Wisconsin s Health Care Workforce 2009 Report

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Wisconsin s Health Care Workforce 2009 Report A report by the Wisconsin Hospital Association

Wisconsin s Health Care Workforce 2009 Report A report by the Wisconsin Hospital Association

About This Report The economy was starting a slight downturn late in 2008, just as human resource directors were completing the 2008 Wisconsin Hospital Association Hospital Personnel Survey. If they were completing it today, the results would be vastly different. However, as is true with every data collection effort, the data contained in this report provides a snapshot of the health care workforce and the challenges that hospitals face to meet a growing demand for care. As this report is published, experts debate whether the economy is showing signs of recovery. For hospitals, the economic downturn precipitated shifts in the health care workforce that no one could have predicted just months in advance. Health care was believed to be one of the few recession proof industries in the country prior to the recession. It soon became apparent that health care was not immune to the impact of a global economic meltdown. The rise in unemployment was accompanied by the loss of employer-sponsored health insurance. At the same time emergency departments experienced a jump in volume, while utilization in other hospital services began to decline as people postponed all but emergent care. The drop in overall volume forced hospitals to reduce or freeze hiring levels or implement targeted layoffs. Uncertainty about the length and depth of the recession raises concerns. So while the health care field as a whole continues to grow, individual hospitals are making adjustments to ensure they remain financially viable and able to meet the health care needs in the communities they serve. Hospitals will continue to offer family-sustaining wages and benefits and stable employment in the long run; however, in what is hoped will be the short term, hospitals are not immune to the broad-sweeping downturn that has held the country in its grip. Current events have not changed the projections in this report that indicate Wisconsin will face formidable challenges maintaining a workforce that can meet the growing demand for care. As the economy heals, people will be back at work, those who postponed retirement will age out of the workforce, and people who are now in health occupational training programs should find rewarding careers in hospitals. Philip Stuart CEO, Tomah Memorial Hospital Chair, WHA Workforce Council Steve Brenton President Wisconsin hospital Association

Table of Contents Executive Summary...1 The Wisconsin Health Care Workforce...2 Wisconsin s Aging Population...3 Recession Slows Hiring, But Doesn t Stop Workforce Shortages...3 The Current Health Care Workforce in Wisconsin: The Status of Five Key Clinical Occupations... 4 Registered Nurses...4 Pharmacists...5 Physical and Occupational Therapists...6 Laboratory Technologists...6 Wisconsin Hospital Association Recommendations...7 Wisconsin Hospitals: Building Tomorrow s Workforce Today...8 Retaining the Current Workforce...9 Support new entrants into the workforce...10 Transition current employees...10 Recruit...11 Other strategies...12 Partnerships...13 Sources...14

Executive Summary While the total number of jobs in Wisconsin continues to decline, modest growth is projected in the number of health care jobs within the next decade. The health care sector comprised of hospitals, nursing and residential facilities and ambulatory care employs over 370,000 individuals in a wide range of skills. By 2010, the Department of Workforce Development (DWD) predicts that health care will account for more than 13 percent of all jobs in Wisconsin. A majority of these health care workers are employed in hospitals. It is expected that the health care industry will continue to generate job opportunities in the future as demand for medical care increases. Wisconsin is home to an aging population. Older residents consume proportionately more health care as they age. This will increase both the demand for health care and the need for a workforce in the future. However, the workforce is aging along with the general population, with many members nearing an age when they expect to retire. Wisconsin will simultaneously be faced with a growing demand for care just as more mature workers are leaving the workforce. The current recession has temporarily reduced the demand for health care and at the same time has pushed retirements farther out into the future for many workers. These temporary changes will delay, but not prevent, predicted future shortages of health care workers. Although tempered by current economic conditions, positions for specific clinical occupations remain difficult to fill. Registered nurses, therapists, pharmacists, and laboratory technology positions will remain on the watch list as demand for these professionals grows in the future. The Wisconsin Hospital Association makes the following specific recommendations: Health care providers and education institutions must look beyond the current economic environment and work to meet predicted future health care workforce shortages. The State of Wisconsin, health occupation professional associations, and health care providers should collect, report and analyze workforce data. Health care providers and academic institutions must collaborate on both statewide and regional workforce planning activities. While progress has been made in some professions, statewide educational capacity for health care occupations must continue to be evaluated and expanded as necessary. Wisconsin hospitals recognize the very real risk that there will not be an adequate future workforce to meet the demand for care. To address that risk and to improve the communities in which they provide care, hospitals support, encourage, aid and promote health careers. Hospitals work to retain and develop the current workforce, support those entering health care work, recruit both youth and second career students into health care occupations and transition workers to other, better positions if that becomes necessary. Examples of these efforts are illustrated in the final section of this report. Page 1

