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Baltimore coalition educates for the future
If a hospital believes that its employees are its most valuable asset, then it surely understands the negative economic ramifications of losing experienced employees to other facilities. The solution to the problem is to retain and promote the best employees within a facility.
That was the problem experienced in the Baltimore area, and the solution was to create the Baltimore Regional Healthcare Training Partnership. (See article, p. 43.)
"Changes in the health care system are forcing hospitals in the Baltimore metropolitan region to reorganize and downsize," explains Laura Chenven, project director of Community Services, Baltimore Regional Healthcare Training Partnership. While jobs that are increasing in complexity remain vacant for lack of trained personnel, experienced health care workers are at risk for dislocation because there are insufficient funds for incumbent worker training and education programs, Chenven says. "Ironically, just as the need for training has increased, hospital funds previously available for training have decreased."
The problem is multifaceted, according to Chenven. "Workers who have received training at a particular health care institution face another difficulty."
One size does not fit all hospitals
Skills acquired at one hospital are not necessarily recognized by other institutions, leaving workers unable to transfer from one facility to another. Chenven says that the transfer problem could be solved by creating a mutually recognized training system and set of skill standards.
The shift in health services from acute care to other settings poses additional problems. "As jobs shift from acute care to outpatient and long-term facilities, incumbent workers need to be better able to make the needed transition to new health care delivery systems and thereby improve their chances of remaining employed, Chenven says. There simply was not a lot of money available for training the incumbent worker," she says. "We have a pool of people who are at risk, who need their skills upgraded, and who need to learn new skills to better fit in the newly re-engineered health care field."
It did not make sense to only wait until people are unemployed to do something to help them, as there are several programs available to assist the unemployed health care worker, Chenven says. "Many workers within a hospital are already invested in that hospital. They have benefits, longevity, and pensions at stake."
She also notes that it is important to give incumbent workers the support and services they need to succeed. Workers included in the target group for the training project are nursing aides, dietary workers, laundry workers, housekeeping workers, and some clerical personnel. Although many of those targeted workers understand that changes in the hospitals could threaten their job security, they do not know what they can do about it, says Chenven.
Using existing funds in combination with a Department of Labor grant, a coalition of labor, hospital management, and state and local governments comprised the partnership that would develop training that was mutually recognized by all participating hospitals. The partnership consists of four hospitals (Johns Hopkins Medical Center, Sinai Medical Center, Greater Baltimore Medical Center, and Maryland General Hospital), the Service Employees International Union District 1199E-DC, Community Services of the Baltimore Metropolitan Council of the AFL-CIO, the City of Baltimore’s Office of Employment Development’s One Stop Career Center, and the Maryland State Department of Labor Licensing and Regulation.
Through coordination with new worker training provided by the region’s One Stop Centers, the partnership will be able to develop cost-effective training and avoid duplication of services, Chenven says. The dissemination of the experiences generated by the project could help spark innovation and collaboration among stakeholders in other economic sectors within the state.
A strict and binding set of criteria was used to determine the eligibility for participation by an institution in the partnership:
• Each employer must have more than 500 employees.
• A portion of incumbent employees are at risk for layoff or demotion because of changes in the industry, low skills, and/or projected changes in jobs and skill sets.
• Eligible employers must have identified jobs at their institution or at their satellite clinics that could be filled by workers who are currently at risk, if the proper training and education programs were available.
• They must have made a commitment to fill available jobs with workers who have obtained the needed skills through the partnership.
• They must have demonstrated their long-term commitment to training and education through negotiated joint labor/management training funds, which supply some of the matching funds.
• They must have committed personnel and in-kind contributions to support the success of the program and partnership.
The partnership also recognizes that although the program provides the training, the institutions need to provide support services for the participants. Participating employers need to encourage workers, schedule release time, and understand the new skills the workers are learning.
Equally stringent are the criteria to determine which employee candidates will be chosen to participate in the program. Chenven says that they must meet the following criteria:
• Eligible employees are nonmanagerial, nonprofessional staff who are likely to be affected by hospital reorganization, downsizing, or layoff.
• Eligible employees need training and education to access available jobs in outpatient facilities or in new or upgraded positions.
• After the outreach, recruitment, and orientation portions of the program, eligible employees express an interest in training and education for continued employment in the health care industry.
"One of the major goals is to train workers for portable skills and to provide employers with well-trained, experienced personnel," says Chenven. The training model includes both basic skills and occupational training. The occupational track includes a core curriculum, specific occupation training, and customized modules to address the particular needs of each institution. "The basic skills training is integrated into the occupational training to improve the success rate."
Workers who meet the criteria undergo a series of confidential assessments in reading, math, and writing. Based on the results, workers are eligible for various training tracks. Those who score above benchmark (determined by the provider of the occupational skill training) are eligible for occupational skills training. All participation is voluntary.
Workers who score at an intermediate level are eligible for job skill training with additional academic support. Those who score below the intermediate level have the opportunity to take a combination of basic skill classes, computer-assisted instruction, and individual and small group tutoring.
By retaining, retraining, and promoting incumbent employees, a hospital creates a win-win situation. The employee who has a history at a facility is further rewarded for loyalty while the facility avoids the hard and intangible costs of locating and training new personnel.