With inpatient, outpatient, home health and palliative care services, Mercy Health Youngstown is the largest employer in the Mahoning Valley region of Ohio. Investments in employee development, therefore, have a positive impact on both the health system and on the community at large, making this a top priority for senior leadership.
Mercy Health Youngstown has expanded access to skills and leadership training for entry-level workers with education programs, college tuition reimbursement and opportunities for career advancement. Entry-level employees with leadership potential, for example, are encouraged to enroll in School At Work (SAW), a training and career development program created by Catalyst Learning Company.
SAW participants complete a series of modules led by a Learning Coach in the Culture and Learning Department at Mercy Health Youngstown. The Principles of Patient Satisfaction and Safety module has proved to be especially valuable.
“We found the Patient Satisfaction course very useful because entry-level employees didn’t realize how the little things they do affect patients and patient satisfaction. Sometimes patients arrive at the hospital frustrated and hard to please, so this particular course made a big difference,” said Learning Coach Georgette Peters. “This course also showed entry-level employees the importance of their work and its impact on HCAHPS reimbursements.”
To demonstrate program value and return on investment, Mercy Health measures impact and tracks aggregate success among SAW participants. Of the 35 students who graduated from SAW last year (20 from Mercy Health Youngstown and 15 from Mercy Health Cincinnati), nine are now enrolled in higher education and pursuing further training to move up within the organization.
SAW graduate Janet Johnson found similar success. She started in an entry-level position at a Mercy affiliate hospital in 2009. With a grant from the Robert Woods Johnson Foundation, she trained to be an entry-level healthcare associate. This resulted in a promotion to Environmental Services, where managers recognized her leadership potential and recommended Janet for SAW. She completed SAW and is now enrolled at Penn State, pursuing a career as an occupational medicine assistant at Mercy Health Youngstown.
Mercy Health is proud to see employees like Janet advance.
“When speaking with our employees who complete the SAW program, I always thank them for bringing me along on their journey. I hope to assist in lighting the flame, and I hope the students keep it burning,” said Peters.
Mercy Health Youngstown plans to continue offering SAW courses and hopes to expand the curriculum to smaller regional partner facilities. Additionally, senior leaders hope that by offering upfront college tuition reimbursement, they can help employees overcome barriers to advancing their education, particularly those who earn the lowest wages.
The health system aims to enroll up to 45 percent of their employees in skills training programs and help more employees pursue advanced educational opportunities. As employees succeed and move up within the organization, senior leaders are seeing morale and retention rates improve, resulting in better patient care. Mercy Health Youngstown believes that employees are their most valuable resource, and by investing in them they hope to make lives better and the community stronger.
Saint Anthony Hospital staff worked hard to improve its Leapfrog Hospital Safety Grade from a D in 2014 to an A in October 2016. The nonprofit, community teaching hospital in Chicago found one key to success came in providing front-line nurse leadership with increased confidence and management tools that would help improve hospital standards and quality of care.
Finding the Right Curriculum
Saint Anthony’s development team was searching for a structured, in-depth learning program that would empower their nurses to take leadership to the next level. What they found was Catalyst Learning Company’s NCharge® Nurses Learning to Lead program. NCharge provided the detailed content and knowledge assessments they were looking for, with results that are measurable. By focusing on relevant leadership scenarios within the hospital, participants were able to easily relate and apply techniques to their everyday environment.
“Like most healthcare organizations, we are growing and changing. We were also in the process of reorganization. It was about sweeping clean on old ideas and looking for ways to be more efficient. Illinois is also tightening on funds and as a nonprofit hospital, we had to look at ways to be more efficient in how we were working and make our staff feel as if they have a way to advancement,” stated Jaqueline Napier, Manager of Talent and Development at Saint Anthony.
Leading with More Confidence
One important outcome noted by Saint Anthony management is the overall improved confidence among nursing leadership. Creating a more autonomous team has positively impacted the hospital environment and proven an effective influence regarding quality of care.
Sonia Haro, an ICU Staff Nurse and NCharge participant, committed her time to the NCharge series with specific objectives in mind. “I was looking for ways to communicate more effectively, especially when setting expectations for the team. Sometimes, not everyone feels like being a team player. I wanted to find a way to encourage my team but stay firm and reach expectations,” explained Haro. This was the type of leadership training that most staff nurses don't get with shadowing or clinical training. Haro was pleased with NCharge, which provided her with a better understanding of communication styles and techniques to handle a variety of situations confidently in the unit.
