The following individuals were in attendance: Health Sector Board Workforce Deep Dive Meeting Notes September 20, 2016 12 p.m. to 3 p.m. Michael Patterson Mississippi Valley Health Sandy Cassidy - SAU Tracy Poolvorde Trinity College of Nursing Sarah Wallace Kelli Mallum Unity Point Jennifer Schmidt - Genesis Jean Hayes Jackson Co Regional Health Center Connie Siffring Select Specialty Hospital Kathy Andresen - SAU Amy Maxeiner - BHC Tom Bowman - CHC Betsey Morthland - BHC Ellen Kabat-Lensch - EICC Don Doucette - EICC Joan Kindle - EICC Laurie Adolf - EICC Gerry Wickham - EICC Ron Serpliss - EICC Ruth Sueverkruebbe -EICC Paula Arends - IowaWORKS Current Needs The following current needs were identified. Attendees selected their top five areas of need noted on the right. Group Votes Nurses 6 Medical Lab Technicians 3 Respiratory Therapists 2 Speech Therapists 3 Medical Assistants 4 Licensed Independent Social Wkrs 1 Paramedics 1 Surgical Technicians 2 Biller/Coders 3 Advanced Practice Nurses/PAs 2 Certified Nursing Assistants 2 Expanded Function Dental Assist 1 Ultrasound Technicians 1 CT/MRI Technicians 0 Educator for Health Careers 0 Future and Emerging Needs The following future and emerging needs were identified. Increased integration of IT into all of Health Care Increased focus on outcomes of Patient Service/Satisfaction Increased use of Care Coordinators Focus on Population Health (targeting health needs for specific populations) Increased use of Tele-health
Note: Michael Patterson added that Mike Parejko would have additional emerging needs due to the changing use of blood in the industry. Existing Programs a. St. Ambrose BSN pre-licensure 75 per year BSN (RN to BSN) 83 per year Human Performance Fitness 10 per year Physician Assistant 30 per year planned; starting in December Master of Social Work 30-35 per year MSW/MBA Speech Pathology 30 per year Occupational Therapy 32 per year; currently converting from master s to doctoral degree Physical Therapy 36 per year Orthopedic Clinical Residency 5-6 per year Healthcare Sales new program Pre-Professional (medical/dental) Exercise Science 300 in program; may be pre-med or Physical Therapy b. Black Hawk College EMS/Paramedic 30 per year Associate Degree Nursing 24 per year Certified Nursing Assistant 120 per year Health Information Management 20 per year Medical Assistant 30 per year Physical Therapy Assisting 24 per year Medical Billing and Coding Practical Nursing 48 per year Radiology Technician Surgical Technician New fall 2016; expect 24 per year Patient Care Aide (Enhanced C.N.A.) Veterinary Assistant 32 currently; plan to grow to 48 per year Veterinary Technician 24 per year c. Trinity (300 total students) Phasing out the associates of science in nursing, and growing BSN Nursing ASN/BSN 81 per year Respiratory Care 8-13 per year Associate of Science in Radiology 12-15 per year CT intern for Radiology Ultrasound intern for Radiology Radiology Technician/Respiratory Tech 8-10 per year RN to BSN 8-10 per year Pre-licensure BSN 70 per year Accelerated program for BSN (for individuals with bachelor s degree) 12 Master of Science in Nursing/Grad programs 15
d. EICC Radiology 23 per year Sonography 23 per year Cancer Information Management 92 per year; on-line class Health Information Technology 58 per year Surgical Tech 27 per year Nursing 80-100 per year LPN 20-30 per year Health Informatics Certified Nursing Assistant -997 Dialysis EMT - 21 Phlebotomy CE -38 Dental Assisting 40 Medications Aide CE 75 Medical Coding and Billing CE online - 21 Gerry noted that EICC is working toward competencies across programs to include: interprofessional teamwork, high value care, and cost-conscious decision making. Nurses - Strategies to Expand Existing Programs What are the Challenges for employers? RN/BSN High level of retirements happening and upcoming Constant state of recruiting very competitive There are many more opportunities (other positions) for nurses in the organizations Program requirements Regulations First year is most difficult for nurses: 35% leave their first job within a year and 11% leave the profession that first year Limit to the number of new graduates and requirement to have staff on the floor with them Long-term training program once hired 1 year for OR nurses Competition (wages, hours, location) Millennial Expectations Affordable Care Act has brought more people into the system Growth is expected to continue for the next 10 years pushing nursing salaries up to six figures; concern about what happens when baby boomers are gone (is this a bubble?) Increases in treatment in other types of facilities (not hospitals; i.e.: Select Care facilities and home health care) Need nurses for critical thinking functions and judgment, not necessarily tasks other healthcare providers can learn tasks Regulatory burden on employer Preceptors need more development and coaching; need incentives Currently regulated for a 8:1 ratio Volume of patients in hospitals is down as the incentive is to get patients out RN Educators What are the challenges for educational institutions?