the Wisconsin Health Care Workforce Health care is a large employer segment in Wisconsin. Nearly 400,000 individuals are employed in Wisconsin hospitals, ambulatory care clinics and long-term care facilities. While the total number of jobs in Wisconsin and nationwide is declining, the number of people employed in the health care industry continues to grow at an anticipated rate of 3 percent this biennium. (Source: http://dwd. wisconsin.gov/oea/employment_projections/ shortterm_projections.htm.) This projected rate of increase is lower than previous estimates as the current economic environment has slowed new job creation in hospitals. However, according to the Wisconsin Department of Workforce Development (DWD) by 2010 health care will account for about 13 percent of all jobs in Wisconsin. Hospitals employ the largest number of persons within the health care sector. These individuals work in many types of occupations. Although this report is primarily about the clinical occupations that are unique to health care, many other occupational groups from cooks, housekeepers, maintenance Graph courtesy of Center on Wisconsin Strategy. Published in The State of Working Wisconsin: Update 2009 workers and transportation staff make up the total hospital workforce. The chart below illustrates the job classes that are included in the health care workforce. It is important that there be thought and care directed at ensuring that this large employment sector has employees prepared in adequate numbers to meet known future job needs. Action now to attract and educate the workforce is critical to meet those needs. While some jobs require little post high school preparation, others require graduate and post graduate study. In the past, action has been taken only after it is clear that there are not adequate workers to fill positions. There is now an opportunity to avoid a replay of that scenario. Page 2

Wisconsin s Aging Population Wisconsin is home to an aging population. In 2009, approximately 750,000 individuals over the age of 65 were living in Wisconsin, and it s growing rapidly. By 2030, this group will comprise 20 percent of Wisconsin s total population and be almost 1.4 million strong, which will have two pronounced effects on the health care delivery system. First, a large number of people working in health care will be at or near retirement. This means recruitment and retention efforts must be escalated to reduce the number of positions that are vacant. Secondly, older people use more health care than their younger cohorts. Staying ahead of the demand for services in an aging population will require a significant amount of advance planning. Attention must also be paid to design of the physical environment and care settings for older patients and older caregivers. Issues like access, lighting, noise, stairways and hall length will impact older patients and older health care workers. Wisconsin hospitals are acutely aware of and deeply concerned that the aging of the workforce and the general population together will create unprecedented challenges to the health care workforce. Workforce issues are a top WHA priority and efforts are focused on ensuring that Wisconsin has a highlyskilled workforce in numbers that are adequate to deliver high quality care. Recession Slows Hiring, But Doesn t Stop Workforce Shortages The economy has had an impact on Wisconsin s health care workforce. Across all industries, Wisconsin has lost 135,500 jobs since the recession started in 2007, according to Dennis Winters with the Wisconsin Department of Workforce Development Office of Economic Advisors. Past recessions have required months to years to recover lost jobs. Job losses and the threat of unemployment have temporarily decreased patient volume in both the inpatient and outpatient settings. This is due to individuals putting off care as family budgets tighten or as health insurance benefits become less generous or are lost altogether. Hospitals have responded to the drop in patient activity by instituting hiring freezes. Overall, however, health care needs have probably not changed, and delayed care will more likely be sought when family financial condition allows. For that reason, the long term projections that indicate there will be health care workforce shortages in the future have not been revised and as the economy gains strength, people who are now in health occupation training programs will find rewarding careers in hospitals. Page 3

The Current Health Care Workforce in Wisconsin: The Status of Five Key Clinical Occupations Registered Nurses Registered nurses are the largest clinical group employed by hospitals. Because they are the largest group, much attention is focused on nurses. More than 50 percent of all registered nurses work in hospitals. Wisconsin hospitals reported 29,845 registered nurses on their payroll in 2008. They also reported that 9.1 percent of their RN positions were vacant. These vacancies are often for experienced nurses with specialty knowledge and leadership skills. Positions for new nursing graduates and inexperienced nurses are not difficult to fill at this time. Just eight years ago, hospitals reported serious shortages of registered nurses. In response, Wisconsin nursing programs did an exceptional job of expanding capacity. Every existing program has increased its enrollment and several new programs have opened. One measure of that growth is the number of new individuals that take the examination for nurse licensure in Wisconsin, referred to as the NCLEX. The graph below shows the growth in test takers, who become new entrants into the RN workforce. The current vacancy rate for RN positions does not constitute a crisis for hospitals. A major reason for this is nurses voluntary increase in hours of work, either returning to work, or working more hours within a current position. A current national survey in Healthcare Finance News indicates that employed registered nurses are working more hours because of the economic climate, but those nurses also indicate that they will return to pre-recession work levels when the economy rebounds. The reasons reported were making up for reduced family income due to spouse s job loss and replenishing retirement funds impacted by the stock market decline. Peter Buerhaus, nurse faculty member at Vanderbilt University, has been following nursing workforce issues for many years. In a recent Health Affairs publication, he said, Recession effects that have eased the shortage of hospital nurses must be viewed as temporary, lest they distract policymakers from continuing to address longerterm indicators. He goes on to say that during difficult economic times nursing employment grows more rapidly, and he calls the current increase in RN hours and availability stunning. The growth is disproportionate in hospital settings. He hypothesizes that this is because of better pay, better benefits and the potential to work 12 hour shifts/3 day weeks. He reports that most of the recent increase has come from nurses older than 50, which means the current easing in shortages is clearly temporary. There is a risk that the ease in filling nurse hospital hours will be interpreted as an end to the nursing shortage. Serious caution is urged about this interpretation because a large number of retirements and reduction of hours is expected in the future as experienced nurses age and choose to retire or reduce their hours. Page 4