Haro wasn’t the only person who noticed a need for better communication and confidence from front-line nursing leaders. When Catalyst Learning surveyed nurse managers at Saint Anthony before the NCharge courses were implemented, less than 20% strongly agreed that the Charge Nurses in their departments displayed confidence when leading their teams. In addition, less than 30% agreed that Charge Nurses were cognizant of the key drivers of a positive patient experience. A few months after the training was held, the same nurse managers were surveyed and reported dramatic improvement with over 65% saying Charge Nurses were more confident and over 70% recognized key drivers in positive patient experience.
Cultivating Team Dynamics
A more efficient, collaborative environment was formed as a result of the NCharge leadership training. The team who completed training worked stronger and smarter together when handling obstacles. “I really wanted to work with others in the hospital in the same position. It’s nice to have others to lean on and run questions by, and share experiences with. Networking with my own colleagues was a great bonus,” stated Haro.
Elizabeth Negrete, Director of Perinatal and Pediatric Services, had staff who completed NCharge training. Staffing in OB, having the right number of staff and the right combination, had been a continuous issue. NCharge class participants looked at staffing and created plans to put the right skills and experience in the best combinations. “Now the staff are the ones doing the schedule, entering it in to the system and balancing. When the census goes down, they adjust appropriately based on the patient grid. This shows how they have been working more autonomously and are able to make important decisions with less guidance,” explained Negrete. “The Charge Nurses are working more in collaboration with the house managers. Before, staff managers were just telling them what the need was, but now the Charge Nurses are more empowered to speak up about needs.”
Haro reported that the rounding process has also gone through changes, giving the NCharge participants an opportunity to observe with fresh eyes what happens within the unit when everyone is not on board with a change. “It takes some buy-in from everyone, and there were days when we were just being run ragged. You could easily see that on days when the new process wasn’t being used, feelings and tensions were high,” conveyed Haro.
By equipping front-line leaders with the skills to embrace change, NCharge prepares staff for reaction from team members and how to move forward as a unit. This can be vitally important and impactful when trying to deal with the constant updates within hospitals. “There is always more trust from staff when changes come from Charge Nurses. There is more peer influence and impact. The staff has more of a buy-in because they know the Charge Nurses truly understand what the impact will be since they are on the frontline with them,” described Negrete.
Made evident in the impressive move of their Leapfrog Safety grade from a D in 2014 to an A in October 2016, the hospital seems to have found the key to success in increasing quality standards. Napier credits the NCharge series with being a factor in that improvement after implementation in early 2016.
The combination of increased confidence, more efficient staffing and adaptability to change have helped Saint Anthony become a more progressive, efficient hospital when it comes to patient care and standards. “The nurses are more cohesive as a team and moving towards a group environment where the charge nurses really stand out as leaders. They are really keeping their team members engaged. All of that correlates to the patient experience and how everyone is measured,” stated Napier. “Our people were skilled but now they have more confidence in those skills and their ability to engage the nurses on their team. They now understand how this all comes together to enhance the patient experience.” By giving front-line leaders new techniques to handle their day-to-day situations and changes, an environment of new ideas and proactive enthusiasm has been cultivated.
By investing in the front-line nursing leadership at Saint Anthony, stronger teams were built and the confidence instilled in the newly trained charge nurses was of great value. The return on investment for the Chicago hospital is shown through the recognition of receiving its first A rating from Leapfrog Hospital Safety Grade and becoming a top-rated hospital.
When the University of Texas Medical Branch (UTMB) assessed its training needs in late 2015, nursing leadership recognized a gap in charge nurse development. With no formal tools in place and a somewhat inconsistent structure to the Charge Nurse position, UTMB decided to take action. Catalyst Learning's NCharge® courses were chosen to bring more commonality and consistency to this vital hospital role for both current and aspiring Charge Nurses. To date, 60 participants in three cohorts have completed all five NCharge courses: Charge Nurse Fundamentals; Critical Thinking; Leading Change in a Dynamic Climate; Supervisory Skills for Positive Outcomes; and Employee Engagement & The Patient Experience. Patient Care Facilitators (PCF), who have similar responsibilities to Certified Clinical Nurse Leaders, have also been included in this comprehensive professional development program. Because Charge Nurses often look to PCFs as experts on the patient care experience, UTMB determined that leadership training could equally benefit the PCF role, said Barbara Bonificio, Director of Nursing Excellence. Bonificio added that the NCharge program could become an important asset in a comprehensive health system initiative to increase employee engagement and patient satisfaction. In fact, UTMB leaders believed the program was valuable enough to include some of its relevant results at the unit level in UTMB's recent reapplication for Magnet status.
