Collaborative Rural Health Workforce

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Collaborative Rural Health Workforce Recruitment
Retention Opportunities Tim Size Executive
Director Rural Wisconsin Health Cooperative for
the National Rural Health Association May 6th,
2009
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Quick Overview of RWHC for Context

• Founded 1979
• Non-profit coop owned by 35 rural hospitals (net
  rev 3/4B 2K hospital LTC beds)
• 7M RWHC budget (70 member fees, 20 fees
  from others, 5 dues, 5 grants)
• 6 PPS 29 CAH 24 freestanding 11 system owned
  or affiliated

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RWHC Vision Mission
Vision (Future we want) Rural Wisconsin
communities are healthiest in America. Mission
(How we do it) We assist Members to offer
quality, cost effective care. assist Members in
partnerships for healthy communities. are an
innovative cooperative of diversified rural
hospitals. are the rural advocate of choice
for its Members. develop and manage a variety
of products and services. generates additional
revenue by services to non-Members. actively
uses strategic alliances in pursuit of its Vision.
RWHC Strategic Plan Updated 5/4/07
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Network Staff Structure Helps Support RR
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Most RWHC Services Relevant to RR

• Advocacy (Market, Government)
• CAHPS Hospital Survey (AHRQ)
• Clinical Audiology, Speech, PT
• Coding Consulting Service
• Compliance (Medicare)
• Credentials Verification (NCQA)
• Financial Consulting Service
• Grantsmanship

• HMO PPO Contracting
• IT Services, Wide Area Network
• Legal Services
• Peer Review Service
• Professional Staff Roundtables
• Quality Indicators (JCAHO)
• Recruitment (Nursing/Allied)
• Reimbursement Credentialing

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Key to Progress Made Strategic Partnering

• La Crosse Medical Health Science Consortium
• Medical College of Wisconsin
• Rural Health Development Council (WI Dept
  Commerce)
• UW School Med Public Hlth
• UW School of Pharmacy
• WI AHEC
• WI Center for Nursing
• WI Dept. Health

• WI Dept. Workforce Dev.
• WI Hospital Association
• WI Health Educational Facilities Authority
• WI Medical Society
• WI Nurses Association
• WI Office Rural Health
• WI Primary Care Association
• WI Vocational Colleges

Above is a PARTIAL list Principle Strategic
Partners
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Academes Attitude Expectations Matter
Schools need to recruit, admit, educate and
mentor to help increase the odds for rural
recruitment and retention.
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RWHC RR Focused Activities

• Advisory Board memberships
• Education Coordinator
• Club Scrub
• H2H (Hospital to Hospital
• CEO Visits)
• Distance Learning Options
• Leadership Development
• Nurse Residency Program
• Nurse Preceptorships
• Pharmacy Task Force
• Retirement/Departure Surveys
• Roundtables

• Rural Ambassador Awards
• Rural Essay Prize - 2,000
• Rural Health Careers Website
• WI Academy Rural Medicine
• (WARM)
• WI Office Rural Health
• Physician Recruitment
• WI Healthcare Workforce Data
• Collaborative
• Workforce Development
• Coordinator

Program started or operated by or with a
strategic partner.
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Workforce Development Coordinator

• Responsible for disseminating info about
  positions via
• listings on Rural Health Careers in Wisconsin
  other websites
• contacting career associations
• direct mailings
• networking with technical college and university
  programs, program directors and career services
• displays at career fairs/professional meetings
• presentations at state and national conferences
• Available to provide supplemental assistance for
  facilities in need of temporary or internal
  recruitment assistance.

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Shared Interactive Job Site rhcw.org
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rhcw.org Powerful Tool for HR Managers

• rhcw.org allows members to post clinical and
  non-clinical positions on the Internet manage
  job postings conduct resume searches. There are
  no fees for this service.
• Qualified prospects are able to view every posted
  position that matches their qualifications and
  preferences.
• HR managers run their own reports to track
  positions,
• Jobs are cross-posted to other web sites
  appropriate to that position.
• RWHC doesnt steer candidates toward one facility
  or another

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Professional Roundtables Aid Retention

• RWHC facilitates retention by directly addressing
  the isolation typically associated with rural
  health with over three dozen professional
  roundtables, representing a wide range of
  clinical and non-clinical disciplines.
• Most of the 35 roundtables meet 4-6 times per
  year, typically for 2-4 hours per meeting.
• Several of the professional roundtables also
  devote meeting time to the development and review
  of competencies for their positions, which serves
  both a functional purpose for their respective
  facilities and satisfies JCAHO requirements.
  Participants discuss topical issues, exchange
  ideas and implement special projects.
• Many RWHC products and services get their start
  via roundtables.?

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Wisconsin Nurse Residency Program

• An innovative, structured learning experience for
  new registered nurses designed to promote
  effective transition into professional practice.
• PROFESSIONAL DEVELOPMENT PLANIn order to address
  the unique needs of new practitioners, WNRP helps
  the new nurse create an individualized plan to
  build skills and develop competency.
• FACILITATED LEARNING SESSIONSEvery month, a
  six-hour learning session is provided that
  engages participants in an enriching learning
  process to encourage critical reflection on
  nursing practice.
• CLINICAL COACHESWhen nurses enter the program,
  they are partnered with an experienced nurse
  designated as a clinical coach.
• WEB-BASED LEARNING AND DISCUSSIONSProviding
  enrichment for these monthly sessions is a
  web-based learning management system Desire2Learn.

