all Healthcare Initiative projects submitted under this Fiscal Year s appropriation of WIA 15% funds will receive an across-the-board reduction in amount. There will be an additional reduction for projects with an active ETP Agreement under last Fiscal Year s appropriation of WIA 15% funds. These reductions will be calculated after all Healthcare Initiative projects have been approved, after the June Panel Meeting at the end of this Fiscal Year. PROJECT DETAILS As a non-profit hospital, CHOC s budgets are stretched thin and its biggest challenge is how to adequately prepare its new graduate nurses for full-time work as competent, successful RNs. The demand for new-graduate RNs exceeds CHOC s ability to hire because the hospital is constrained by the high cost of providing the requisite training to transition new graduate RNs to independent, competent nurses. ETP funding will enable CHOC to hire and train additional new graduate nurses through its nurse residency program. The goal of the proposed training is to help CHOC s new graduate RNs effectively and efficiently develop into skilled nurses, ensuring that they have the expertise to serve patients with the highest level of medical care. Therefore, CHOC requests ETP funds to train approximately 74 new graduate RNs in Medical Skills training, Continuous Improvement and Computer Skills. In general, training will cover a wide range of Medical Skills training in both Didactic and Clinical with Preceptor in technical and advanced nursing specialties involving pediatric patient assessment and care. CHOC will train its RNs through the Versant RN Residency program, which is a 20-week long, outcomes-validated educational and clinical immersion program that transforms and transitions new graduate RNs into safe, competent nursing professionals. Versant defines a set of standards based upon an outcomes-validated set of competencies, teaches to those standards, monitors and manages adherence to those standards, and objectively evaluates - by use of quantitative and qualitative measures success in achieving the demonstrated competencies. The Versant program has become the national model for graduate pediatric nursing programs in the United States. Of the 20-weeks of ETP Single (02/16/11) 3 of 4

4 Children's Hospital of Orange County May 26, 2011 ET training provided by CHOC (720 hours), on average, each new graduate RN will receive 300 hours of ETP training and the remaining weeks of training will be provided at the hospital s expense. Hospital representatives report that the continuous focus on patient safety and quality requires advanced critical thinking skills, teamwork and communication. Therefore, some new graduate RNs are projected to receive one or more modules of Continuous Improvement training. Additionally, new graduate RNS are projected to receive one or more modules of Computer Skills training to ensure the nurses have advanced knowledge of electronic medical record applications. Commitment to Training CHOC represents that ETP funds will not displace the hospital s existing financial commitment to training and anticipates that the opportunity for enhanced training made possible by ETP funds will encourage an ongoing financial commitment in this area. CHOC s ongoing training efforts consist of on-the-job training, recertification, and government mandated topics. CHOC represents that safety training is, and will continue to be, provided in accordance with all pertinent requirements under state and federal law. ETP-funded training will allow CHOC to carry out its commitment to train and augment the skills of its professional caregivers. Hospital representatives anticipate that the ETP funded training will allow CHOC to hire more nurses at a quicker pace and start to acculturate them into the CHOC Versant Nurse training system quicker than they could without ETP funding. RECOMMENDATION For the reasons set forth above, staff recommends approval of this proposal. DEVELOPMENT SERVICES CHOC retained Deloitte Tax LLP in Los Angeles to assist with development of its proposal. At the time of the writing of this memo, Deloitte Tax representatives estimate a flat fee amount of approximately $24,000, but could be less once development is concluded. ADMINISTRATIVE SERVICES CHOC also retained Deloitte Tax LLP to perform administrative services in connection with this proposal for an amount not to exceed 13% of payment earned. TRAINING VENDORS To Be Determined ETP Single (02/16/11) 4 of 4