Data-based planning for the nursing workforce continues to be a necessity in Wisconsin and a priority for the Wisconsin Hospital Association. The 2009-2011 Wisconsin budget set a requirement for a nurse workforce study. This study will generate useful information about which licensed nurses are in the workforce, how many hours they work, how many jobs they hold and when they intend to reduce hours or retire. Wisconsin will have an opportunity to improve workforce planning functions by utilizing statewide and regional survey information. In addition, nursing programs have been willing to discuss program capacity. Combined, this will accelerate long-term resolution of Wisconsin s nursing shortage. Pharmacists Pharmacist positions are the most difficult to fill in hospitals. In the 2008 WHA Personnel Survey, hospitals reported 94 vacant full-time and 45 vacant part-time pharmacist positions. This equates to a reported vacancy rate of 9.8 percent. This rate has increased over the past six years to the point where the pharmacist vacancy rate is now higher than the vacancy rate for nursing positions and illustrates how difficult it is for hospitals to recruit pharmacists. In December 2008, the Health Resources and Services Administration (HRSA) released a report, The Adequacy of Pharmacist Supply 2004 to 2030. They reported shortages nationally that are similar to those in Wisconsin. The national report, however, was optimistic that vacancy rates are declining nationally. That has not occurred in Wisconsin, where there is still only one educational program that prepares pharmacists. The Pharmacy Manpower Project (PMP) collects, analyzes and disseminates data on the supply of licensed pharmacists in the United States. Their June 2009 report lists only one state at the highest level of shortage or unmet demand Wisconsin at 4.80 on a scale of 1-5. There were 35 states at the 4 level (some difficulty filling open positions) and 14 states at 3 (balance between supply and demand). This shortage remains despite ongoing efforts. Hospitals have examined more efficient ways to leverage the skills of pharmacists. One way has been to increase the efficiency or output of existing pharmacists. The Wisconsin Pharmacy Examining Board has been open to changes that allow pharmacists to oversee the dispensing of medications at remote locations where having a full time pharmacist on staff is not practical. A second strategy involves improving the speed with which pharmacists transferring into Wisconsin may be licensed a move WHA strongly supports. Concordia University of Wisconsin has committed to opening a new pharmacy program. That program will admit its first students in 2010 and plans to accept 100 students in each class. This new program offers the potential that Wisconsin will be able to provide training for the number of pharmacists necessary to meet the anticipated demand for their services. The continued increase in older residents and the exponential growth in the number of pharmacologic interventions available to prescribers suggest that demand for these professionals will only grow in the future. Page 5

The Therapy Professions: Physical and Occupational Therapists Physical therapist positions have the highest vacancy rate of all the health care occupations in hospitals. More than 13 percent of physical therapist positions are vacant, for a total of 245 vacant positions statewide. Occupational therapist positions are a close second with a vacancy rate of more than 12 percent or a total of 134 positions. More than half of the vacant occupational therapist positions are part time, while about one third of the physical therapist vacancies are part time. These occupations are not unique in the part-time nature of the jobs. This makes jobs attractive to some workers, but not to others. The rate at which vacancies for these two occupations is increasing is particularly concerning. Therapists help people maintain or return to optimal physical functioning. This is an especially important service given that an older population and an aging workforce will access therapies in growing numbers. More opportunities in outpatient settings and a stable number of academic programs and graduates have resulted in fewer individuals seeking hospital-based experience. WHA is working with a committee of the Wisconsin Physical Therapy Association with the goal of increasing the supply of physical therapists in Wisconsin. Laboratory Technologists Hospitals report laboratory technology positions are becoming much more difficult to fill. The current vacancy rate for this group is 9.7 percent, reflecting 167 positions. Hospitals are concerned that this occupational group has more workers over the age of 55 than others and their positions are more difficult to fill. More than 28 percent of current employees in this category are approaching retirement. So, in addition to a current difficulty in filling positions, it is clear that age-related retirements and hour reductions will contribute to future vacancies. The University of Wisconsin-Madison, Clinical Laboratory Sciences/Medical Technology (CLS/ MT) program within the School of Medicine and Public Health recently stopped admitting students and will close. This has the potential to negatively impact the supply of persons available to fill what will be a growing number of available positions. Hospitals are concerned about this reduction. It is important that existing programs in Wisconsin: Increase capacity in current medical technology programs; or, Create new programs to not only offset this loss, but increase overall capacity to meet both current needs and expected/predicted vacancies. Page 6