Begun with a federally funded collaboration
between Marquette University now funded by RWHC.
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Wisconsin Nurse Residency Program ROI?

• Estimate of Return On Investment for 4 new nurses
  assuming
• Prior 50 turnover rate in first three years of
  employment.
• Retention rate improved to 75 for nurses in
  program.
• Annual salary at 44,000 starting wage with 30
  fringe benefits.
• Cost of recruiting a new nurse is 100 of annual
  nurse salary.
• Nurse Replacement Costs Saved 57,200 (25 x 4
  RN 1 RN)
• Wages/benefits to attend 12 days of off-site
  training 10,560
• Program participation fees 4,000
• Travel expense (assumes 120 miles per trip)
  700
• Total Additional Costs 15,260
• ? ? ? ROI 57,200/15,280 375 ? ? ?

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H2H (Hospital to Hospital Sharing)

• Implementation of futurist Leland Keysers
  suggestion at 2005 WI Annual Rural Health
  Conference--that CEOs should routinely seek out
  and visit other hospitals in order to gain
  additional insights to enhance their
  organizations performance.
• RWHC Member CEOs continuously learn from each
  other through a process of structured site visits
  at nominated sites.
• CEOs nominate their own hospital or another in
  response to a RWHC staff initiated request and
  specific annual objectives.
• Selected hospitals who agree, host a four hour
  visit.
• This program is based on the belief that strong
  hospitals stay strong and get stronger through
  continuous quality improvement.

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Club Scrub

• Club Scrub is a hospital-based, interactive,
  after-school, hands-on program that teams up
  rural hospitals with local school districts to
  expose middle school-age students to many
  different local healthcare careers.

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A Sustainable Grow Your Own Program

• Participants work and learn side-by-side with
  hospital employees in multiple areas such as
  nursing, emergency services, dietary, rehab., RT,
  radiology, lab.
• Participants learn career ladders, skills, work
  environments, educational requirements, education
  institutions, and more.
• There in no cost to the students who participate
  in this program and each meeting includes a
  healthy snack, a hands-on activity, a career
  presentation, and a healthcare career-related
  prize.
• Hands-on activities include suturing, emergency
  triage, pulse oximetry, microscope use, blood
  typing, casting, range of motion, vital signs.
• Start-up funding to RWHC though a Wisconsin
  Office of Rural Health a Federal Rural Hospital
  Flexibility.

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Mediasite (Sonic Foundry) Webinars
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Value of Network Based Distant Learning

• Address the specific educational need of Members
• Address issues unique to rural health care
• Can access at any time and from any computer
• No travel costs incurred by the rural facilities
• Decrease in loss of staff time due to travel
• Convenience of working educational programs into
  staff schedules
• Assist hospitals in meeting training needs or
  requirements
• Continuing Education Credits available to Member
  staff
• Climb career ladder within rural hospital
  (Radiology program, ADN to RN programs)

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Physician Recruitmet WORH

• Recruit 15 to 20 per year with half being to
  rural communities
• 140 rural openings at any one time
• 80-90 are for family practitioners

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Wisconsin Academy Rural MedicineWARM

• WARM is dedicated to improving the supply of
  physicians in rural Wisconsin and the health of
  rural Wisconsin communities the size of the
  medical school class will increase by 25
  students.
• Students participate in an educational curriculum
  designed to prepare them for rural practice by
  providing extensive clinical training in rural
  Wisconsin during years three and four.
• Students learn to address medical issues that are
  unique to rural areas, and give the students the
  opportunity to appreciate a rural lifestyle.
• WARM has the unique distinction as being the only
  rural focused program in the nation that supports
  a students pursuit of any specialty.

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WI Health Workforce Data Collaborative

• NEED current and impending shortages and
  maldistributions of certain health occupations in
  Wisconsin and the paucity of data regarding the
  future supply of, and demand for these health
  care occupations.
• WHWDC PURPOSE The WHWDC collaborative is
  organized around the Vision that access to
  healthcare and prevention services not be limited
  by gaps in workforce supply and demand and that
  Wisconsins workforce planning be data driven. It
  is to provide critically needed evidence about
  the data for others to argue policy.

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WHWDC Participants (Partial List)

• UW System
• UW School of Pharmacy
• WI Center of Nursing
• WI Department of Workforce Development
• WI Association of Homes and Services for the
  Aging
• WI Nurses Association
• WI Department of Health Family Services

• WI Office of Rural Health
• WI Technical College System
• WI Medical Society
• Rural Wisconsin Health Cooperative
• WI AHEC System
• WI Department of Workforce Development
• WI Hospital Association

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WHWDC Goals Infrastructure

• Develop an infrastructure for the timely,
  accessible, sustainable and ongoing collection
  and analysis of data including a health care
  workforce projection model based on trends.
• Assist in the designation of HPSAs and MUPs in so
  as to maximize eligibility for federal resources.
  
• Implement a data collection and management
  system.
• Provide information to multiple stakeholders
  educational institutions, health care agencies,
  policy makers, industries, and prospective
  students about future needs for health
  professions.

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State Licensure Protects Patient or Guilds?

• Do any of your state licensure processes (partial
  list)
• require a practical examination, above and
  beyond other required tests in most other states?
• refuse to accept the results of professional
  examening board, even when accepted by many to
  most other states?
• prohibit license of foreign graduates, regardless
  if they have held a license and practiced in any
  other states?
• enforce outdated practice restrictions of related
  (potentially competing) allied health
  professionals?

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Newsletter Focuses on Rural Collaboration
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