Washington State’s Health Workforce Sentinel Network March 24, 2016 Future of Healthcare in Washington Bellevue College, Washington Lisa Hager Center for Health Workforce Studies University of Washington Seattle, WA

Washington State’s Health Workforce Sentinel Network Funding Washington State Healthier Washington Initiative (CMMI SIM grant), subcontract to: Washington State Workforce Training and Education Coordinating Board, working with: University of Washington Center for Health Workforce Studies The project described was supported by Funding Opportunity Number CMS-1G from the U.S. Department of Health and Human Services, Centers for Medicare & Medicaid Services. The contents provided are solely the responsibility of the authors and do not necessarily represent the official views of HHS or any of its agencies.

The healthcare landscape is changing… ACA ACOs: Accountable Care Organizations PCMH EHR HIT Exchange Meaningful Use Patient-Centered Interprofessional Telehealth Bundled Payment Value vs. volume Teams “Quality not quantity”

Washington State’s Health Workforce Sentinel Network Purpose Support efficient and effective health workforce preparation and deployment by: - identifying emerging demand trends - rapidly disseminating information to education, training and policy partners

Washington State’s Health Workforce Sentinel Network Objectives Create the network: - healthcare industry, - workforce education & training, and - policy stakeholders Gather frequent data from industry “sentinels” about changes in demand Rapidly disseminate information Use data to inform policy and practice

Washington’s Health Workforce Council Charged with convening a diverse group of stakeholders to: examine the supply and distribution of healthcare professionals in Washington, recommend strategies to the Governor and Legislature to address shortages Comprised of leaders from education and training, healthcare employers, migrant/community health centers, and labor and professional groups Staffed by the Washington State Workforce Training and Education Coordination Board Leads the Sentinel Network’s recruitment and dissemination activities, and contributes to program design

WA State Health Workforce Sentinel Network HWSN Data Hub Data collection Analysis Dissemination on HWSN Dashboard: Recent results from industry Trends Relevant health workforce data from other sources

WA State Health Workforce Sentinel Network HWSN Data Hub Data collection Analysis Dissemination on HWSN Dashboard: Recent results from industry Trends Relevant health workforce data from other sources Industry Sentinels Employer/workforce input: - Early signs of workforce changes - New demand signals Data submission via web portal every 4 months

WA State Health Workforce Sentinel Network HWSN Data Hub Data collection Analysis Dissemination on HWSN Dashboard: Recent results from industry Trends Relevant health workforce data from other sources Industry Sentinels Employer/workforce input: - Early signs of workforce changes - New demand signals Data submission via web portal every 4 months Education/ Training & Policy Stakeholders Respond to actionable information emerging from HWSN Data Hub Share information

WA State Health Workforce Sentinel Network HWSN Data Hub Data collection Analysis Dissemination on HWSN Dashboard: Recent results from industry Trends Relevant health workforce data from other sources Industry Sentinels Employer/workforce input: - Early signs of workforce changes - New demand signals Finalizing now: Identifying relevant information needed to meet planning needs Developing questions for data collection Identifying and recruiting industry sentinels Determining appropriate feedback of results with industry Data submission via web portal every 4 months Education/ Training & Policy Stakeholders Respond to actionable information emerging from HWSN Data Hub Finalizing now: Developing best methods to exchange information with education/training and relevant policy stakeholders Information dissemin- ation facilitated by the WA Health Workforce Council Feedback to industry and data/information system

Washington State Health Workforce Sentinel NetworkTimeline

Selecting Sentinels 12 Organizations willing to participate in the network by sharing a limited amount of information about health workforce demand on a regular basis. Which and how many sites (hospitals, long term care, primary care, behavioral health, etc. Understanding any sensitivities to providing data Communicating the benefits of collaboration Issues for consideration

Selecting Data Elements 13 Questions need to provide data that can be used to detect workforce “outbreaks” and emerging issues affecting employers, educators, training institutions, and other key stakeholders in health workforce development and deployment. How many questions are reasonable to ask at each data collection point? How much qualitative vs. quantitative data? The best way to reference information provided at registration without complicating the questionnaire Issues for consideration

Geography for Reporting 14 Level of data collection and reporting that will provide “actionable” information but preserve confidentiality (if relevant) of network participants Pros and cons of reporting data at the county level Criteria for “censoring” the reporting of data if there is any risk to the confidentiality of responses Issues for consideration

Dissemination Strategies 15 Sentinel network findings will be provided ~ 3 times a year, via a Web-based report and “Dashboard”. Over time, the reports/dashboards will be strengthened by having trend information What are the most useful and accessible ways to present results How to involve Sentinel Network participants in the interpretation of results Issues for consideration

Where we are now: Finalizing demand questions “Over the past 3-4 months…” Recent demand changes has your organization experienced prolonged vacancies (i.e. posted job vacancies that went unfilled for longer amounts of time than usual)? did your organization experience a change in the usual demand for specific occupations? New occupations and roles are there any new healthcare occupations that your organization has employed (that it did not employ previously)? are there healthcare occupations that your organization is using in different ways ? Recent changes in workforce priorities have there been changes in your organization’s priorities regarding: onboarding for new employees? training required for your existing (incumbent) workforce? technology-related skills/training needs (e.g., because of implementation of a new EHR, use of telemedicine, use of robotic prescription dispensing systems)? (if yes, “For which occupations?” “Possible reasons?”)

Results – Examples of Expected Types of Findings Prolonged vacancies in past 4 months: Most frequently cited occupation types (e.g., RNs, medical assistants, PTs) By geography: Statewide, county, eastern vs. western WA, rural/urban By facility type: large hospital, small hospital, primary care clinics, LTC

Where we are now: Also… Finalizing the data collection and reporting infrastructure Next big push: RECRUITMENT 18

Why employers should want to be Sentinels – to: Help ensure that Washington’s health workforce is prepared to respond to the ongoing transformation of healthcare Have access to up-to-date and actionable information about emerging workforce needs across the state Add their voices to inform the Washington Health Workforce Council, policy makers in Olympia, training/education leaders and other stakeholders about emerging health workforce needs Compare their organization’s experiences and emerging workforce demand trends with similar employer groups Explore best practices and new training ideas 19

Contact Information Sue Skillman Lisa Hager