Instructor shortages skills and pay are factors; many do not have teaching skills; difficult to maintain high quality Nursing programs are expensive to run Instructors are no longer on a typical daytime/weekday schedule more programs offer evening and weekend programs. These times are not attractive to work Difficult to find master s degree and Ph.D. level instructors Nurses went into the field to care for people, and they don t want to leave the field to teach The average educator nurse is 12 years older than the average bedside nurse Nurses don t want to do direct care with students; many nurses would teach online At BHC, over 600 indicate a pre-nursing major, but only 48 enter the program each year; many are not well prepared academically At Ambrose, nursing instructors need to complete their PhD. They spend a lot of time meeting tenure requirements and find it difficult to complete education There is a lack of ample clinical sites (reasons cited include regulatory burden, workflow must shift to accommodate learners, preceptors must have critical skills and provide effective coaching) Sometimes students see the struggles of training nurses, and it discourages them from nursing there is a need to make sure that interactions are positive. Trinity noted the desire to create a more diverse workforce. They have worked to adjust recruiting habits to accommodate, but find a need for additional resources to make it work Needs for accommodations and funding for living expenses for students were identified A high percentage of nurses leave the industry in the first year Millennial/generational issues students don t want to put in the time; do the work or have discipline issues Solutions for instructor issues Leased faculty from a health care provider Joint appointments/joint hires (training provider/healthcare provider) Build Scholarships have them available over time to grow person (AND -> BSN -> MS -> PhD) More loan forgiveness Purposeful mentoring There is a need to create a more diverse workforce and diverse student population Solutions for Clinical Sites Look at other types of facilities, not just hospitals More wrap around services for students to enable them to participate: problems are 50% academic and 50% socioeconomic Would like nursing students to serve a longer length of time like other health professionals (not just half days) More work with preceptors to train them on evaluations Chicago has one standard contract for all training institutions, which would streamline paperwork; the group noted that there would be challenges with two states in doing this may have to do two agreements Take some clerical burden off of the preceptor Provide incentive and training for nurses who are preceptors (some already do this) Consider the benefits of virtual learning
Medical Assistants - Strategies to Expand Existing Programs What are the Challenges? Not getting the right people in the field work discipline issues, generational/millennial Issues Regulations depend on the state Need to create a career pathway similar to EMT -> Nursing College readiness is a problem with entering students Need to reach into high schools create high school CNA programs In high school can it tie to service learning? Need to be willing to become certified within six months Low starting pay $13.50/hr ($12-$14) Need more and better trained; many are not prepared to do basic clinical tasks Need to know EMRs 3 Governing bodies: AMA, NCCT and NCMA Currently do clinicals in physician s offices Many end up working in other areas to get more money Some differing views of the definition of MA; group needs to define tasks and skill sets Do a DACUM this fall Medical Lab Technicians - Strategies to Expand Existing Programs What are the Challenges? Need to bring in Lab Corp to learn more about needs Northern Illinois University has a technologist program Genesis hires both technicians (A.S.) and technologists (B.A.); currently employs #85 Certifications are MLT (2 year) and MT (4 year) Companies are relocating people from other areas due to no local training programs Metro Lab is growing their own NEED to do a DACUM this fall Areas covered include processing, instrumentation, phlebotomy, calibration, pathology, sterile technique Governing bodies: ASCP, NCA, AMT and HEW Billers and Coders Coders can easily work from home Want certified coders Billers are grown with experience in-house