Transition to Practice: Making OJT Work in the Healthcare Sector. Pamela Tonello, Capital Workforce Partners Korey Roth, Bristol Hospital

Transcription

1 Transition to Practice: Making OJT Work in the Healthcare Sector May, 2015 NAWDP Conference Pamela Tonello, Capital Workforce Partners Korey Roth, Bristol Hospital

2 Transition to Practice: OJT in Healthcare Sector Overview Background Projects Mechanics Tools for Success Best Practices & Examples

3 Transition to Practice: OJT in Healthcare Sector Background 2003: Board identified healthcare industry cluster as a strategic priority Convened the Healthcare Workforce Advancement Committee First project Bridges to Health Careers USDOL/Robert Wood Johnson CNA Advancement Initiative

4 Transition to Practice: Background Work-based model included: Contextualized basic skills instruction Development of 7 clinical specialty courses delivered in both workplace and work-based settings. Issues in Aging Mental Health Rehabilitation Hospice and Palliative Care Dementia and Alzheimer s Substance Abuse Medical Terminology Customized leadership course Awareness of healthcare career advancement opportunities Culture change activities to enhance the leadership skills of supervisory staff

5 Transition to Practice: Background Metro Hartford Alliance for Careers in Healthcare (MACH) Co-convened by CWP and CT Women s Education and Legal Fund An employer-led partnership whose purpose is to identify and respond to workforce development and policy issues for entry level and middle skill positions in the healthcare industry Engagement Engagement Engagement

6 Transition to Practice: On-the-Job Training Meet the demand for skilled workers in targeted healthcare careers Focus on the transition to practice for unemployed or underemployed workers Provide a combination of occupational skills training and on-the-job training (OJT) Assist employers with cost of hiring and training new employees into fulltime permanent positions 6

7 Transition to Practice: Initiatives Health Careers Project - $4.7M from US DOL (11/ /2015) $2.3 million in wage reimbursements for employers providing OJT Re-Employment Alliance for Careers in Health - $6.8M from USDOL (11/ /2018) $3.6 million in wage reimbursements for OJT and IWT T2P - $198K from Bank of America Foundation and Regional Employment Board of Hampden County (11/ /2015) $112K in wage reimbursements available to eligible employers 7

8 Transition to Practice: New England Knowledge Corridor Health Careers Project CWP and the Regional Employment Board of Hampden County, MA were awarded an H-1B grant $5 million for the Health Careers Project Occupations: Nurses, Medical Coders, Health IT (170 OJT slots) Partners Include: Capital Community College Central CT State University UMASS Amherst Hartford Hospital Saint Francis Hospital Genesis Healthcare Cooley-Dickinson Hospital Charter Oak State College Springfield Technical College ECHN Hospital of Central Connecticut Bay State Medical Center VNA HCP assists unemployed workers transition to practice in targeted healthcare careers through a combination of occupational skills training and on-the-job training (OJT) MACH serves as the HCP Advisory Group Target Occupations: Registered Nurses, Medical Coders and Health IT

9 Transition to Practice: Health Careers Project OJT Program Requirements Voluntary participation Unemployed or underemployed status Provide eligibility documentation Customized training plans Meet quarterly with case manager Complete evaluation and report employment outcomes 9

10 Transition to Practice: Health Careers Project Target Population Under and unemployed individuals with a minimum of an Associate s Degree or work experience in target occupation Four primary mechanisms for recruitment 1. Employers with job openings who identify qualified candidates that may lack an adequate credential or necessary experience 2. Individuals being supported through a post-layoff process in related fields, including insurance and financial services 3. Educational partners 4. One-Stop Centers that serve UI claimants and other underemployed workers

11 Transition to Practice: Health Careers Project HCP Coordinators screen candidates for eligibility and assist them through the process Set of tools to include: career interest inventory, competency assessment, analysis of work experience OJT Reimbursement: 50% of wages (6 to 12 months) Other components: Tuition assistance Facilitation between educational and employer partners to ensure employers needs are met

12 Transition to Practice: Health Careers Project Registered Nurses BSN Degree Holders Immediate placement into OJT (6-12 month) ADN Degree Holders Placement into an OJT while also completing their BSN degree On-site RN to BSN pilot Elms College / Baystate Model Immediate OJT placement (6-12 month) Eligibility contingent on passing the NCLEX 12

13 Baystate and St. Francis Nurse Residency Program Model RN Residency Coordinator Nurse Resident Training Plan External Case Manager Nurse Manager 13

14 Transition to Practice: Health Careers Project Medical Coders and Health IT Promotion to Employers Hospitals and Home health providers Small physician and specialty offices with posted coding and IT openings IT Specialty firms and consultants that serve other health sector employers Specialty Training and Credentialing Variety of roles and responsibilities Coding: Dedicated coding, office support, inpatient vs. outpatient IT: Software, implementation support, hardware and infrastructure 14

15 Transition to Practice: Health Careers Project Employer Benefits Hire and TRAIN new healthcare workers at their place of business! Streamlined paperwork contracting process Single point of contact Increased retention rates! Funds to hire preceptor 50% reimbursement of wages 15

16 Transition to Practice Grant (REB) Other Allied Health Occupations (26 positions) Medical Assistants Medical Billing Certified Nursing Assistants Community Health Workers Medical Office/Administration 16

17 OJT Participants 4 Medical Assistants from STCC s Medical Assistant program recently offered at GCC Completed week training plans Pioneer Valley Family Medicine Pioneer Women s Health Franklin Adult Medicine 17

