Health systems redefine training to re-energize employees

Most hospitals and health systems have grown their management training programs as employees look to ascend the administrative ladder. But Hosparus Health recently implemented a new course for an increasing number of nurses who prefer to stay by the bedside.

The hospice and palliative-care provider in Kentucky and southern Indiana rolled out a program about a year ago for registered nurses who want to improve their care-delivery techniques, interpersonal aptitudes and other bedside-care skills. It was a response to pushback from nurses who would rather remain at the bedside than become managers, said Melissa Merrifield, Hosparus vice president of human relations.

“Our data analytics tell us that our nurses who leave don’t see a lot of opportunity for growth and development,” she said. “This is an opportunity for growth and development that has led to a lot of internal movement.”

Modern Healthcare’s Best Places to Work survey reflects a similar sentiment. Some of the lowest marks were related to the questions: “I trust that if I do good work I will be considered for a promotion,” and “There is room for me to advance in this organization.” Employees from at least a quarter of healthcare organizations surveyed said they disagree.

Repurposing and re-energizing employees has also been a focus for Conway (Ark.) Regional Health System, which has adopted self-directed training videos that replace time-consuming seminars. The biggest problem the broader healthcare workforce faces is losing their calling, CEO Matt Troup said.

“More and more, we’ve lost our soul,” he said. “We have gotten so preoccupied with things that take people away from the bedside—mundane tasks like order entry, complying with regulations or what have you. We have added more to the work but not more to the staff.”

While some systems have adapted their workforce development opportunities to keep up with today’s technology and demands, others are entrenched in legacy programs that have damaged employee morale. The healthcare industry lags other sectors’ training practices and many providers will need to adapt their internal development programs to remain competitive, experts said.

“Technology can free up folks to spend more time in direct patient care, but adoption has been somewhat slow and can be expensive,” said Pamela Hepp, a healthcare attorney at Buchanan Ingersoll & Rooney.

New research indicates that healthcare workers spend 25.5 hours on training a year, which is about a third less than the average 34.1 for other industries. Healthcare organizations spend less money on training, too—$602 compared to $1,296 per employee each year, according to the Association for Talent Development.

“Healthcare organizations can no longer afford to shrink education and training budgets; this practice is manifesting in a workforce unprepared for changing patient demographics, technology and data analysis and multigenerational workforce integration, among others,” said Donna Bodin, vice president of employee and wellness services at Woman’s Hospital in Baton Rouge, La.

Meanwhile, automation will displace as many as 1 in 4 female workers across all sectors, which will likely disproportionately impact healthcare given its core female workforce, according to a recent report from the McKinsey Global Institute. As machines handle more of healthcare’s administrative work, streamline diagnoses, improve scheduling and ease employees’ workload, providers are left to grapple with legacy infrastructure that may not keep them as busy or productive.

Disengaged employees can drain the life out of an organization. Revenue drops along with productivity. Unhappy employees displease patients, which can swing reimbursement.

“We couldn’t even conceive of the tools and jobs that exist today 15 years ago,” said Gina Ameci, labor and employment attorney at Buchanan Ingersoll & Rooney. “You either adapt or dissolve.”

Memorial Healthcare’s employee development programs are grounded in patient care, said Margie Vargas, chief human resources officer for the Hollywood, Fla.-based system.

One of its programs provides a tablet to patients, a practice it is expanding across its six hospitals. The goal is to remain connected, where patients can ask questions through the device related to their medication or request help.

“We constantly ask ourselves ‘How do we leverage technology to not only keep a patient safe but to foster a very personal connection to the patient and family?’ ” Vargas said.

New software that streamlines data-gathering has helped decompress staff to keep them closer to the patient, she added.

Providence St. Joseph Health adopted a new digital training platform that uses augmented reality and video storytelling. Employees can quickly access everything from compliance checklists to initiatives related to boosting engagement, improving clinical care and leadership training. They are customized for five different types of employees.

Staff can not only consume but also collaborate, said Johnny Hamilton, senior learning designer and innovation consultant for Providence St. Joseph.

“The platform shows who you can connect with and what you can contribute, like a document or article you wrote,” he said. “Social and informal learning are adding to a larger view of what we are calling learning. That is when behavioral change happens.”

The No. 1 reason millennials and Gen Xers, who make up nearly two-thirds of Providence St. Joseph’s workforce, leave a company is due to a lack of career development, Hamilton said.

Similar to other systems, the organization has piloted a program for bedside nurses that focuses on improving care and keeping up with current regulations.

Hosparus’ bedside nurse-development program features five levels, from novice to expert. Participants earn points by serving on internal committees, presenting at a conference, earning palliative-care certifications and other distinctions. They take on more responsibility as they progress.

The post-acute and home health provider also has a new management track for nurses, who have been hard to source outside of the organization.

About a third of Hosparus’ open positions are filled internally, Merrifield said. However, that has damaged care continuity, at least through the perspective of patients, she said.

“You build relationships in end-of-life care, so we need to keep a close eye on how to best maintain the continuum,” Merrifield said.

Memorial Healthcare has also boosted its training programs to improve internal mobility and retention. It invests more than 110,000 hours a year, up from 95,000 in 2017. Now, about 30% of its open positions are filled within the organization, which was up from 18% in 2016.

“Our employees want more. They want career progression, ongoing skills building,” Vargas said, adding that it assesses any gaps in workforce training every year. “We have shifted our focus in the last two years from traditional succession planning to accelerating paths for key positions in the organization.”

Day-to-day operations can put coaching and development on the back burner. But lower unemployment rates, market competition, nursing and physician shortages, tighter profit margins, and stagnant wages have reprioritized these recruitment strategies from routine HR work to a strategic initiative, Woman’s Hospital’s Bodin said.

Woman’s Hospital has responded by developing job-specific competency-based assessments and individualized training and development plans for all team members. As more employees seek promotion opportunities than what is available, it has expanded the definition through lateral moves or additional responsibilities, Bodin said.

She described a clinical ladder program that encourages nurses to remain at the bedside while offering opportunities for higher salary by performing functions such as teaching, research and leading or joining a committee, task force or project work.

Woman’s Hospital is also adapting to new technology, Bodin said. A recent upgrade to its recruitment system, artificial intelligence technology, manager and employee self-service and onboarding systems have automated functions that were previously under HR’s purview. Those employees have been redirected to recruitment, training and data analytics.

New roles and training programs are shifting responsibilities away from clinical professionals to technical or midlevel workers to allow those with specialized skills to function at the top of their license, she said.

“Professional development is the key to preparing our workforce for the future,” said Bodin, adding that the hospital has invested significant resources in a three-year plan that includes training for all team members, patient and employee resource groups, ongoing assessment, recruitment and development plans, and community partnerships.

“Our succession planning program, for instance, formerly reserved for leaders and clinical management, is being revamped and integrated throughout the organization.”

Conflict management, strategic agility, coaching/developing and delegation are areas of opportunity for Woman’s Hospital’s leadership team, she said.

“As a result, training on crucial conversations, transformational leadership, change management, facilitation, creating a climate of inclusion, strategic planning and delegation skills will be offered by experts in these areas.”

Employees will need to be tech savvy, nimble and customer-centric to keep up with the evolving healthcare landscape.

But like most things, it ultimately comes down to cost, Buchanan Ingersoll & Rooney’s Ameci said. If providers can’t use workforce training programs to recruit employees, it could become a self-perpetuating cycle, she said.

“The more systems become cost-crunched, particularly with some of the workforce shortage issues, the less they have to invest in education internally,” Ameci said.

Best Places to Work in Healthcare 2019