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1 | MCHC Workforce Development Mary Anne Kelly, VP February 18, 2010

2 2 Welcome & Overview MCHC Mission –MCHC is a membership and service organization dedicated to helping members care for their communities through access to health care and improved delivery of services. MCHC Vision –High quality, accessible healthcare for all communities Overview of Workforce –Governors Subcabinet on Economic Development –Chicago Workforce Investment Council (CWIC) –Common goal: To ensure a thriving healthcare workforce for the communities of Metropolitan Chicago

3 3 Partners in the Regional Healthcare Workforce Initiative State of Illinois and 15 State Agency Directors Regional Partners Employers, educators, community groups, state and city partners Workforce Development-- Pilot-testing regional sector approach starting with healthcare/nursing in Northeast (MCHC) and Southern (Connect SI) Regions 3

4 4 Our Approach Recognize and embrace our diversity and our similarities Working with the Southern (rural) and Northeast (urban) regions, identify barriers, root causes and strategies Identify and implement solutions that meet the specific challenges of the regions Where appropriate, replicate those solutions in other regions/across the state

5 5 Executive Summary Regional Work Plan –Step 1: Estimate Regional Nursing Shortages –Step 2: Analyze Baseline Performance at Each Stage of Pipeline –Step 3: Identify Root Causes and Potential Solutions (Regional Framework) –Step 4: Develop Final Regional Plan--Goals, Strategies and Action Plan

6 6 Executive Summary Measuring Performance and Identifying Root Causes and Solutions: Developing Diverse Qualified Applicant Pool Program Capacity, Progress, and Completion Transition of Program Completers to Healthcare Employment Retention of Experienced Nurses

7 7 Executive Summary 1.Diversity Mapping Project Healthcare Academy Student Support Services (IEF & MOWD Pilot Projects) 2.Education Expansion iCRSP Standard Affiliation Agreement Clinical Faculty Academy Business Case Team Illinois

8 8 Executive Summary 3.Transition On-boarding Programs 4.Retention Leadership Training Work Design

9 9 Labor Market Supply/Demand Analysis Northeast Region Southern Region Current RN Employment71,6643,442 Annual Projected Growth 1,86560 Annual Projected Replacement 3,125125 Annual Estimated Regional Demand 5,000185 Annual Adjusted Supply Data, adjusted for leakage 1,500115 Adjusted for in-migration500-700 Estimated Shortage of RNs per year, through 2014 2,800-300070

10 10 Developing Diverse Qualified Applicant Pool Create P-20 Programs of study Connect secondary, post secondary, career and technical Potential Applicants are unaware of career opportunities IDES/ICCB State Career Clusters Project Shifting Gears – Joyce Foundation School at Work K-12 and adults are inadequately prepared in math and science Bilingual Nurses Consortium Carreras en Salud Opportunity Chicago Social and cultural barriers; lack of role models

11 11 Instituto Health Sciences Career Academy

12 12 Instituto Health Sciences Career Academy (IHSCA) IHSCA will create the next generation of doctors, nurses, scientists, and healthcare leaders to care for the baby-boom generation as they retire. Opening in 2010, IHSCA will instruct grades 9-12 to a maximum of 600 students, preparing students for success in college, and readiness for high-wage, entry-level positions in the healthcare sector. Curriculum: IHSCA challenges students with acquiring 32 credits, 33% beyond those required for graduation in Chicago and the health sciences curriculum prepares students for industry- recognized credentials in the fields of nursing, health administration and health technology.

13 13 Expanding Education Capacity 13 Clinical Faculty Academy Expand number of MSNs Faculty costs Lack of Prepared Faculty Expand clinical placements through the implementation of iCRSP – online scheduling tool Lack of other resources Provide tutoring, mentoring and financial services to students Build on existing models Students need additional support/resources to improve completion

14 14 Purpose: To provide tools for Deans of Nursing and Chief Nursing Officers to make the case for educational expansion of nursing programs One size doesnt fit all. Tailor the business case to the needs/resources of each individual school of nursing and/or clinical partner. Toolkit fosters collaboration and partnership between education and service. Target audiences could include university, college and hospital CEOs, foundations, sponsors and public officials. Illinois Board of Higher Education Education Expansion: Building the Business Case

15 15 Business Case Background Why develop a business case? –State of Illinois Framework for developing the Nursing Workforce –RWJF/AARP National initiative on building nursing education capacity Collaborators included the Illinois Board of Higher Education, MCHC and representatives from public universities; private universities/colleges and community colleges

16 16 As of March 19, 2009 Q. 11 How many additional students could your nursing program admit for the 2009-2010 school year if you had the resources available (more faculty, space, etc.)?

