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Building the New Healthcare Workforce:Translational Research to Improve Financial, Clinical, Patient and Staff Engagement Outcomes
Presented by:
Marcia Faller, PhD, RN
Chief Clinical Officer
AMN Healthcare
Brenda Fischer, PhD, RN, MBA, FACHE, CPHQ
Vice President Education and Professional Advancement
Center for Professional Advancement
AMN Healthcare
Learning Objectives
Identify key strategic, operational and leadership actions to ensure effective workforce planning to meet person-centered care mandates under the Affordable Care Act.
Translate the new workforce building model’s application into your organization.
Understand the impact of effective workforce planning and training programs on improving financial, clinical, patient and staff engagement outcomes.
Outline
Industry Workforce Challenges and Risk of Inertia
Financial and Operational Impact
Center for Professional Advancement
– National Emerging Roles Study
– Poll on emerging roles
– Futures Program
– Poll on workforce planning
Workforce Building Model
– Evidence-informed framework
Strategic, Operational and Leadership Actions
Industry Workforce Challenges and Risks of
Inertia
Workforce Challenges
Increased demand for competent contemporary roles
Aging workforce and population
Tsunami of retirements
Influx of patients due to Affordable Care Act
Risks of Inertia
Hazards of not planning for the new healthcare workforce
Recruitment and retention disaster
Aging workforce without necessary new skills
Not going to have a workforce
Reimbursement loss from lack of outcomes
Market share loss from patient dissatisfaction
Reputation loss from declining quality
Financial and Operational Impact
Financial Impact
Labor costs 54.2% of operating budget
Turnover costs
Recruitment costs
Decreased reimbursement if not performing at benchmark in value based system
Market/volume/reputation loss if not performing on publicly reported metrics
Operational Impact
Acute care census fluctuations
Shift to community based care
Staffing new roles
Staffing existing high demand/low supply roles
Care coordination challenge
Rough transitions
The Center for Professional Advancement
The Mission of The Center
TO ADVANCE PRACTICE, EDUCATION AND RESEARCH IN HEALTHCARE
Center for Professional AdvancementNational Strategic Innovation Leadership
Available Now Phased Progression
PRACTICE
EDUCATION
RESEARCH
Transitions into Practice Residency/Fellowship
Internships Virtual Professional Communities of Practice Knowledge/Competency Assessment
Leadership Assessment and Development Professional Portfolio Management Client Portals Standardized Onboarding
Futures Program ANCC rn.com ACPE RxSchool
e and Blended Learning Allied Health Continuing Education Continuing Medical Education Electronic Health Record Conversion Transitions into New Facility Academic Progression Programs
Foundation Grants Scholarships
Federal Funding QualifiedProgram Development
Translational Research Quality Outcomes Research
National Emerging Roles in Healthcare Study
First of its kind
Examine new roles and organizational readiness
Clinical and Human Resource leaders across the country
Final report presented at Healthcare Workforce Summit November 6 & 7 in Washington DC
Invitation to participants
http://www.healthcareworkforceforum.com/
Emerging Roles Poll
Healthcare Futures
Mission: Build the Future Workforce with High Quality
Education and Training Programs
Creating Value at a Critical Moment
Healthcare Futures: Delivers your new workforce supply so all your energies can focus on patient care.
Healthcare Futures: Key Components of Creating the New Workforce
Forecasting consult
Customize training program
Partner with professional organizations
Build cohort program
Blended learning
Clinical placement
Mentoring/Precepting
Competency assessment
National Certification
The Healthcare Futures Mission: Build the future workforce with high quality education and training programs.
