The Daily Briefing's Josh Zeitlin spoke with Advisory Board's Eric Cragun and Jennifer Stewart about their work with the Health Career Pathways Task Force, which recently released a report outlining the recommendations of hospital, community college, and workforce development stakeholders on how to increase the number of qualified entry-level candidates for health care jobs.
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The Advisory Board convened the Task Force as part of a larger Pathways initiative by Hope Street Group and The Advisory Board Company, which was announced last year by the White House.
Question: Before we get into the Task Force's work, I wanted to get a better sense of the scale of the problem. How big is the projected demand for entry-level workers?
Jennifer Stewart: Several of the occupations that are projected to have the greatest job growth between 2014 and 2024 are in health care. Among the top dozen by projected growth, home health aides rank 3rd, nursing assistants rank 6th, and medical assistants rank 12th. So there's huge running room across just those three entry-level health care roles, and many more.
Q: Why can't hospitals and community colleges address that demand by sticking with their current approach?
Stewart: The siloed way that hospitals and community colleges operate right now just isn't sustainable. It's a very inefficient system: Community colleges largely work by themselves, and health care organizations largely work by themselves. There's an information gap—it's really hard for a community college to know what's most important to each of the different hospital employers in its market.
Eric Cragun: Right now, there's a lack of consistency in the skills and preparation of community college graduates who apply to entry-level roles. And that makes it difficult for health systems to predict what capabilities they are getting in these entry-level applicants.
Q: So that's the problem. What can hospitals and community colleges do about it?
Stewart: What the Task Force found is that to fix this issue, to take the guesswork out of whether graduates will have the skills they need, community colleges and hospitals need to come together on a regional level to agree on specific skills, competencies, and preparations for these entry-level roles.
The scale of that effort can feel very intimidating, but there's some good news. We surveyed about 2,000 health care leaders and staff about the health care competencies that are most important today and which will be most important 5 years from now. And we found remarkable agreement about what's most important today and what will be important tomorrow.
Another thing the Task Force recommends to make this work less intimidating and frankly more effective is for hospitals and community colleges to focus their collaborations on the usual suspects for entry-level jobs, such as nursing assistants, medical assistants, home health aides, and pharmacy technicians.
In some ways that's counterintuitive, because there's so much buzz out there about population health and all the new roles that you're going to need to support that. But there's a lot less consensus among hospitals about what types of roles they'll be hiring to support population health—and there's a ton of opportunity for hospitals and community colleges to better integrate workforce planning with curriculum planning on the roles that hospitals know they'll need today, tomorrow, and 5 years from now.
Q: Even with agreement on needed skills and the key roles, that kind of regional collaboration still might not come easy to some health systems. How would you recommend they get started?
Cragun: It can seem really daunting for hospitals and community colleges to come together, because there might not be an existing forum for them to meet and exchange information. But it's OK to start very small and have that partnership grow over time.
There are a couple of natural starting points, such as a couple of employers and a community college collaborating on a grant application or around the issue of background checks. Or it could be sharing a single piece of expensive training equipment across the organizations or collaborating on something like addressing an uninsured population in their region.
But it's also important to note that in some cases, effective regional partnerships with a community college involve not just a single health system but all the health systems in their markets. And sometimes that can feel a little different or uncomfortable because those health systems might be competitors in many ways. That makes the sort of trust-building efforts I highlighted above all the more important.
Q: To dive in on that a bit more, does your work with the Task Force make you think some health systems will be resistant to working with their traditional competitors on these efforts?
Cragun: I didn't get the sense that there would be any resistance, I just think it feels a little unusual to be working with your competitors.
Stewart: I think a rising tide lifts all boats here: There are major benefits for all hospitals and community colleges that participate—as well as for students, who will find it easier to get hired and will be more likely to have the skills needed to thrive.
What's also really exciting is that most hospitals have some sort of tuition reimbursement or support for further education that will then allow people to move outside those entry-level jobs and continue to progress. So a worker may start as a nurse aide but can later become a licensed practical nurse or eventually a registered nurse.
Q: In addition to these regional collaboratives, what else can hospitals do to better fill these entry-level roles?
Stewart: Hospitals can think about sourcing candidates with a broader range of backgrounds than they traditionally have. A big way they can do this is by going out to under-tapped talent pools, which can differ by community but can be anything from veterans to high school graduates.
We also highlight lessons learned from particular health systems, such as Mercy Health West Michigan's remarkable results since moving to an evidence-based selection screening process.
Q: One final question: What should hospitals and health systems do next if they are interested in this work?
Stewart: First, Advisory Board members and nonmembers can sign up for our webconference on the lessons and best practices identified by the Task Force.
On Wednesday, February 22, we'll go over how hospitals can source candidates with a broader range of backgrounds, reduce turnover by reconnecting staff to the outcomes of their daily work, and embed opportunities for growth in entry-level roles.
You can also watch our on-demand webconference on eight lessons from the Task Force for building the entry-level workforce of tomorrow.
And our full report on paving health care pathways to the middle class is also available here.