Getting Ahead by Growing Your Own

Getting Ahead by Growing Your Own
•March 12, 2013
Healthcare Association of New York State
www.hanys.org
Today’s Agenda
Overview of Pioneer Employer Hospital Initiative
Research Component
Profiles of New York Hospitals
• Bassett Medical Center
• Faxton-St. Luke’s Healthcare
• Good Samaritan Hospital Medical Center
• Thompson Health
Best Practices and Toolkits
Questions and Comments
Healthcare Association of New York State
www.hanys.org
About the Pioneer Employer
Hospital Initiative
Sponsored by the Hitachi Foundation
In collaboration with the Washington State Hospital
Association and the UNC Institute on Aging
Profiles the next generation of workforce
management
Represents diversity and best in class practices
Healthcare Association of New York State
www.hanys.org
Pioneer Employer
Hospital Initiative
11 in-depth case studies from hospitals/
health systems across the country
Summary report
Implementation toolkit
Healthcare Association of New York State
www.hanys.org
What is a Pioneer
Employer Hospital?
Invests in frontline
workers
Business rationale
tied to the
strategic plan
Formal systems
and strategies
Supported in part
by operating
budget
Proportionately
significant number
of employees
participate
External partners
included
Healthcare Association of New York State
www.hanys.org
Pioneer Employer
Hospitals/Health Systems
Illinois
Advocate
Lutheran General
Hospital
Massachusetts
Beth Israel
Deaconess
Medical Center
New York
Bassett Medical
Center
North Carolina
UNC Health Care
– Chapel Hill
Washington
Group Health
Cooperative
Healthcare Association of New York State
Northwestern
Memorial
Hospital
Faxton-St. Luke’s
Healthcare
Good Samaritan
Hospital Medical
Center
Providence St.
Peter Hospital
Virginia Mason
Medical Center
Thompson
Health
www.hanys.org
Jennifer Craft Morgan, Ph.D.
Healthcare Association of New York State
www.hanys.org
Types of Programs
Credentialing
Programs
Job-Specific
Training Programs
Basic Skills
Development
Programs
Leadership
Development
Programs
post-secondary
credential and/or
degree
skill development
and education to
enhance
competencies
opportunities to
improve
foundational skills
management skills
to prepare for
leadership
positions
Example:
nursing
pipeline
programs
Example:
training unit
clerks to draw
blood in the lab
Example:
English as a
second
language
Example:
supervisory
communication
skills
Healthcare Association of New York State
www.hanys.org
Commonly Achieved Outcomes
Improved
Productivity/Efficiency
• Faster on-boarding of new
graduates
• Increased familiarity with
policies/values
• Staffing flexibility through
strategic cross-training
• New systems for
integrating process
improvements
Healthcare Association of New York State
Improved
Recruitment/Retention
• More job applicants from
the community
• Incumbent workers
staying for opportunity to
move up within the
employer
www.hanys.org
Commonly Achieved Outcomes
Better Work
Environment/Work
Relationships
• Increased employee
satisfaction
• Increased skills/
competencies of current
workers
• Creating a learning
environment
• Better management/problem
solving
Healthcare Association of New York State
Better Match Between
Community and Workforce
• Diversity of community
reflected in workforce
• Increasing the potential for
diverse group of workers to
advance
www.hanys.org
Getting Ahead by Growing
Our Own
Connie A Jastremski, RN, MS, MBA, ANP
Network CNO
Frontline Worker
Development Programs
Sequential Pipeline programs:
• Incoming/Incumbent Worker → RN
• RN → BS (with a major in nursing)
• RN Professional Pathway/Career Ladder
Institutional Supports:
• Full tuition and books
• Tuition Assistance
• Schedule accommodations while in school
“As a learning organization, we are committed to the
development and advancement of our staff. Education
has been one of the three tenets of Bassett’s mission so
the PNO program is a natural fit to meet our mission
while providing excellent patient care”
-Bertine C. McKenna, PhD, COO
Employer Benefits
Reduced Turnover:
“The easiest sell is the retention of the
students that we put through the program…if
it costs $80,000 to turnover one nurse and I’ve
been able to retain 75% of the 100 nurses that
we sent to this program, I think I’ve more than
paid for the program. And that’s exactly the
bottom line to my CFO every year.”
– Connie Jastremski, Chief Nursing Officer
Employer Benefits
Increased Productivity:
“In addition to having ten nurses, we have ten
nurses who already know the organization,
who already know the culture and the values
and the expectations and the different units.
So it’s almost like having ten five-year
employees.”
– Sara Albright, Director of Talent and
Learning
Employer Benefits
High worker satisfaction:
“I love working here.” – Participant
“The PNO program was the most intriguing, best
thing I have ever done in my life.”
- Participant
Critical Success Factors
•
•
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•
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Culture of Learning
Manager involvement
Strong partnerships with the local colleges
Progressive HR policies
Full time coordinator position
One Nurse’s Journey - KL
•
•
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•
•
Started as a nursing unit clerk
Data person for dialysis program
PNO to Delhi for RN
PNO to Hartwick for BS in Nursing
Assistant Nurse Manager Medicine Unit
Other Organizational Outcomes
• Community Development
• Employer of Choice
• Strengthened Integration of Education and
Practice
• Improvements to Care Delivery
Where do we go from here?
• Increase the numbers of slots for the BS in
Nursing students
• Create a new model for second degree/second
career staff who want to pursue Nursing
• Continue to support advancement to MS and
Ph.D., DNP programs through tuition
reimbursement
Learning from the Pioneers:
Investing in Frontline Workers
Paul Rubsamen, Director of Organizational
Development and Chief Learning Officer
FSLH - Who we are:
Not for profit, community based healthcare
system, in Utica, NY
 ~ 3000 employees
 Inpatient - 346 acute care beds
 Outpatient facilities:

◦ Regional dialysis sites, cancer center, ambulatory
surgery, urgent care, PT/OT
◦ 8 General Practitioner offices (Patient Centered
Medical Home designee)
FSLH - Who we are:

Continuing Care Center
◦
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◦
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242 bed long term skilled nursing
Intensive rehabilitation unit
Visiting Nurses Association
Senior Network Health
Adult Day Health Center
Bariatric Surgery Center of Excellence
 Designated Primary Stroke Center

FSLH - Who we are:


2004: Consolidation of Faxton Hospital and St. Luke’s
Memorial Hospital
Desire to create a unified culture:
◦ Began informal and later formal training of all existing managers
and supervisors
◦ Adapted Relationship Based Care (RBC) as patient care model
(Creative Healthcare Management)
◦ Integrated learning and development into our strategic plan with
the goal of being a learning organization and becoming an
“Employer of Choice”
◦ Recognized need to provide development of existing employees
at all levels
Frontline worker development
strategy:
Tuition Reimbursement: 12 credit hours/year
for any course leading to a degree
 “Tuition on Us”: for those pursuing an RN
degree
 Certification course for Health Unit Coordinator
 Departmental Career Ladders:
◦ Pharmacy Technician I – IV
◦ Environmental Technician I - III

Frontline worker development
strategy:

School at Work (Catalyst Learning):
◦
◦
◦
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Front line workers
Six month program
Meets one day/week for 2 hours
Areas of focus:
1. Foundational skills : (reading, math, patient
safety, medical terminology)
2. Exploration of healthcare careers
3. Basic computer skills
Frontline worker development
strategy:

Aspiring Leader Program:
◦ 16 employees who are not in a formal
management role
◦ Application and two part interview process
◦ One day/month for 12 months
◦ Areas of focus:
1. Foundational leadership skills
2. Understanding of the strategic and day-to-day
operations
3. Hospital related project
Frontline worker development
strategy:

Aspiring Leader Program Outcomes:
◦
◦
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Participants: 47
Completion Rate: 87%
Number of promotions: 12 (29%)
Number of raises: 11 (23%)
Avg. hourly increase $3.48
Critical Success Factors
Committed executive leadership
 Organizational Learning Culture
 Relationship Based Care: Employee
engagement and empowerment

Organizational Outcomes
Increase staff retention
 Employee Engagement/Satisfaction
 Increase in leadership bench strength
 Increase in employee skill level and
commitment to our organization
 Overall better experience for our patients