5 Children s Hospital of Orange County ET Class/Lab Hours Exhibit B: Menu Curriculum Healthcare Initiative New Graduate RNs Trainees will receive any of the following: MEDICAL SKILLS TRAINING CLINICAL PRECEPTOR Pediatric Intensive Care Unit/Critical Care Unit Training o Critical Care Nursing Skills o Intracranial Pressure Monitoring & Ventriculostomy o Hemodynamic Monitoring o Ventilator & Tracheotomy Care Pediatric Medical/Surgical Unit Training o Medical/Surgical Nursing Skills o Orthopedic Nursing Skills o Oncology Nursing Skills Neonatal Intensive Care Unit (NICU) Training o Neonatal Resuscitation Provider (NRP) o Neonatal Advanced Life Support o Neonatal Intensive Care Unit (NICU) Nursing Skills o Neonatal/Infant Pain Scale (NIPS) o Palliative Care Pediatric Operating Room and Post-Anesthesia Care Unit (PACU) Training Pediatric Services Unit o Care of Pediatric Patients (Acute Care, Intensive Care) o Pre & Post Operative Care Pediatric Rehabilitation Services Unit Training o Medical/Surgical Nursing Skills o Post-Orthopedic Surgery Nursing Skills o Post-Neurological Injury Nursing Skills Pediatric Special Care Unit Training o Patient Assessment and Care o Critical Care Nursing Skills o Ventilator & Tracheotomy Care ETP 100 Exhibit B Menu Curriculum (02/15/11) 1 of 3

6 Children s Hospital of Orange County ET o o Hemodynamic Monitoring Total Parenteral Nutrition Pediatric Surgical Services Unit Training Pediatric Telemetry Unit Training o Care of the Cardiac Patient o EKG & Cardiac Monitoring o Dysrhythmia Interpretation o Care if the Neurosurgical Patient o Intravenous (IV) Therapy o Oncology Nursing Skills MEDICAL SKILLS TRAINING DIDACTIC Arterial Blood Gas (ABG) Interpretation Basic Life Support (BLS) Body Mechanics Care of the Cardiac Patient Care of the Neurosurgical Patient Care of Pediatric Patients (Acute Care, Intensive Care) Central Lines Management Chest Tube Care & Management Code Blue Response & Procedures Critical Care Nursing Skills Decontamination Procedures Diabetes Care & Management Dysrhythmia Recognition & Interpretation Educating the Patient & Family EKG & Cardiac Monitoring Equipment Skills (IV pumps, cardiac telemetry, vital signs, pulseoximeter, ventilators, specialty beds and mattresses, etc.) Evidence Based Practices Gastrointestinal Assessment and Management Hemodynamic Monitoring Infection Control Intra-Cranial Pressure Monitoring & Ventriculostomy Intravenous (IV) Insertion & Therapy Medical/Surgical Nursing Skills Medication Administration & Management Moderate Sedation Neonatal Advanced Life Support (NALS) Neonatal/Infant Pain Scale (NIPS) Neonatal Intensive Care Unit (NICU) Nursing Skills Neonatal Nursing Skills Neonatal Resuscitation Provider (NRP) New Graduate Nursing Skills Nurse Orientation Training (for New Grads only) Nursing Diagnosis Skills Nursing Process Skills ETP 100 Exhibit B Menu Curriculum (02/15/11) 2 of 3

7 Children s Hospital of Orange County ET Oncology Nursing Skills Orthopedic Nursing Skills Ostomy & Continence Care Pain Management (Acute & Chronic) Patient Assessment & Care Patient Fall Prevention Pediatric Advanced Life Support (PALS) Pre and Post Operative Care Renal Assessment & Management Respiratory Assessment & Care Restraints Surgical Nursing Skills Telemetry Nursing Skills Total Parenteral Nutrition (TPN) Transfer Techniques Triage Nursing Skills Trauma Nursing Skills Ventilator and Tracheotomy Care Versant New Graduate Program Skills Wound & Skin Care CONTINUOUS IMPROVEMENT Case Management/Discharge Planning Communications Skills Conflict Resolution Skills Critical Thinking Skills Culturally Appropriate Care Customer Service Skills Documentation Skills Organization and Time Management Skills Patient and Family Centered Care Skills Performance and Quality Improvement and Procedures Skills Team Building Skills Utilization Review COMPUTER SKILLS Microsoft Office/Excel Skills (Intermediate and Advanced) Electronic Medical Records Application Skills Note: Reimbursement for retraining is capped at 300 total training hours per trainee for New Graduate RNs. ETP 100 Exhibit B Menu Curriculum (02/15/11) 3 of 3