Funded by a three-year grant from the Medical College of Wisconsin Healthier Wisconsin Partnership, the Wisconsin Workforce Data Collaborative is surveying laboratories and laboratory workers. The information from the survey will greatly improve knowledge of this workforce and facilitate better planning. Wisconsin Hospital Association Recommendations Hospitals are dedicating substantial human and financial resources to grow the health care workforce in their communities. For their efforts to be successful in addressing current and anticipated workforce shortages, an understanding of Wisconsin demographics along with quantitative data on the current workforce and future demand for care is required. It is also critical that health care providers and the educational institutions that prepare health care professionals work together as they develop long range plans that have the flexibility to address external dynamics that often cause fluctuations in the demand for health care, as the recent recession demonstrated. The Wisconsin Hospital Association makes the following specific recommendations: Health care providers and education institutions must look beyond the current economic environment and work to meet predicted future health care workforce shortages. The State of Wisconsin, health occupation professional associations, and health care providers should collect, report and analyze workforce data. It is imperative that those involved in workforce planning have real time information regarding the current number of individuals in the workforce, the hours they work, where they work and how much longer they intend to work. Health care providers and academic institutions must collaborate on both statewide and regional workforce planning activities. It can take in excess of four years to prepare health care professionals and that requires considerable advance planning in both the educational and health care environment. While progress has been made in some professions, statewide educational capacity for health care occupations must continue to be evaluated and expanded as necessary. Education institutions must work closely with health care providers to ensure that space is available in occupational training programs where the need for these professionals is greatest, which at this time would include pharmacists, physical and occupational therapists, laboratory technologists and registered nurses. More occupations could be added to this list as data is collected and accurate projections can be made relative to the supply and demand. Health care is an important employment sector for Wisconsin. In the current economy, it remains one of a handful of industries that is expected to grow while jobs in other sectors, such as manufacturing and construction, continue to decline. The health care industry offers stable and rewarding career options for people that are just entering the workforce as well as to those starting a second career. A structured way to find and prepare the next generation of health care employees is critical if Wisconsin is going to maintain its reputation for providing high quality, accessible health care. Page 7

Wisconsin Hospitals: Building Tomorrow s Workforce Today Anticipated workforce shortages in Wisconsin hospitals have two dimensions. Health care requires a large workforce, but it also demands that employees have highly specialized training to perform the work. Both pose unique human resource challenges for hospitals. An increasing number of older workers will eventually leave the workforce and a stable number of younger workers will be required to take their places. Health care requires long term strategies to ensure workforce needs will be met. As older workers retire and an unprecedented number of vacancies occur, health care will compete with other industries for these employees. Some industries will fare better than others in this intensely competitive environment. Health care can only compete with other industries if it offers employees a rewarding and satisfying work life. Creating interest in health care occupations will not be enough. It is also necessary to help members of the future health care workforce obtain the education necessary to perform the work. Hospitals are developing programs to both attract and educate people by providing opportunities for clinical experience close to home and supporting their employees and Photo submitted by Memorial Medical Center, Neillsville Clinicals are the only way we truly become medical professionals, be it nurses or whomever. The real-world education that hospitals provide is what polishes our skills and independence, so it s great that you open your doors to us. - Jason Tischer, nurse anesthetist student from St. Mary s University. students in the community with job shadowing, scholarships and loans. What first comes to mind when thinking of hospitals and the future workforce is clinical education, especially related to the preparation of nursing and medical students. In fact, Wisconsin s hospitals are excellent sources of practical experiences for students in many health occupations. Hospitals offer clinical experiences for private and public education programs at the diploma, associate degree, bachelor s degree and graduate programs. They also offer experiences in programs not limited to health care, such as clerical work and skilled trades. Clinical education is not the only way that hospitals address workforce issues. Hospitals also participate in other strategies to create, attract, encourage, retain and reward the health care workforce. It is important to keep today s workforce at work. High retention rates reduce the need for replacement workers. Hospitals can also attract displaced workers that had been employed in other industries. These workers will have a shorter number of years that they are available to work than new entrants, but retraining opportunities for both displaced workers and incumbent workers can be a non-traditional source of workers for hospitals. Finally, hospitals create interest in health care careers and encourage individuals, students and adults to prepare themselves for rewarding work in this field. Wisconsin hospitals are using their own resources to build tomorrow s workforce. This section provides examples of some of the numerous programs hospitals have initiated to attract, recruit or retain a health care workforce. Page 8