Role/Specialty-Specific Implementation Example
Upskilling with ProgressiveLearning
Specialty training – L&D
Previously untrained with no clinical experienceNew Grad BSNResidency
Experienced RN withoutspecific knowledgeFellowship
Blended LearningDelivery
Perinatal Orientation andEducation Program
120 hours over 30 weeks
120 hours over 30 weeks
Transition into Practice TIPPrecepted Experience
On Site
1 year
6 months
Contract CommitmentWithin Client Organization
2 year
2 year
Identified preceptor with AMN Advanced Practice project management
Goal of National Certification
Perinatal AdvancedContinuing Education
Front Loaded LearningE-Learning
Content
Transition into Practice (TIP) Precepted Experience
On Site
Contract CommitmentWithin Client Organization
Care Coordination and Transition ManagementRole
American Academy of Ambulatory Care Nursing
Previously untrained with no clinical experienceNew Grad BSN Residency
Experienced RN withoutspecific knowledgeFellowship
30 hours over 3 weeks
30 hours over 3 weeks
6 months
2 months
2 year
2 year
APN without specific knowledge Fellowship
30 hours over 3 weeks 1 month 2 year
Role/Specialty-Specific Implementation Example
Identified preceptor with AMN Advanced
Practice project management
Goal of National Certification
Crosswalk of Dimensions for Care Coordination andTransition Management with Core Competencies*
*Haas, Swan, & Hanes, 2013
Dimension RN in CareCoordination and
Transition Management
Quality and Safety Educationfor Nurses (QSEN)Core Competencies
Interprofessional EducationCollaborative Core
Competencies
Public HealthNursing Competencies
Advocacy
Support Self-Management
Education and Engagementof Patient and Family
Cross-Setting Communicationand Transition
Coaching and Counseling ofPatients and Families
Nursing Process: Assessment,Plan, Intervention, Evaluation
Teamwork and Collaboration
Patient-Centered Planning
Population Health Management
Patient-Centered Care Safety
Patient-Centered Care
Patient-Centered Care
Patient-Centered Care
Patient-Centered Care
Evidence-Based PracticeQuality Improvement
Teamwork and Collaboration
Patient-Centered Care
Quality Improvement Informatics
Values/Ethics forInterprofessional Practice
Interprofessional Communication
Roles and Responsibilities
Team and Teamwork
Domain #5: Community Dimensions of Practice SkillsDomain #6: Basic Public HealthScience Skills
Domain #3: Communication Skills
Domain #4: Cultural Competency Skills
Domain #1: Analytical Assessment Skills
Domain #8: Leadership andSystem Thinking Skills
Domain #1: Analytical Assessment Skills
Domain #2: Policy Development/Program Planning Skills
Care Coordination: Priorities for Measurement
Patient and Family Experience of Care
Coordination
Measures that address timeliness and responsiveness of care and services.
Measures that capture patient and family goals and preferences for care and services.
Measures that consider unique care coordination and transitional care needs of children and their families.
Measures that consider the extent to which care coordination and transitional care are culturally appropriate.
Process Measures of Care Coordination
Measures of the development, implementation, and regular review of an integrated plan of care incorporating patient and family preferences and goals.
Measures of timely and accurate communication of the plan of care across providers and settings.
Outcome Measures of Care Coordination
Standardized measures of preventable hospitalizations and emergency room visits.
Measures of patient and family satisfaction with care coordination and transitional care.
Measures of quality of life and functional status across the continuum of care.
American Academy of Nursing Care Coordination Policy Brief 3.5.12
Structural Measures
Measures of staff and team competence in care coordination, particularly competence in complex care coordination and transitional care for seriously ill patients and their families.
Measures addressing access to appropriate and competent care coordination and transitional care.
Workforce Planning Poll
Workforce Building ModelEvidence-Informed
Framework
Workforce Building Model Process Components
Analysis
Operational need
Proactive industry stance
Continuous improvement cycle/evaluation
Analysis
Ask the right questions
Support the questions with appropriate data
Metric profile
Population served
Staff diversity
Staff retirement schedule
Job and competency analysis
Job progression chart
Operational Need
Forecasting with key stakeholder involvement
– Current workforce profile
– Future workforce needs
– Gap analysis
– Plan to close gaps
Proactive Industry Stance
Focus on transformational change
How will that effect how we provide care?
Plan to support our people to bridge the change
Efficient and cost effective
Community and industry pipeline partnerships
Continuous Improvement Cycle/Evaluation
Clear goals
Reassess industry changes
Revisit assumptions
Monitor balance scorecard dashboards
Strategic, Operational and Leadership Actions
Actions
Courage to practice and lead innovation
Strategic priority at the Board of Directors level
External expertise partnering for success
Built into organization balanced scorecard
Workforce planning committee with key stakeholder membership
Standing leadership reporting agenda item
Internal clinical, operational and finance leadership planning partnership.
References
“Emerging Roles in Healthcare Study”, Center for Professional Advancement, AMN
Healthcare, preliminary findings, November 2014.
“Developing an Effective Health Care Workforce Planning Model” American Hospital Association/American Organization of Nurse Executives/American Society for Healthcare Human Resources Administration, October 2013.
“2015 Environmental Scan”, American Hospital Association, September 2014.
“Collective Genius: The Art and Practice of Leading Innovation”, Hill, Brandeau, Truelove, Lineback, Harvard Business Review Press, 2014.
“Care Coordination and Transition Management Core Curriculum”, American Academy of Ambulatory Care Nurses, 2014.
“Care Coordination: Priorities for Measurement”, American Academy of Nursing Care Coordination Policy Brief 3.5.12.
Contact Info
Healthcare Workforce Summit Registration
http://www.healthcareworkforceforum.com/
Center for Professional Advancement web page
www.amnhealthcare.com/thecenter
Questions and Answers
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