Healthcare Workforce of the Future Sandi Vito Director, 1199SEIU League Training and Upgrading Fund

Transcription

1 Healthcare Workforce of the Future Sandi Vito Director, 1199SEIU League Training and Upgrading Fund

2 What Changes With Health Reform? Shift in focus for the health care delivery system to primary and preventive care Emphasis on effective management of chronic diseases Emphasis on care coordination and care transitions Payment reform, e.g., incentives for keeping people healthy and penalties for inappropriate hospital readmissions 2

3 Select re-admissions Healthcare-Acquired Conditions/Serious Adverse Events Hospital Consumer Assessment of Healthcare Providers & Survey (HCAHPS) Core Measures Shift to home and community based settings

4 Emerging Models of Care New York State Health Home Accountable Care OrganizaLons Delivery System Reform IncenLve Payment (DSRIP) Program Level 3 PaLent Centered Medical Home Managed Long Term Care

5 A virtual network of agencies providing coordinated care to individuals with complex needs

6 Care Manager Care Navigator The Care Manager has overall day- to- day responsibility for: } } } } } CoordinaLng the aclviles of the Care Team Facilitates access to medical and social services Coordinates/writes with input Care Plan IdenLfies and removes barriers to care ULlizing resources efficiently and effeclvely to enable palents to access needed services and avoid unnecessary use of inpalent and ER services The Care Navigator ensures successful implementalon of the care coordinalon aclviles through: } CommunicaLon and collaboralon with the Care Manager } ULlizaLon of health IT tools to monitor and track palent health informalon to accomplish care coordinalon } Monitoring alerts regarding palent hospitalizalons to ensure Lmely communicalon to select clinical staff and appropriate follow- up } Monitoring and sharing informalon with other care team members throughout care transilons } Monitoring that palents have follow- up appointments azer a medical or psychiatric discharge as needed

7 Findings Coordina6on Roles Survey of Health Centers 73% of praclces reported staffing at least one dedicated coordinalon role Care Coordinator Care Manager Case Manager Community Health Worker PaLent Navigator PosiLons have overlapping responsibililes, including: Pre- visit planning and parlcipalon in team meelngs and huddles Self- management and palent educalon aclviles ConducLng populalon health management aclviles and coordinalng care transilons Source: Emerging Positions in Primary Care: Survey Results, Greater New York Hospital Association

8 Survey Findings Hiring Requirements for Coordina6on Posi6ons Source: Emerging Posi,ons in Primary Care: Survey Results, Greater New York Hospital AssociaLon Educa6on requirements Workers/Job Titles

9 Source: Emerging Posi,ons in Primary Care: Survey Results, Greater New York Hospital AssociaLon Recruitment Challenges: Relevant work experience Related job skills Bilingual candidates Training Needs: Team- based care Care coordinalon PaLent communicalon

10

11 Exercise #1 10 minutes Discuss and Report Out: Health Care Reform Impact On: Workers Providers PaLents/Residents Community

12 What are the issues and challenges for training and educa6on? Emerging jobs and new competencies CreaLng new career pathways New higher ed. curricula for tradilonal occupalons Nurses Social Workers Training and new skills for incumbent workers PaLent Service RepresentaLves Medical Assistants Others

13 Training and EducaLon New skills for exislng workers Redeployment/mobility/Career Pathways New Workers & New Jobs 13

14 Core Competencies Core Competencies Categories: CommunicaLon Chronic diseases PaLent Care Access Electronic Medical Records and Computer Skills PaLent Care Follow- Up Resource Support Ethics and ConfidenLality Home Visits (if applicable) 14

15 Principles of care coordinalon EffecLve verbal and non verbal skills Elements of effeclve palent relalonship MoLvaLonal interviewing PotenLal roadblocks to communicalon CharacterisLcs of effeclve communicalon with collaborators and other professionals What it means to be part of a health team How personal bias and culture can impact the way people interpret illness; including idenlfying your own bias EffecLve interviewing skills to bejer understand palent's behavior and belief system Culturally competent queslons to understand beliefs

16 Understand the basics of common diseases, including common diagnoslc tests and treatments Self- care measures palents can use CharacterisLcs of common mental illness CharacterisLcs of substance abuse Wellness as its relates to chronic disease; nutrilon, obesity, smoking, exercise

17 Strategies for scheduling Lmely appointments How different centers schedule palents Barriers palents face when accessing care Differences between palent services in hospitals, outpalent and other semngs Barriers that palents face transiloning between a hospital semng and outpalent, clinic or community semng Ways to help palents transilon between semngs TransiLon to Care: Steps involved when a palent is referred to a specialty provider Basics of Medicaid, Medicare, insurance systems Obtaining authorizalon for service

18 Resource Support EffecLve skills/strategies for working with community agencies, team, etc. Ways to find appropriate resources and match them to palent needs IdenLfy characterislcs of credible and non- credible sources of informalon Access resources for uninsured Social support and the form it might take, including housing Ways to help enhance palent's support network Assess a palent's support system and idenlfy/review areas where support is needed

19

20 Exercise # 2 Source: Care Coordina,on Fundamentals 1199SEIU Training & Upgrading Fund

21 Do s Focus on main ideas Be aware of verbal and non- verbal messages Acknowledge and restate the person s message Use the person s name Don ts Interrupt the person Give the palent advice Talk about yourself Tell the person how he or she feels

22 Exercise #2 - InstrucLons Without reading exactly what is on the card, tell a story that describes your situalon (as indicated on the card) Engage in AcLve Listening Summarize 3 or 4 main issues you heard Do not offer advice or even asking probing queslons Write down your observalons 22

23

24 RN Care Manager Behavioral Health Specialist Care Manager Community Health Worker Peer Navigator Peer Support Worker Advanced Home Health Aide CerLfied Chronic Disease Educator

25 Common Skills & Competencies

26 Exercise #3 - InstrucLons Ø Common skills and competencies in the 4 jobs Ø Who might move into these jobs Ø From incumbent workers Ø From community Ø What core competencies do workers/ community members already have? 26

27 Jobs, Roles, Competencies Examples of Training Capacity Evaluate Coordinate Build Create Abundant Training Exists Community Health Workers CommunicaLon, AcLve Listening Care CoordinaLon Medical Assistant Capacity Needed Curricula Exists Nurse PracLLoner CerLfied Asthma and Diabetes Educators Behavioral Health Advanced Home Health Community- based Care Management New Curricula Needed? Not Yet Clear

28 Sandi Vito Director 1199SEIU League Training & Upgrading Fund