New England Rural Health RoundtableNew England Rural Health Roundtable

Regional Healthcare Workforce

Collaboration MeetingJuly 22nd

Portsmouth, NH

Presenters:Marion Pawlek, RHRT Executive

DirectorCraig Stevens, Project Staff

Goals for this SessionGoals for this Session

• Review Vision and Mission for project

• Orient to process for identifying priority topic areas

• Review thematic topic areas• Develop and prioritize goal

statements• Set direction for afternoon

strategic planning

Regional Workforce Collaboration

Regional Workforce Collaboration

State Office of Rural Health

National Organization of State Offices of Rural Health

VisionVision

Rural New England has an adequate supply and distribution of healthcare workforce.

Project MissionProject Mission

Identify strategies which improve the healthcare workforce development, recruitment and retention capacity of New England stakeholders through regional projects, partnerships and collaborations.

Priority Setting ProcessPriority Setting Process

ResearchResearch

InterviewsInterviews

SurveySurveyAdvisoryGroup

AdvisoryGroup

DraftPriority

Activities

DraftPriority

Activities

Advisory Group Membership

Advisory Group Membership

Denis BartonBarbara Berger Susan CarllLiz CoteCharles DwyerCarla Lundquist Tammy MackenzieCathleen Mcelligott

Other ParticipantsOther Participants

• Academic Institutions• Area Health Education

Center Program• Community Health

Centers• Dental Society• Department of Labor• Emergency Medical

Services• Home Health• Hospital Association• Local Public Health

Offices• Medical Society

• Nurse Practitioner Association

• Nursing Homes• Physician Assistant

Association• Primary Care

Associations• Primary Care Offices• Rural Health Offices• State Oral Health,

Mental Health• Workforce Development

Organization

• Approximately 60 individuals provided input either through a survey or interview. These individuals

represented:

• Approximately 60 individuals provided input either through a survey or interview. These individuals

represented:

Priority Setting ProcessPriority Setting Process

ResearchResearch

ResearchResearch

• Review of existing healthcare workforce planning materials from New England states as well as comparable states (OR, MI, etc)

• Define the potential parameters of priority activities

Priority Setting ProcessPriority Setting Process

ResearchResearch SurveySurvey

SurveysSurveys

• From research, develop and disseminate surveys to capture information on state activities as well as perceived priorities.

• Develop state healthcare workforce development, recruitment and retention profiles.

Priority Setting ProcessPriority Setting Process

ResearchResearch

InterviewsInterviews

SurveySurvey

InterviewsInterviews

• Discuss survey results with regional stakeholders.

• Discuss opportunities for state healthcare workforce activities.

• Identify priorities for regional collaboration.

Priority Setting ProcessPriority Setting Process

ResearchResearch

InterviewsInterviews

SurveySurveyAdvisoryGroup

AdvisoryGroup

Advisory GroupAdvisory Group

• Approved data collection instruments.

• Identified key state stakeholders for survey and interviews.

• Review preliminary findings.• Shape strategic planning for

July 22nd meeting.• Recruit meeting

participants.

Priority Setting ProcessPriority Setting Process

ResearchResearch

InterviewsInterviews

SurveySurveyAdvisoryGroup

AdvisoryGroup

DraftPriority

Activities

DraftPriority

Activities

Nursing, 17%

Physicians, 19%

Oral Health, 17%

Allied Health, 3%

EMS, 2%

Pharmacist, 6%

Mental Health, 11%

Laboratory, 2%

Respiratory, 2%

Imaging, 11%

Physical Therapists, 3%

Direct Care Workers, 3%

PA/NP, 5%

Speech Pathologists, 1%

Physicians, 24%

Primary Care, 48%

Specialists, 29%

Oral Health, 5%

Dentists, 68%

Hygienist, 26%

Hospital, 21%

Nursing Home, 21%

Home Health, 18%

Pharmacy, 2%

EMS, 4%

Outpatient, 16%

Dental, 4%

Mental Health, 5%

Community Health Center, 4%

Corrections, 2%

Public Health, 2% Personally Directed , 2%

Findings: State Similarities and Differences

Findings: State Similarities and Differences

• Pipeline k-12– Many similar activites –

enrichment, camps, awareness, shadowing

– AHECs major partner in healthcare workforce development in k-12

– Varying levels of capacity across states

Findings: State Similarities and Differences

Findings: State Similarities and Differences

• Pipeline: Higher Ed and Training– Capacity – faculty, schools

• New England Dental Schools• Nursing faculty

– Distance education for nursing students– Electronic registries to manage inter and