By putting in place formal training, UTMB hopes to make significant improvements not only in patient satisfaction, but also RN-to-RN communication, nurse sensitive indicators and workflow on the units. Comparisons of participant surveys conducted before classes began and after completion indicate positive movement in critical skills development across several of these areas.
Most notably, when asked if they were cognizant of the key drivers of positive patient experience, only about 65% of respondents strongly agreed when surveyed before taking classes. After completion of the program, more than 85% strongly agreed with that statement. When asked if they understood the linkage between employee engagement and the patient experience, nearly 90% strongly agreed after the course, up from less than 70% before entering the program. Also, only about 60% of respondents strongly agreed they were cognizant of key drivers of an engaged team prior to NCharge. That number jumped to close to 90% after completion.
A Timely Decision
When UTMB launched NCharge in December 2015, hospital staff was preparing to relocate to a new facility and would be faced with a new set of workflows. The program's Leading Change module proved to be timely, as all participants in the class were involved in this major move. One especially valuable component of the Leading Change module educated students about the change curve, demonstrating that workers at different levels in an organization also are at different stages of the curve, said Sharon Hensley, Nursing Program Manager. Those in leadership roles may have already processed a change, while frontline workers may have just been introduced to it. "That was very impactful for them," she said. Prior to taking the Leading Change class, only 55% of survey respondents strongly agreed they were cognizant of their role to assist the team with change management. After completion, nearly 90% strongly agreed. In terms of leadership, 100% of respondents reported strong agreement that they were cognizant of their influence on the attitude and tone of the unit, up from only 60% prior to the class.
Beyond these targeted outcomes, NCharge has been successful in helping to dispel some misconceptions and illuminate different perspectives. For example, before the courses, many participants believed value-based purchasing simply meant that if system departments bought in volume, UTMB got a discount. "The financial impact of value-based purchasing was a real eye-opener for everyone," said Bonificio. "I don't think they realized the significant dollar amounts attached to not being reimbursed, as well as the penalties for not reaching certain targets."
Because each cohort comprised a mix of experienced Charge Nurses and those hoping to land the role, NCharge was beneficial to both groups because they were exposed to each other's perspectives. In addition, the module on types of communication is already being put to use on the floor. "Participants learned the best way to talk to people whose communication styles are different than their own," said Bonificio. Now, graduates are "excited to share the skills they have learned with their units."
Looking to the Future
Reception to the NCharge program has been overwhelmingly positive overall, Hensley said. "There were significant dollars connected to the people being selected, and I think that was impressive to them - that we are investing in them." UTMB nurse leaders are happy with the program response and results so far, and plan to continue offering it to PCFs and Charge Nurses. In fact, they envision further advantages across other nursing roles. "It would be beneficial if all nurses could understand challenges their charge nurse colleagues face," according to Bonificio. "If everyone understood these challenges, it would make the units run much more smoothly."
University Health System’s (UHS) focus on its front line employees is delivering outstanding outcomes that it’s Talent Development strategy has been designed to deliver. With an 81% student/employee job advancement rate for a group of its frontline employees, UHS has created an environment that is supportive of employee growth and organizational success. Appropriately termed their “Talent Garden”, UHS has created an environment where everyone can thrive.
The Talent Garden’s recently graduated its first ECHO skill development cohort for mid-level associates who are now well on their way to achieving big career dreams and goals. And, while turnover costs make retention an obvious organizational priority, UHS’ efforts are still at the cutting edge of frontline engagement trends.
Studies show that highly engaged employees report that they experience ALL of these and more:
· an opportunity to learn and grow,
· are encouraged to seek development,
· have a manager that cares about them
· they view their job as important
· and someone talks about their progress
The Executive Director of the Center for Learning Excellence, Jacque Burandt, provided all of these when she chose to offer the ECHO program. “We have lots of programs, not just for directors and managers, but also for the front line,” says Jacque. “We are always working on two paths, better skill development in whatever your job is, then secondly, where do you want to go in the big vision of the health system.”
According to Jacque Burandt, Executive Director of UHS’s Center for Learning Excellence, “the ECHO program supports their philosophy of promoting from within. ECHO offers a unique opportunity for the organization to fill a gap that often prevents non clinical employees from having the tools and educational foundation necessary to successfully transition to more advanced roles within the system, should they so choose.” ECHO’s delivery format is designed for the adult learner, incorporating multiple learning modalities while at the same time providing a foundation for increased confidence, academic discipline, and formal career planning.