18 OJT Participants Chicopee Visiting Nurse Association 2 Registered Nurses (RN) from Holyoke Community College and Elms College Completed 10 month training plans 18

19 Re-Employment Alliance for Careers In Health (REACH) $6,695, months effective November 1, 2014 Target Population: 85% Long-Term Unemployed and 15% Incumbent Workers Goal: 300 Individuals Served Primary Partners: MACH & CT Board of Regents

20 Transition to Practice: Re-Employment Alliance for Careers In Health (REACH) Key Components FIRST Program One-Stop Program launched in 2009 to serve professional level unemployed job seekers Intense case management/career counseling with FIRST Re- Employment Specialists Workshop series Resume Consultation, Advanced Networking, Social Media Strategies, LinkedIn Lab, Interview Stream/Coaching Impact Job Networking Component Job Development Monthly Networking events

21 Transition to Practice: Re-Employment Alliance for Careers In Health (REACH) Key Components On-the-Job Training 3 to 9 months Individual Development Plans Career Coaches / Coordinators

22 REACH Service Flow FIRST Pre-Employment Phase All Participants Strategy/Track 1 Rapid Re-employment For those individuals who just need brush up on interviewing skills and resume help Strategy/Track 2 Accelerated/Short Term Training For those individuals needing accelerated shortterm training to make them competitive in today s job market Strategy/Track 3 Long Term/Contextualized Training with Career Pathway For those individuals with fewer skills who need long-term training to be on a career pathway Health IT Strategy 1a IT Path direct employment, STEP UP placement,3 to 6 month OJT placement, or referral to P2E Strategy 2a IT training leading to industry-recognized credentials including: A+, Network+, Healthcare IT Technician, Electronic Health Record (EHR), Computer Analyst IT 3 to 6 month OJT, or STEP UP placement Nursing and Health Practitioners Strategy 3a IT training leading to certificates with industryrecognized credentials in: networking, database management, project management, systems analysis IT 3 to 6 month OJT, or STEP UP placement Strategy 1b Nursing (ADN or BSN) 6 to 9 month transition to practice OJT Strategy 2b Nursing RN Nurse Refresher Course Nursing 6 to 9 month transition to practice OJT Strategy 3a Nursing to include following tracks LPN to ADN or BSN ADN to BSN Nursing 6 to 9 month transition to practice OJT

23 Transition to Practice Tools for Success Strong Employer Relationships Strong Relationship with Participants Job Ready Coordinator Role Flexibility Clear Expectations of Roles/Responsibilities FAQs

24 Transition to Practice Lessons Learned/Challenges On-site Pilot Affordable Care Act Climate Change Coding (ICD-9, ICD-10) Best Practices Cohort model Immersion program Job Shadowing

25 Employer and Employee Recognition

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27 33% 42% >30%

28 CT Registered Nurse Supply/Demand and Shortage Projections Year FTE Supply FTE Demand Excess or (Shortage) Percent Overage or Shortage ,000 30,200 (2,200) -7% ,400 31,800 (6,400) -20% ,900 34,000 (11,100) -33% ,900 36,600 (16,700) -46% ,200 39,600 (22,400) -57% *Source: HRSA Registered Nurse Supply, Demand and Shortage Projections for CT, 2004

29 Nurse Residency Orientation Program RN to BSN courses for the ADN grant recipients cohort model at central location open to grant participants at all hospitals Job Shadowing between settings

30 Tale of Two Implementations: Hospital of Central Connecticut Bristol Hospital

31 Hospital of Central Connecticut Initial cohort began in Winter of 2013 with 15 participants Nurse Residency Orientation Program Dedicated Preceptor teams for each new graduate nurse Added de-escalation training for all new graduates

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33 Hospital of Central Connecticut Job Shadowing for Home Care new graduate nurses in the inpatient setting established in June 2013

34 Hospital of Central Connecticut Second cohort began in Summer of 2013 with an additional 12 participants In the Fall of 2013, RN to BSN on-site courses began for the ADN grant participants to support successful completion of their BSN

35 Bristol Hospital Cohort Number of Participants Degree Unit Type March % BSN 3 Medical/Surgical August % BSN (4/7) 1 Behavioral Inpatient 2 Labor/Delivery/Postpartum 4 Medical Surgical February % BSN 2 Medical Surgical Total 12 86% BSN 1 Behavioral Inpatient 2 Labor/Delivery/Postpartum 9 Medical/Surgical

36 Lessons Learned Create a safe environment while brainstorming new models for OJT, especially in rigid healthcare environments Ask simple and clarifying questions along the way Need enthusiastic Leadership contact in setting to navigate through administrative hurdles Need savvy clinical educators who can creatively schedule new graduates with consistent preceptors without burdening already stretched resources RN to BSN program was successful yet some were overwhelmed consider adding individualized sessions with grant contact rather than group

37 Words from a grant participant I am very thankful for the opportunity to work here and understand that without the (Capital Workforce Partners) grant support, I was not going to be able to work at Bristol Hospital, especially in the department that I always wanted to work on (Labor & Delivery). The orientation program was very supportive in a way that really helped me successfully transition from the role of new graduate nurse to obstetric/neonatal registered nurse. Nara Paula Oliveria, RN

38 Questions? Contact Information: Pamela Tonello, CWDP Director of Special Programs Capital Workforce Partners, Hartford, CT Korey Roth, RN Systems Director of Quality Improvement and Compliance Officer Bristol Hospital, Bristol, CT