intrastate clinical placements– Specialized rural health scholars programs– Assisting front line, low wage staff with GED,

literacy and moving up the career ladder– New England Clinicians Forum to identify

excellence among existing clinical providers in region working within public health setting

– Health careers investigation course

Findings: State Similarities and Differences

Findings: State Similarities and Differences

• Recruitment– Recruitment centers– Scholarships and loan

forgiveness– Tapping foreign trained

professionals living in US – combining with literacy programs

– Tapping older workers/second career workers

– Marketing to minority or underrepresented populations

Findings: State Similarities and Differences

Findings: State Similarities and Differences

• Retention– Magnet hospitals– Management training– Culture change– Loan repayment– Retraining older workers

Findings: State Similarities and Differences

Findings: State Similarities and Differences

• Other– Appropriations language for loan

repayment/forgiveness– Unfunded legislation (MA)– Forming new professional associations– Tax incentives/tax credits– Regional Nursing Compact– Varying levels of industry vs govt driven

resources and programs– Linking healthcare workforce

development and economic development– Varying levels of data and reports– Model legislation for telehealth payment– Change in scope of practice PA and NP,

independent practice of Dental Hygienists

Thematic ActivitiesThematic Activities

• Review survey results• Review interview

responses• Identify thematic areas• Clarify, adjust with

Advisory Cmte• Integrate into strategic

planning process

PipelinePipeline• Improve guidance counselors understanding

of highschool classes and the necessary preparation for health careers

• Develop post high school, preparatory classes

• Develop post career ladders (entry level CNA)

• Develop regional dental school or develop/improve reciprocal agreements

• Expand rural residency programs, across state placements

• Increase faculty capacity• Promote collaboration among hospitals and

universities to develop joint appointment of staff/faculty

• Regional marketing for students to enter health careers

Recruitment and Retention

Recruitment and Retention

• Improve cross state licensing and credentialing• Promote culture change to improve workplace

environment• Improve reimbursement• Develop shared training opportunities• Engage in group purchasing with headhunter

firms• Develop regional marketing for health

professionals to come to New England• Explore job redesign to keep older staff

(nursing)• Engage hospitals to support recruitment for

rural practices• Promote successful models such as recruitable

communities• Maintaining Federal designations for J-1,NHSC

etc

CoordinationCoordination• Assist with state coordination of

workforce activities• Assist with regional coordination of

workforce activities– governors, New England Board of Higher Education, regional medical society meetings, AHECs, PCOs etc

• Develop regional website, locus of information regarding New England development, recruitment and retention activities including best practices.

• US Dept of Labor WIRED initiatives want to fund multistate activities, develop cross state proposals

DataData

• Development of regional reports (comparison of workforce data, resources across regions)

• Development of communication tools regarding healthcare workforce, promoting models like Rural Health Works to help states communicate issue and related data

• Understand demand and production

Scope of PracticeScope of Practice

• Hold forums regarding the design of health care professions and service delivery to recommend changes in scopes of practice

• Models for use of PAs and NPs

Strategic Planning Phase I: Identifying Priority Goals

Strategic Planning Phase I: Identifying Priority Goals

•Self select groups•Within each group:

– Environmental scan/SWOT analysis– Develop goal statement(s)

•A facilitator is assigned to each group who will also be responsible for scribing•Report out to full group – defend your topic area•Full group votes to identify priority areas for the afternoon

Strategic Planning Phase II: Developing Strategic Action

Plans

Strategic Planning Phase II: Developing Strategic Action

Plans• During lunch report what groups

remain• Convene with facilitator, each

will receive guidance in terms of how to develop action plans – 90 minutes to develop

• After session, report to larger group

• Discussion• Prioritize goals• Review next steps