The quotes below show some of the successes thus far and just how well participants used and appreciated the opportunity:
"I hope that UHS can continue with programs like this one, to show their employees this company cares about continuing education." - Irma Beltran, ECHO graduate.
"I currently work in the Patient Business Services Department. The ECHO program has inspired me to go back to school. I plan to go to St. Phillips for nursing. I appreciate all you do for us."
"The ECHO Program...was an opportunity I could not pass up. It has helped me in getting motivated to go back to school. I am enrolled with Concordia University and pursuing my Bachelors in Healthcare Administration."
"I am attending Southern Careers Institute and am working towards receiving my Medical Coding Certification. The ECHO program gave me the opportunity to see that I am not too old to go back to school and pursue my dreams."
Looks like UHS certainly has some future leaders on their hands! Fifteen total employees were chosen to participate in ECHO, 12 of those completed the program - an 80% completion rate. ECHO was facilitated by a former School at Work program graduate, Laura Hernandez. She found her passion for helping others through that experience and has since earned a Bachelors in Healthcare Administration which she puts to good use at UHS.
Certainly outcomes are very important and the Talent Garden continues to track them for this first class. Be on the lookout for the continuation of this story as results come in!
Administrative assistants - they save you time, money, ensure you're prepared for half a dozen meetings a day and ward off unwanted calls and emails. If you did the math on the amount of time (money) your office assistant saves you in a given week, you'd probably be looking for the same return in all your investments.
The use of medical secretaries in hospitals, physician practices and outpatient facilities is projected to rise by 36% in the next 10 years, reports the US Department of Labor. That's more than RN's, LPN's, Medical Techs or even healthcare IT professionals. [read article]
1. Outstanding office benefits and
2. A strong belief in their own abilities.
So what about the other office support roles in your organization? If you think they can't impact quality or patient satisfaction, you might want to consider this: registrars and schedulers deal with patients that skip appointments, forget their paperwork, and pay their bills late. Medical records clerks and transcriptionists type notes that go into medical files for quality review. And coders contribute to reimbursement through accuracy, timeliness, and their efforts to make the switch to ICD-10. See our special offer on 2.5 hour seminars - good only through April 23rd.
The duties of Patient Service Reps can also have a powerful impact on HCAHPS and operational effectiveness. Last month our newsletter highlighted one organization's work in professionalizing this role. If you missed it, read here.
Timmicia Ward has worked hard to transform herself into a role model who exemplifies the standards of her organization. Through the School at Work program, she actively supported her classmates and worked diligently to improve her scores – impressing her managers with an increasingly positive and can-do attitude. The hard work paid off. Timmicia graduated from SAW with honors and immediately sought opportunities to expand her professional portfolio. Soon after, she won a scholarship to defray college expenses and is currently earning a bachelor’s degree in healthcare administration while carrying a 4.0 GPA. Timmicia was also nominated to attend a six-month leadership development program so that she graduated with an additional certificate for exceeding expectations.
Timmicia was recently promoted to a lead specialist position. She has not only increased her knowledge, but also has transformed herself into the forward-thinking, goal-oriented, positive person she is today. She’s an amazing example of a “Dream Achiever.”
"Dream Achievers!" awards recognize professional and personal accomplishments in the health care industry. The awards are part of a nationwide contest sponsored by Catalyst Learning. Catalyst Learning is a leader in healthcare workforce development with an emphasis on strengthening the front-line workers employed in entry- and mid-level positions.
Employers nominate employees for the “Dream Achievers!” award based on an employee’s continuing efforts towards professional education and career achievement, as well as serving as an inspiration to coworkers and members of the community. Nominees were selected through an online voting process hosted by Catalyst Learning.
While working as an administrative assistant with the UC Davis Health System, Robin Shelton told a coworker she wanted to manage the office within five years. That was 2009 – the same year Robin began the School at Work (SAW) program. Although it was a challenge, Robin completed her coursework while also balancing work and family responsibilities. Last year, she began an accounting certification program at UC Davis. Robin is currently working as an Analyst II Supervisor, four positions higher than she was four years ago.
“This is all due to the SAW classes,” Robin said. “It not only gave me the tools, but also the confidence that I could do anything I set my sights on. Thanks to the encouragement of family and my supervisor, I will work towards my goal as Finance Manager of our office, one step closer to my dream.”