WORKFORCE RECRUITMENT AND RETENTION

FROM THE NACHC LENS Innovative Approaches to Workforce Recruitment Youth Education Initiative to Help Grow Local Health Care Workforce At NEW Health, Chewelah, WA, recruiting staff from the local community has been a challenge for many years. In an area where logging and mining are the main industries, high school graduates are encouraged to leave the community to attend college and find employment opportunities. “We saw gaps in educational opportunities,” says Desiree Sweeney, CEO, NEW Health, “and have a passion about creating opportunities for our own community members.” This passion led to the health center’s new youth education initiative. With a local high school partner, the health center is engaging students in an MA pre-apprenticeship program. Students participate in a non-clinical internship and earn credit towards an MA certification while earning high school credits. The health center hopes to extend its pilot program to additional high schools across the state helping to grow the state’s potential health care workforce. The Value of Social Drivers of Health Questioning During Interviews Finding staff who are the right fit to handle the multiple demands and pressures placed on health center staff is key for patient care and for successfully working in a health center setting. Selecting the candidates who can thrive in this type of health care environment can translate into positive staff retention. “We have gone back to the drawing board and looked at our interview process, our interview questions, and the type of people we were looking to be face-to-face with our patients,” says Naiomi Jamal, MD, Chief Health Officer, Swope Health, Kansas City, KS and MO.   All Swope Health care team candidates are now asked questions to assess their understanding of social drivers of health (SDoH), and how they influence the care provided. For example, MAs and nurses may be asked, “If you have a patient who struggles with transportation or food insecurity how would you go about assisting that patient? How would that information inform your care, and who from the team would you involve?” These types of questions are given a fair amount of weight because it is not just enough to say, “I am mission minded and want to serve the underserved.”

Retention Strategies That Reinforce Staff Value and Engagement Retaining health center staff has been a challenge long before the COVID-19 pandemic intensified the situation. As part of staff retention efforts, health center leaders continue to look for ways to improve how they attract, train, recognize, and cultivate care team staff.  One retention strategy employed by Swope Health aligns community needs with clinician areas of interest. For example, clinicians can work four days a week in primary care and devote their fifth day to working in an area of interest needed by the community, such as HIV care, Hepatitis C care, substance use disorder care, women and adolescent health, and pain management. This strategy is helpful to reducing clinician burnout and improve retention, especially for early career physicians who are still developing their areas of interest. “They get a chance to be champions for something and have input in how the health center provides care,” says Naiomi Jamal, MD, and Swope Health’s Chief Health Officer. In addition, allowing clinicians to pursue their interests enables them to stay engaged in primary care. “It is also a win-win for patients and the community who would otherwise be on long waitlists for receiving specialty care," added Dr. Jamal. Swope Health also strives to create a culture where staff feel valued and heard. This empowers them to stay engaged in their work which can translate into retention. Swope Health's CEO, Jeron Ravin, is a personal champion for this approach. Ways leadership is embedding this culture into the organization include: Fostering staff connection and open communication across the organization and with senior leadership such as inviting staff to participate in “This Week at Swope Health,” a weekly virtual all-staff meeting led by Ravin. Supporting staff passions to help staff grow vertically and laterally. (i.e., giving a primary care nurse the opportunity to transition into psychiatry because she has an interest for behavioral health) Encouraging care team members at all levels, to have a greater voice and share good ideas. If their team agrees, staff are encouraged to “just run with it”. Creation of a meditation room that is accessible to all staff for them to unwind, relax, and rejuvenate during the work day. These retention strategies highlight some ways health centers can foster a work environment that meets staff personal and professional needs and reinforce how staff are valued and appreciated, while staying focused on its mission.

HEALTH CENTER SPOTLIGHT

NEW HEALTH Where Staff Training Takes Center Stage As CEO of NEW Health for the last 16 years, Desiree Sweeney is all too familiar with recruiting and staffing challenges. Adequately staffing her seven medical clinics, three dental, and three pharmacy clinics that serve a large ural and mountainous area in northeastern Washington comes with several obstacles. Challenges include gaps in educational opportunities with most high school graduates encouraged to leave the area for college or better job opportunities and physician turnover. The health center often has young physicians join care teams through the three-year HRSA National Health Service Corps program. After their program ends, many leave for other opportunities which can cause disruption to teams and services. Sweeney knew something had to change. “We had a strong commitment for our organization to survive, but in order to do that we had to train staff and not assume that we would put out a posting and someone would come work for us.” In 2021, after ten years of numerous workforce development pilot programs, research on best practices, and studying lessons learned, the health center launched NEW Health University. This comprehensive internal workforce development program encompasses growth and advancement, recruiting, training, internal and external workforce development, and retention. And the program is working! Between January and June 2022 NEW Health hired 45 new employees                                       Sign-on bonuses are no longer needed to recruit entry-level and support positions The health center has more qualified applicants than they can hire and now have a growing number of prospective employees The health center is now not only positioned in the community as a health care provider but as an employer supporting jobs and local economic development Training and investing in its workforce is a top priority for NEW Health and together with education, are central elements of the program's key components. “I challenge my teams to find the diamonds in the rough,” says Sweeney. “Find the individuals who want to work, succeed, and improve our patients' lives in our service area, and we will guide them and support them.”

NEW Health University Key Strategies

Growth and advancement are key performance indicators for the leadership team Promotions are closely tracked and growth of staff closely monitored Training is a serious organization commitment An internal training program supports skill development and staff advancement All clinics close for two hours each month for training and staff meetings. Trainings are customized to specific roles and growth plans. All staff receive onboarding curriculum and 90-day and annual skill assessments Internal workforce development and strategic department organization charts empower employees in their job role and beyond Departments have been reorganized, and new roles have been created with succession plans for when positions become vacant Staff are cross-trained on different roles allowing for vacation coverage, thus promoting a work-life balance mindset Partnerships with schools, tuition assistance, and on-the-job training are offered to help staff attain skills and certifications in order to advance Visualizing career pathways for every position creates excitement for career growth and helps identify staff wanting to advance

RESOURCE

NEW NACHC Workforce Wellness Toolkit This toolkit offers sample workflow changes, emails, meeting agendas, and brief individual and team exercises that health centers can integrate when instituting new or enhancing current workforce wellness initiatives.

Four Simple Way to Bring Mindfulness Into Your Every Day Spending too much time during your workday planning, problem-solving, or having negative or random thoughts? Practicing mindfulness helps you redirect those thoughts and help you be in the present. Pay attention and take the time to experience your environment with all of your senses — touch, sound, sight, smell, and taste.  Live in the moment. Be intentional with all you do. Be open and accepting.  Accept yourself. Treat yourself the way you would treat a good friend. Focus on your breathing. When you have negative thoughts, with eyes closed, take a minute to sit down, inhale, and exhale. Source: Mayo Clinic

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