Retaining the current workforce Keeping current employees seems a first and simple strategy for workforce. Today s health care employees have many employment opportunities. Hospitals recognize that and work to keep current employees. Although many employers interview staff that choose to leave, employees at Luther Midelfort Oakridge, Osseo that have history with the organization are offered the opportunity for a face-to-face conversation on why they stay with the hospital. ProHealth Care, Waukesha offers on-site educational programming that allows registered nurses to progress to a bachelor s degree. Tuesday is school night at the hospital for a cohort of nurses advancing through the course sequence together. Supporting employees in leadership positions helps leaders examine their leadership style and likely leads to better connections and retention of staff. Vernon Memorial Healthcare, Viroqua uses the services of the Rural Wisconsin Healthcare Cooperative to support leaders as they examine how they lead and how to improve as leaders. Luther Midelfort, Eau Claire offers a two-year leadership education and development program (LEAD) for high-potential employees who may be interested in leadership opportunities at the hospital. Participants and mentors both benefit from this program. Photo submitted by Aspirus Wausau Hospital The Career Ladder Program gives employees an opportunity to move to a higher level of achievement without leaving their current job at Mercy Health System, Janesville. Employees in all areas of the organization can demonstrate new skills, acquire certifications, participate in education and advance on the career ladder. Aspirus Wausau Hospital offers a clinical advancement program within the nursing department. Nursing staff developed the program, which includes two award levels for staff whose professional achievements go beyond their routine work. Bellin Health, Green Bay designed a clinical advancement system to increase job satisfaction and retention, but also has the impact of improving patient outcomes as a result of a more highly-educated staff. Gundersen Lutheran Health System, La Crosse offers a guide-at-the-side to offer support for nurses at the bedside. Each hospital unit has a nurse educator to offer support and education. Nurses can stay at the bedside doing what they do best, but be kept up-to-date by the unit-based guide. Fitness challenges from the Columbus Community Hospital Wellness Squad encourage healthy lifestyles, foster teamwork and improve morale among the hospital staff. Retention practices at Black River Memorial Hospital include teamwork and a family atmosphere, flexible schedules, cross-training opportunities and employee involvement in decision-making. Programs that create an innovative workplace for nurses and improve patient care and satisfaction characterize retention efforts at Hudson Hospital and Clinics. Last year the hospital participated in the national program Transforming Care at the Bedside of the Robert Wood Johnson Foundation. The program offered direct caregivers the opportunity to Photo submitted by Columbus Community Hospital Page 9

participate in a national program and to increase the amount of time spent directly with patients, resulting in better patient outcomes. Offering retention loans, encouraging membership in regional, state and national professional organizations and formalized employee development plans are ways that Amery Regional Medical Center retains their competent workforce. Strong and supportive leadership is one reason that employees stay in Photo submitted by ProHealth Care their jobs. ProHealth Care has created a new program designed to promote the rapid development of strong, positive working relationships between new leaders and their teams. Team members have the opportunity to provide input into their expectations, challenges and support in a way that is safe but also promotes trust, engagement and hope for new leaders. Support new entrants into the workforce Photo submitted by Black River Memorial Hospital Successful onboarding of new employees is the goals of Aurora Health Care, Milwaukee. Pre-employment and orientation phases have been designed to engage employees from their first contact and though the first year of employment. The program goal is greater employee engagement and retention. The first year of employment for registered nurses is critical. Evidence indicates that many new graduates leave their first position within 12 months. Most stay in the field of nursing, but changing employers is costly for the employer, who has invested time and effort in the new nurse and is often discouraging for the nurse. Evidence also suggests that this first year turnover can be reduced and perhaps nearly eliminated by a strong supportive program of entry level nurses usually labeled as a residency program. Wisconsin has been fortunate that Marquette University has held a grant from HRSA to implement such a program statewide. Hospitals in rural and urban areas have supported the program in many ways. Nurses in their first year of work attend classes, are paired with a peer support person and have a local or regional forum that offers support and feedback on practice issues. This program, currently in its fourth year, had demonstrated that nurse turnover can be reduced and that strong support from employers enhances satisfaction and practice in new nurses. Transition current employees Students completing high school are not the only place that hospitals look for members of the workforce. Their own employees, displaced workers and other adults are possible workers for hospitals. When new voice recognition software eliminated the need for some medical transcriptionists at ThedaCare, Appleton, those workers were offered other opportunities within the organization. Job shadowing and support from the human resources department helped workers find role changes that were rewarding, convenient and interesting. Nurse Practitioner for the Future Program provides funding for Affinity Health Care, Menasha employees who wish to pursue a master of science in nursing. This program offers great opportunity for staff interested in a new career. Affinity is also prepared to fund students working on a doctorate in nursing practice. Page 10

