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.
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."
Even the White House takes notice when employers display the level of dedication to advancing front-line workers for which CLC's customers are known! On Friday 4/24, Mercy Health (Cincinnati), Norton Healthcare, TriHealth and UnityPoint Health represented all entry level healthcare champions who provide upward mobility for their associates.
At the White House Upskill Summit, employers were lauded for their success in helping their employees move into Middle Class jobs. Best practices for helping frontline workers develop new skills and earn higher wages were shared. Congratulations to all! Read more about Norton and TriHealth's frontline efforts.
Why This Is a Really Big Deal
Ongoing development at the entry level is not always the first thing on the minds of healthcare executives, even if it is smart business. And recent challenges stemming from ACA make you wonder how these hospitals manage to prioritize these program and why they feel it's still so important. But then, that's what Catalyst Learning is all about:
"We are grateful for the opportunity to have worked with over 500 healthcare employers to increase the skills and upward mobility of entry and mid-level associates. It's a win for the organization in retention and engagement and a win for the associate who gains a career he/she never dreamed possible. Executives like Jenny, Molly, Tony and Joyce are making this happen from one end of America to the other - and we humbly and sincerely thank them for their partnership."
- Lynn Fischer, Founder & CEO, Catalyst Learning Company
And for those still craving information on facilities using more flexible approaches and targeted academies, download the write-ups in the CLC blog.
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