17 17 As of March 19, 2009 160 Rotations 50 Rooms Labs $10 M I L I O N Q. 12 What resources would you need to expand to that number of seats for the 2009-2010 school year?

18 18 An Innovative Approach to Developing Preceptors for Undergraduate Students

19 19 Designed and implemented in 2005 by the Kansas City Metropolitan Healthcare Council to develop qualified staff nurses for the role of clinical nurse educators in order to increase faculty workforce and expand enrollments in schools of nursing. Using a DOL WIRED grant, faculty content experts developed standardized curriculum materials: Presenters Guide Participant Reference Manual All program materials are based on adult learning theory, had been in use for 3+ years when Illinois began pilot and were critically reviewed during that period. Background

20 20 The CFA supports nine educational modules, consistent with National League for Nursing clinical competencies: The context for curricular design and clinical instruction Legal issues in clinical education Student learning in the clinical setting Clinical evaluation: concepts and processes Clinical evaluation tools Multiple roles – from staff to teacher (panel discussion) Conducting pre-clinical and post-clinical conferences Dealing with difficult students Creating a positive learning environment Educational Modules

21 21 Participants were committed faculty members with contracts to teach in the upcoming school year –Deans and Directors of Nursing were required to submit an application on behalf of the participant It was recommended that participants had less than 2 years of teaching experience. Participants were required to attend both days of the academy to receive CEUs (11.75 CEUs per person) 51 Participants completed the CFA in the pilot phase Pilot Participant Requirements

22 22 Thoughts on Being an Educator Following the Academy Q 13: Please describe your experience as a nurse educator following the Academy:

23 23 I love it. Attending the Academy helped boost my confidence as a teacher! Thoughts on Being an Educator Following the Academy (continued): I had to use a lot of the techniques of dealing with difficult students. The students wanted to jump to critical situations without having a grasp of fundamental/ basic skills nursing. The second group of students, however, have been totally different. They are more concerned with learning than about criticizing the nurses on the floor and hence have a better foundation on which to learn. I entered a school of nursing that has an amazing dean and supportive, helpful faculty. My transition to faculty has been quite easy, mainly because teaching has always come naturally to me. It helped me to prepare as a novice instructor, but I feel that I was so overwhelmed at the initiation of teaching a group of students that I still am not so sure I am doing a good enough job. It is exciting, challenging and at times frustrating. But I wouldn't give it up unless I really had to. Q 13: Please describe your experience as a nurse educator following the Academy:

24 24 Clinical Faculty Academies 24

25 25

26 26 About iCRSP: MCHC has partnered with the Oregon Center for Nursing to purchase a license for StudentMAX® for use throughout the state of Illinois. iCRSP is a centralized clinical placement system that will provide unique benefits to nursing education programs. Educators are able to search for active, open placements by category type, healthcare facility, dates and times, as well as student ability level. iCRSP utilizes a database which houses clinical availability at participating healthcare facilities. Hospitals maintain existing relationships and long- standing placements by having final approval of requested placements. Clinical Rotation Scheduling Program of Illinois Expanding iCRSP

27 27 The Benefits of Using iCRSP Expanding iCRSP iCRSP increases the efficiency of the placement process by: –Decreasing the time it takes to process a request. –Increasing the number of sites available by creating new opportunities for clinicals. –One hospital using the clinical placement system was able to save the time equivalent of one FTE –freeing the staff to use their time for other activities. Increases the number of sites available by creating new opportunities for clinicals. –By using StudentMAX®, the Oregon Center for Nursing was able to increase the number of placements by 25%. New opportunities benefit the students educational needs and graduation requirements.

28 28 Student Retention Initiatives NE Illinois Regional Nursing Workforce Initiative 28 Student support pilot program at Prairie State College Illinois Education Foundation Chicago City Colleges and the Department of Planning partnership to provide student support services City of Chicago

29 29 Improving Retention of Experienced Workers NE Illinois Regional Nursing Workforce Initiative 29 Create a regional standard for management/supervisory training and excellence Develop retention and turnover metrics Create Leadership Academy- Pilot in Autumn, 2009 Measure results Front-line supervisors lack effective leadership skills Promote work design/retention strategies Determine metrics, collect baseline data Identify current programs in use Develop a toolkit/resource guide of regional best practices and promote expansion Evaluate results Better work environment

30 | Healthcare Leadership Academy Pilot Program

31 31 NEED The American Hospital Associations Commission on Workforce has released national recommendations to hospitals for developing the health care workforce. These recommendations emphasize five areas of focus for hospitals, which included: F OSTERING MEANINGFUL WORK I MPROVING WORKPLACE PARTNERSHIPS Management development is key to enhancing the workplace partnership.