The career symposium of Beaver Dam Community Hospital is available to people considering a midlife career change from an entirely different field or from one area of health care to another. The symposium includes a tour of the hospital, details about the variety of jobs in health care, how to prepare for these jobs and an opportunity to meet representatives from educational facilities to discuss admission and financing. Helping students by offering employment and tuition reimbursement is a strategy of Sauk Prairie Memorial Hospital and Clinics, Prairie du Sac. For difficult to fill positions like laboratory workers, clinical experience in the hospital offers both learning and part time employment. Because employment Photo submitted by Sauk Prairie Memorial Hospital means tuition reimbursement, the student-employee learns about work life and feels the support of the hospital. Laboratory learning is also a focus at Black River Memorial Hospital. Students from UW Stevens Point and Western Technical College allow hospital staff to impart valuable knowledge and experience to every student and ensures that students experience their discipline in a practical setting. Recruit The Wisconsin Youth Apprentice Program (YAP) offers high school students hands on learning at a worksite in conjunction with classroom instruction. The two-year elective program combines academic and technical instruction with mentored on-the-job learning that makes a real world connection for the students. Ministry Health Care - Saint Clare s Hospital, Weston assists high school students in the youth apprenticeship program with clinical learning and supports certification as a nurse assistant through Saint Clare s Foundation. Beloit Memorial Hospital partners with two local high schools to support their health Photo submitted by Agnesian HealthCare care youth apprentice programs. They provide classroom space, an RN instructor, hospital beds and equipment for the learning lab. Aurora BayCare Medical Center, Green Bay has offered the health care youth apprenticeship program since it opened in 2001. Agnesian HealthCare, Fond du Lac works with the Fond du Lac Area Association of Commerce to offer the YAP. The Medical Explorers program introduces students in seventh to ninth grades to health-related careers. Red Cedar Medical Center, Menomonie works with the local school district to offer rotations through patient care and non-patient care departments for a closer look at work in these areas. ProHealth Care also offers medical exploring. Students and their parents find the experience a valuable aid in career decisions. The Medical Service Academy of St. Mary s Hospital and the Ministry Medical Group in Rhinelander introduces and nurtures high school students interested in health care careers. The program offers observational clinical experiences plus guidance for these students. Aurora Medical Center in Two Rivers partners annually with the Lakeshore Health Care Alliance and the Northeastern Wisconsin Area Health Education Center to offer Career Camp to high school students Photo submitted by Ministry Health Care - Saint Mary s Hospital, Rhinelander Page 11

that want to know more about opportunities and challenges in health care careers. Agnesian HealthCare partners with Marian University to offer high school students a one-week career exploration summer camp experience to explore nursing careers. UW Health Partners Watertown Regional Medical Center hosts a Take Our Sons and Daughters to Work Day for students who get to work with a parent or adopted parent to explore the inner workings of the hospital and job shadow in the area of their choice. Aurora Sheboygan Memorial Medical Center offers Mini-Med School. The program is designed for the person with a keen interest in medicine and how the body works. Students age 16 and over receive a comprehensive overview of the human body taught by health care providers. Community Memorial Hospital, Menomonee Falls collaborates with local school district in an experiential opportunity for juniors and seniors to explore health professions through a program called Healthcare Career Academy. If you might be interested in a career in health care, but do not really understand a job or position, the opportunity to shadow a worker and view the work first hand is invaluable. Ministry Health Care Good Samaritan Health Center, Merrill offers a job shadowing day for high school students. Aurora Medical Center, Hartford also offers job shadowing to high school students interested in health care careers. Each year 16 to 20 students from Washington County high schools witness health care in action. Photo submitted by Divine Savior Hospital Medical School for Teens offers a hands-on learning approach to the world of medicine for students ages 14 to 21 at Mercy Health System, Janesville. The class focuses on many clinical areas plus career opportunities. Medical discovery days is a program of Rusk County Memorial Hospital, Ladysmith where area freshman and sophomore students interested in health careers can tour the hospital and observe care providers in action. Staff at Luther Midelfort Northland speak to Barron High School students about careers in health care. Club Scrub is an after school program designed to spark interest in health related careers among seventh and eighth grade students. They have the opportunity to participate in hands-on learning activities and meet health care providers. Club Scrub is offered by several Wisconsin hospitals including Divine Savior Hospital, Portage and UW Health Partners Watertown Regional Medical Center. Other strategies Mile Bluff Medical Center, Mauston, has been recognized by the Western Wisconsin Workforce Development Board for their involvement in the regional registered nursing program. They award scholarships to assist students enrolled in the associate degree nursing program, helping to educate more than 20 students to date. Photo submitted by Black River Memorial Hospital Helping teens learn about the world of work is the focus of Summer Jobs and Training for Teens offered by Froedtert Photo submitted by Stoughton Hospital Page 12

Memorial Lutheran Hospital, Milwaukee. The program teaches teens the importance of being on time, a professional personal appearance, a positive attitude, and taking pride in work. Students work about 20 hours per week. The program provides a paycheck and a real work experience that helps them develop a work ethic and exposes them to working in a team environment. Froedtert also teams with workforce intermediaries and community-based agencies to offer the Reach program aimed at 10 to 24 year olds that lack the skills or experience to compete in the job market. Stoughton Hospital hosts the Big Give program of River Bluff middle school and introduces students to volunteerism and giving back to the community. Vernon Memorial Healthcare, Viroqua works with fifth graders in Project STAR (Serving Together, Achieving Results). The project provides the opportunity to explore interests and work on community service projects. St. Croix Regional Medical Center hosts students grades four to eight as part of Know Your Community Program. Photo submitted by Vernon Memorial Healthcare To keep talented students in the community as they earn a bachelor s degree, Ministry Health Care - Saint Clare s Hospital, Weston is working with area groups to create an opportunity that allows registered nurses to complete general education courses at UW Marathon County, take one more year through the university system, and graduate with a BSN. Photo submitted by St. Croix Regional Medical Center Gundersen Lutheran Health System, La Crosse teamed with their foundation to create the Western Campus of the University of Wisconsin, School of Nursing. The program offers the upper-division component of the nursing curriculum taught on-site at Gundersen Lutheran. More than 70 percent of these graduates work in Wisconsin. Partnerships Hospitals partner with individuals and groups in their region to address workforce issues. In the Fox Valley, the Workforce Investment Board has partnered with Aurora, Affinity, Agnesian and Theda Clark, and educational facilities, nursing homes and public health to create Fox Valley Health Care Workforce Alliance. The Alliance s goal is to ensure an adequate workforce for the future. The group has a variety of initiatives, which include collecting workforce retirement data, standardizing job shadowing opportunities for students and adults and optimizing utilization of clinical time for students by standardizing the sign-up and preparation process. In La Crosse, area hospitals participate in the La Crosse Medical Health Science Consortium. Education and service facilities in the region help direct and implement a program to enhance health care and strengthen education. This group is currently implementing an online listing of clinical education opportunities in health care settings for the entire region with a goal of optimally making this limited resource for all educational programs. The Lakeshore area has supported new educational opportunities and increased the visibility of health careers. Comprised of hospitals, clinics and academic institutions, the group has sponsored career camps aimed at attracting students to health occupations. Page 13