Employer Benefits
Increased worker satisfaction and
productivity:
“ [I now have] better organization, better
time management, better speaking skills,
more comfort going in to meetings, [and]
comfort with projects. – Participant
“I’m glad I did it. It has made a positive
change in my life.” - Participant
Employer Benefits
Culture change:
“It’s worth the investment…It’s more of a soft
payback. It’s all about outcomes for our
patients, and for their families, and that our
staff are satisfied. You can put an ROI on
that, we have not; we just believe that it has
just made a difference…When you put the
soul back in the organization, how do you
measure that”?
– Pat Roach, Chief Nursing Officer
Pioneer Employer
Hospitals
Good Samaritan
Hospital Medical
Center
Presented with HANYS
March 12, 2013 by:
Lori Spina
Vice President of Human Resources
Good Samaritan Hospital Medical Center
 Located on the south shore of Long Island,
Good Samaritan is a not-for-profit hospital and
member of Catholic Health Services of Long
Island.
 Good Sam is a regional hospital with 437
licensed beds, plus 100 nursing home beds
employs 3,780 (3,112 FTEs). Many accolades
have been awarded the medical center since its
opening in 1959 and now achieving Magnet
designation.
 Home to Suffolk County’s first pediatric
emergency room, first 3-D digital breast
tomosynthesis system, advanced cardiac
and cancer care and sophisticated surgical
procedures including da Vinci® robotic-assisted
surgical system
Pioneer Employer Hospitals – Good Samaritan, West Islip, NY
The need identified
Nursing shortages and lack of capacity in local programs
Good Samaritan partners with Suffolk County Community College
(SCCC).
2005 - Good Samaritan commits $1.7 million from operating budget to
enable SCCC to expand its nursing program. This expansion included
an increase in faculty and the renovation of a local school to serve as
teaching and laboratory space.
SCCC is then able to increase its yearly pool of graduates by nearly
50%, dedicating 30 seats for Good Samaritan employees.
Additional master’s prepared faculty were drawn from Good Samaritan
to engage in teaching without leaving the practice of nursing.
Pioneer Employer Hospitals – Good Samaritan, West Islip, NY
Investing in the solution
HR and Nursing leadership screened
incumbent employees, selecting the
candidates based on objective criteria and
work performance.
Work schedules flexed around school
schedules and tuition reimbursement
programs applied to those who were
eligible. Books and fees were paid for by
the employee.
Four years of service to Good Samaritan
was expected upon graduation.
Pioneer Employer Hospitals – Good Samaritan, West Islip, NY
Critical Success Factors
Culture of Loyalty
Team Environment
Ongoing Support for Career Development
Tuition Advancement
Self-Scheduling
Benefits for Part Time Workers
Recognition
Leadership Involvement
Pioneer Employer Hospitals – Good Samaritan, West Islip, NY
Return on Investment
Good Samaritan invested $2.2 million
over the course of six years
142 employees participated, investment
of $16,143 per nurse
Balanced cost of inadequate staffing,
turnover costs, recruitment expenses
and on-boarding costs
92% (105 participants) continue to be
employed by Good Samaritan
Pioneer Employer Hospitals – Good Samaritan, West Islip, NY
Return on Investment
Decreased Nursing vacancy rate
Staff Cohesion
Stronger integration of Education
and Practice
Increased Employee Engagement
Community Development
Molding the ideal worker
Pioneer Employer Hospitals – Good Samaritan, West Islip, NY
RN Vacancy rate
2005 = 10.7%
2010 = 5.0%
Participant average
wage increase
22% - 101%
Pioneer Employer Hospitals – Good Samaritan, West Islip, NY
Thank You
Program Coordinator
Presented by:
Marie Hambel, RN
Lori Spina
Vice President of Human Resources
Learning from the Pioneers:
Investing in Frontline Workers
Jennifer Devault, Vice President,
Associate Services and Wellness
Frontline worker development
strategy
Onsite Certified Nursing Assistant Training
Departmental Career Ladders
• Continuing Care Center (CNAs)
• Laboratory Department (Phlebotomists)
Supportive Human Resource Policies and Practices
• Tuition assistance
• Internal recruitment
• Promotion from within
Certified Nurse Aides
• Retention Specialist/Educator
• Comprehensive screening process
• Hire as trainees, advance with certification
and competence
• Career ladder for Aides
Phlebotomy Career Ladder
• Associate driven
• Cross training beyond phlebotomy and EKG
tasks
• POP
Critical Success Factors
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Appropriate screening during hiring
Wrap around services
Barrier reduction
Preceptor training
Other Organizational Outcomes
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Better equipped to respond to vacancies
Staffing flexibility
Staff involved in process redesign
Increased physician satisfaction
Healthcare Association of New York State
www.hanys.org
Strategies for Successful Implementation
Develop a culture of learning
Dedicate staff time to program coordination
Institute progressive human resource policies
Respond to the needs of frontline health care workers
Make sure buy-in is secured (e.g. execs and supervisors)
Ensure that communications is built in
Rely on strong partners to leverage resources
Healthcare Association of New York State
www.hanys.org
Implementation Toolkit
Quick reference guide
Key program elements
Roadmap for collaborating
with colleges
FAQs
Recommended reading
Healthcare Association of New York State
www.hanys.org
Additional Resources
• HANYS Web site
(http://www.hanys.org/workforce/resources/
pioneer_hospital_study/)
• CareerSTAT
(http://www.jff.org/projects/current/workforc
e/careerstat/1370)
Healthcare Association of New York State
www.hanys.org
Healthcare Association of New York State
www.hanys.org