32 32 Adventist Bolingbrook Hospital Advocate South Suburban Gottlieb Memorial Hospital La Rabida Children's Hospital Little Company of Mary Hospital and Healthcare Centers Mercy Chicago North Shore-Skokie Norwegian American Hospital Provident Hospital of Cook County Rehabilitation Institute of Chicago Resurrection Health Care - Holy Family Medical Center Riverside Medical Center Roseland Community Hospital Rush Oak Park Hospital Shriners Hospital for Children – Chicago Swedish Covenant Hospital St Mary's & Elizabeth Medical Center Rush-Copley Medical Center Organizations PARTICIPATION

33 33 Pre and Post Survey Findings

34 34 PRE SURVEY FINDINGS Years as clinical manager/supervisor Supervision or Leadership Training 1.Charge Nurse training in the hospital. 2.RHIA 3.EdD - Leadership & Educational Policy Studies 4.Orientation for supervision 5.Clinical experience at work

35 35 PRE SURVEY FINDINGS Other 1.Assisting the direct Mangers of two separate units 2.Define Direct Reports 3.72 4.40 5.46

36 36

37 37 I used the new techniques I learned at the Leadership Academy to have two staff people solve a problem themselves without me interfering in the solution. I had the opportunity to teach another manager one of the skills I had learned. The manager wanted her to quit. I suggested that she speak to the behavior, to the things the staff person said and to what she heard that lead her to believe that this staff person was unhappy. The manager stopped me the next day and said that the approach worked wonders. She was able to have a meaningful dialogue with the staff person. DEALING WITH CONFLICT

38 38 While I was dealing with an employee that rolls her eyes and says things without thinking, I used the language of I observed" instead of making assumptions of what the eye rolling was about. She admitted that she rolls her eyes too much and has made an effort to be more careful with her body language. MENTORING DIRECT REPORTS Since the Academy, I am more aware of the DISC styles of communication, and trying to communicate with everyone in their best method of understanding. I have a staff member with a dominant personality, a physician complained she was disrespectful and unprofessional. I used the tools I learned to inform her of this incident. She apologized and stated she would mind how she communicates with others from now on.

39 39 I was working with a small team to develop a plan for change. Knowing it would be an uphill climb to get additional FTEs approved during this economic climate, we started with the end in mind and built out a complete and transparent plan to gain the administrative approval we needed. By accounting for all sides of the proverbial coin, we nullified any and all administrative concerns with this proposal. In the Pilot, we learned to use this tool when introducing ideas to subordinates, we were able to accomplish a huge feat by applying this same tool to our superiors. We are currently in final development with staff input, and plan to roll it all out in March. On a side note, my CFO was so very impressed that he has nominated me to be on the Capital Review Board for the hospital being next fiscal year. He's hoping that I will be able to bring this kind of "full circle thinking" to the board when considering large capital purchases. Thank you Leadership Pilot! ADMINISTRATIVE DUTIES Some changes I have made to my practice: - Use e-mails for very basic information only, discuss any issues face to face - Set - up a weekly meeting with a low - performing staff member, which has helped me build my relationship with her and improve her performance on the team. - Organize my meetings better with agenda's, minutes, formal invitations, etc. This has been very helpful. - Before the academy I delegated a task to an employee without much background. After the classes, I followed up with him and apologized for not further explaining the importance of that task being completed, and the impact it had on the department

40 40 It was a great experience. It has really helped me to look at each employee as an individual with specific strengths and weaknesses. It helped me to work with their personalities, rather than have a "one size fits all" approach. This by far the most helpful, the most informative academy I have been to. I am in the process of sharing everything I learned to the other coordinators. As a newcomer in this position this academy gave me a huge amount of confidence to be able to face the situations that I find most challenging. There is so much to say. I could start with Thank you. Thank you to all those involved in developing this course and seeing it through to fruition. Thank you for investing so much time and energy into to us. Leadership is a very underdeveloped skill in most areas of academia. The required schooling, K-12, only hints at it if you are on sports teams. That's a shame. Leadership is what takes an average performer and guides them to becoming one of the best. The skills to become a leader can be learned, and with the tools provided during the Leadership Academy, any number of workers can make the jump from manager to leader. Any additional comments …

41 | Contact Information Mary Anne Kelly, VP P: 312-906-6107 E:

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