Sources Healthcare Finance News. Accessed at: http://www.healthcarefinancenews.com/news/survey-nurses-workingmore-during-recession Office of Economic Advisors, Wisconsin Department of Workforce Development. Accessed at: http://dwd. wisconsin.gov/oea/ The State of Working Wisconsin - Update 2009. Center on Wisconsin Strategy. Accessed at: http://www.cows. org/pdf/rp-sowwupdate09.pdf Buerhaus,P; Auerbach,D; Staiger, D. The Recent Surge in Nurse Employment: Causes and Implications. Health Affairs-Web Exclusive. 12 June 2009. The Adequacy of Pharmacist Supply: 2004 to 2030. Department of Health and Human Services Health Resources and Services Administration, Bureau of Health Professions. December 2008. Accessed at: ftp://ftp. hrsa.gov/bhpr/workforce/pharmacy.pdf Aggregate Demand Index, Supported by Pharmacy Manpower Project Inc. Accessed at: http://www. pharmacymanpower.com/index.html Aging population leads to healthcare salary increases. Healthcare Financial News. July 16, 2009. Accessed at: http://www.healthcarefinancenews.com/news/aging-population-leads-healthcare-salary-increases Winters, Dennis. Are We Done Yet? Office of Economic Advisors, Wisconsin Department of Workforce Development. Accessed on Sept 10, 2009 at: http://dwd.wisconsin.gov/oea/ Page 14

Wisconsin Hospital Association Member Hospitals Agnesian HealthCare/St. Agnes Hospital, Fond du Lac Amery Regional Medical Center, Amery Appleton Medical Center, Appleton Aspirus Wausau Hospital, Wausau Aurora BayCare Medical Center in Green Bay, Green Bay Aurora Lakeland Medical Center in Elkhorn, Elkhorn Aurora Medical Center in Hartford, Hartford Aurora Medical Center in Kenosha, Kenosha Aurora Medical Center in Oshkosh, Oshkosh Aurora Medical Center in Two Rivers, Two Rivers Aurora Medical Center Summit, Oconomowoc Aurora Memorial Hospital of Burlington, Burlington Aurora Psychiatric Hospital, Wauwatosa Aurora Sheboygan Memorial Medical Center, Sheboygan Aurora Sinai Medical Center, Milwaukee Aurora St. Luke s Medical Center, Milwaukee Aurora West Allis Medical Center, West Allis Baldwin Area Medical Center, Baldwin Bay Area Medical Center, Marinette Beaver Dam Community Hospitals, Inc., Beaver Dam Bellin Hospital, Green Bay Bellin Psychiatric Center, Green Bay Beloit Memorial Hospital, Beloit Berlin Memorial Hospital, Berlin Black River Memorial Hospital, Black River Falls Boscobel Area Health Care, Boscobel Burnett Medical Center, Grantsburg Calumet Medical Center, Chilton Children s Hospital of Wisconsin, Milwaukee Children s Hospital of Wisconsin-Fox Valley, Neenah Children s Hospital of Wisconsin-Kenosha, Kenosha Chippewa Valley Hospital, Durand Clement J. Zablocki VA Medical Center, Milwaukee Columbia Center, Mequon Columbia St. Mary s, Inc. - Columbia Campus, Milwaukee Columbia St. Mary s, Inc. - Milwaukee Campus, Milwaukee Columbia St. Mary s, Inc. - Ozaukee Campus, Mequon Columbia St. Mary s - Sacred Heart Rehab. Institute, Milwaukee Columbus Community Hospital, Columbus Community Memorial Hospital, Menomonee Falls Community Memorial Hospital, Oconto Falls Cumberland Memorial Hospital, Inc., Cumberland Divine Savior Healthcare, Portage Edgerton Hospital and Health Services, Edgerton Flambeau Hospital, Park Falls Fort HealthCare, Fort Atkinson Franciscan Skemp Healthcare-Mayo Health System, Sparta Franciscan Skemp Healthcare-Mayo Health System, La Crosse Franciscan Skemp Healthcare-Mayo Health System, Arcadia Froedtert Memorial Lutheran Hospital, Milwaukee Grant Regional Health Center, Lancaster Gundersen Lutheran Health System, La Crosse Hayward Area Memorial Hospital, Hayward Holy Family Memorial, Inc., Manitowoc Hudson Hospital & Clinics, Hudson Indianhead Medical Center/Shell Lake, Shell Lake Kindred Hospital Milwaukee, Greenfield Lakeview Medical Center, Rice Lake Lakeview Specialty Hospital & Rehab, Waterford Langlade Hospital - An Aspirus Partner, Antigo Luther Midelfort Chippewa Valley, Bloomer Luther Midelfort Eau Claire, Eau Claire Luther Midelfort Northland, Barron Luther Midelfort Oakridge, Osseo Memorial Health Center, Medford Memorial Hospital of Lafayette Co., Darlington Memorial Medical Center, Neillsville Memorial Medical Center, Ashland Mercy Health System Corporation, Janesville Mercy Medical Center, Oshkosh Mercy Walworth Hospital and Medical Center, Lake Geneva Meriter Hospital, Madison Mile Bluff Medical Center, Mauston Ministry Health Care - Door County Memorial Hospital, Sturgeon Bay Ministry Health Care - Eagle River Memorial Hospital, Eagle River Ministry Health Care - Good Samaritan Health Center, Merrill Ministry Health Care - Howard Young Medical Center, Woodruff Ministry Health Care - Our Lady of Victory Hospital, Stanley Ministry Health Care - Sacred Heart-St. Mary s Hospitals, Rhinelander Ministry Health Care - Sacred Heart-St. Mary s Hospitals, Tomahawk Ministry Health Care - Saint Clare s Hospital, Weston Ministry Health Care - Saint Joseph s Hospital, Marshfield Ministry Health Care - Saint Michael s Hospital, Stevens Point Monroe Clinic, Monroe Moundview Memorial Hospital & Clinics, Inc., Friendship New London Family Medical Center, New London Oconomowoc Memorial Hospital, Oconomowoc Oconto Hospital & Medical Center, Oconto Orthopaedic Hospital of Wisconsin, Glendale Osceola Medical Center, Osceola Prairie du Chien Memorial Hospital, Prairie du Chien Red Cedar Medical Center - Mayo Health System, Menomonie Reedsburg Area Medical Center, Reedsburg Rehabilitation Hospital of Wisconsin, Waukesha Ripon Medical Center, Inc., Ripon River Falls Area Hospital, River Falls Riverside Medical Center, Waupaca Riverview Hospital Association, Wisconsin Rapids Rogers Memorial Hospital, Inc., Oconomowoc Rusk County Memorial Hospital and Nursing Home, Ladysmith Sacred Heart Hospital, Eau Claire Sauk Prairie Memorial Hospital, Prairie du Sac Select Specialty Hospital-Milwaukee, West Allis Select Specialty Hospital-Milwaukee-St. Luke s, Milwaukee Shawano Medical Center, Shawano Southwest Health Center, Platteville Spooner Health System, Spooner St. Clare Hospital & Health Services, Baraboo St. Croix Regional Medical Center, St. Croix Falls St. Elizabeth Hospital, Appleton St. Joseph s Community Health Services, Hillsboro St. Joseph s Hospital, West Bend St. Joseph s Hospital, Chippewa Falls St. Mary s Hospital, Madison St. Mary s Hospital Medical Center, Green Bay St. Mary s Hospital of Superior, Superior St. Nicholas Hospital, Sheboygan St. Vincent Hospital, Green Bay Stoughton Hospital Association, Stoughton The Richland Hospital, Inc., Richland Center The Wisconsin Heart Hospital, Wauwatosa Theda Clark Medical Center, Neenah Tomah Memorial Hospital, Tomah Tri-County Memorial Hospital, Whitehall Upland Hills Health, Inc., Dodgeville UW Health Partners Watertown Regional Medical Center, Watertown UW Hospitals and Clinics, Madison VA Medical Center, Tomah Vernon Memorial Healthcare, Viroqua Waukesha Memorial Hospital, Waukesha Waupun Memorial Hospital, Waupun Westfields Hospital, New Richmond Wheaton Franciscan Healthcare - All Saints, Racine Wheaton Franciscan Healthcare-Elmbrook Memorial, Inc., Brookfield Wheaton Franciscan Healthcare-Franklin, Franklin Wheaton Franciscan Healthcare-St. Francis, Inc., Milwaukee Wheaton Franciscan Healthcare-St. Joseph, Inc., Milwaukee Wild Rose Community Memorial Hospital, Wild Rose William S. Middleton Memorial Veterans Hospital, Madison

PO Box 259038, Madison, WI 53725-9038 608-274-1820 / Fax: 608-274-8554 / www.wha.org