27© 2014 Wiley Periodicals, Inc.Published online in Wiley Online Library (wileyonlinelibrary.com). DOI 10.1002/ert.21440

The role of human resources has changed dramatically over the years and in today’s

economy has shifted from transactional pro-cessing to strategic roles, such as workforce planning, recruitment, and talent manage-ment. In recent years, workforce planning and development has become a strategic imperative, where HR and organizational leadership drive the strategy, processes, systems, and programs that ensure that they have a pipeline of workers to meet current and future needs.

In most organizations, workforce planning and development takes on a programmatic approach, with short-term solutions being developed to address specific short-term needs. High-performing organizations, how-ever, can likely attest to workforce planning and development as key to gaining a strate-gic advantage and equally important as HR practices, processes, and functions. Organi-zations already utilizing advanced strategies for workforce planning and development view this as necessary to inform the larger strategic organizational planning and budget-ing process. These efforts span the entire workforce, allowing workers to advance their careers from every stage of the employee life cycle, with clear career paths to advancement and, ultimately, the leadership ranks.

FACTORS DRIVING THE HEALTH-CARE INDUSTRY TO INVEST IN THE FRONTLINE WORKFORCE

In the health-care industry, this investment is critical. Trends point to the need to think strategically and invest soundly in policies and programs that will create talent sup-ply chains to fill the many jobs required to ensure high-quality delivery of patient care. Moreover, the health-care industry grapples with high turnover in certain occupations. Health-care employers who are partnering with CareerSTAT (an employer-led initia-tive of the National Fund for Workforce Solutions and its implementation partner, Jobs for the Future) cite an anticipated mass retirement in the US workforce, the changes required by the Affordable Care Act (ACA), and the growth in the elder patient population that will lead to the need for additional workers. Human resource practitioners in the health-care industry are also concerned about the skills and educa-tion gaps that exist across the United States. These issues will especially affect the work-force available to fill frontline health-care roles such as patient intake coordinators, nursing assistants, home health aides, and phlebotomists.

The Strategic Imperative for Investing in the Health-Care Industry’s Frontline Workforce

Jan Hunter

Employment Relations Today

28 Jan HunterEmployment Relations Today DOI 10.1002/ert

middle-management ranks due to an aging workforce, it may consider implementing a leadership-development and career-ladder program for its younger workforce by pull-ing from its frontline workforce. This work-force offers an untapped resource of eager, ambitious workers who can thrive if given the resources and tools to develop, such as tuition assistance, student loan forgiveness, or even on-site learning programs designed to increase their leadership skills. On the other hand, if a company finds that it is experiencing high turnover within its front-line workforce, such as customer service, billing representatives, or sales representa-tives, or having trouble filling open posi-tions within this group, the company may choose to develop career tracks and educa-tional offerings to increase retention.

WHAT IS THE RIGHT INVESTMENT?

Across the United States, CareerSTAT is working with human resources and other leaders in health-care organizations, imple-menting cost-effective programs to sup-port frontline-worker development. Results show that removing the barriers to access-ing programs can pay big dividends without increasing costs. For example, using current education staff to deliver training on-site lowers overall program costs, while making programs accessible to workers who may lack transportation.

Our experience and data show that companies often overlook their most valuable untapped resource: the frontline worker. These workers, generally in entry-level and clerical positions, make less than $40,000 a year and often lack the time, access to child care and transportation, and the basic education skills, such as basic reading, math,

Health-care employers across the con-tinuum of care, whether in a hospital, com-munity health clinic, or primary-care office setting, mention the changing expectations and needs of the patient population who want an educated and customer-service-oriented workforce available to them when receiving care in any health-care setting. With these changing expectations come the need to invest in education, skills training, and development.

CareerSTAT employers are engaging in collaborations with educational institutions to ensure that each curriculum relevant to the health-care industry meets the standards of their organizations.

Further, federal and state workforce-investment grants and partnership oppor-tunities available through the federal Workforce Investment Act has helped fund and facilitate new regional workforce part-nerships in health-care and other growth industries.

STRATEGIC-PLANNING PROCESS AS A DRIVER FOR WORKFORCE INVESTMENTS

The different types of investments made can vary depending on the specific and unique workforce demographic make-up of an indi-vidual company. Companies should examine growth projections for critical positions and supply information available from the reli-able data sources, including the Bureau of Labor Statistics and other workforce forecast-ers. The frequency of the workforce analysis should be at least annually and should always be tied to the strategic-planning process that the organization undertakes at the senior-management level.

If, for example, a company discovers that it has a high turnover risk within its

Spring 2014

29The Strategic Imperative for Investing in the Health-Care Industry’s Frontline WorkforceEmployment Relations Today DOI 10.1002/ert

employees take courses delivered by BIDMC department leaders one night a week for six to ten weeks, sometimes transitioning to a full-time, hands-on practicum for the final weeks of training. Staff can gain access to a BIDMC staff member who provides career and academic advising.

From these programs, BIDMC learned that many talented employees lacked the basic skills needed to succeed in a pipeline program. Staff selected for and successfully completing pipeline programs are guaranteed jobs with advancement opportunities at the end of their training.

As another example, education is a core value to Norton Healthcare, which owns five Louisville hospitals and numerous medical facilities across the region. The organization’s commitment to furthering the education and careers of its more than 12,000 employees is evident by how many are working toward advanced degrees and certifications with the system’s help.

Norton Healthcare is one of Kentucky’s largest health-care systems and, at any one time, continually supports approximately 725 student employees through its Office of Workforce Development. Assistance includes tuition funds and career coaching to align employees’ skills and interests with jobs that are growing in demand.

Through educational-assistance programs, Norton Healthcare employees can transition from nonclinical jobs to in-demand health-care careers, such as medical-lab technician or respiratory therapist. They can grow their

and critical thinking, to access the programs their employers may offer to them.

Unlike doctors, nurses, and allied health workers, frontline workers may be unaware of available programs because they may not have easy access to communications tools, such as e-mail or the corporate intranet website, where such programs are advertised. They may also lack the ability to navigate through the steps of applying for complex programs.

Some examples of frontline-workforce programs being implemented by CareerSTAT health-care partners include:

• On-site training and educational programs before or after work or transportation to the training site,

• Partial or full coverage of cost for learning and training,

• Tuition assistance accessible by providing dollars up front,

• Full or partial paid time to attend training,• Career coaching or mentoring services,

and• Academic and/or career counseling and

academic readiness programs and tutoring.

Examples of Successful Programs

At the Beth Israel Deaconess Medical Center (BIDMC) in Boston, pipeline programs are varied and address the specific workforce needs. The hospital has developed a set of programs to train employees for jobs that it has difficulty filling.

For some professions, such as medical-laboratory technicians, BIDMC has contracted with a local community college to bring free precollege reading, English, math, and college-level science courses on site. For other professions, such as pharmacy technicians,

Results show that removing the barriers to accessing programs can pay big dividends with-out increasing costs.

Employment Relations Today

skills by obtaining “stackable” credentials—earning a degree or allied health credential to become a laboratory technician, for instance, and then adding a degree to become a regis-tered nurse.

The educational and advancement oppor-tunities pay dividends, not just to Norton Healthcare employees, but to the system and community, according to Tony Bohn, system vice president and chief HR officer, Norton Healthcare. “Norton Healthcare benefits from educational programs through increased employee engagement,” Bohn said. “Patients benefit from having caregivers with the most up-to-date knowledge and skill sets. The community benefits from having a more edu-cated workforce providing care in the most-needed areas.”

Like the health-care field itself, Norton Healthcare career education has evolved. The Office of Workforce Development partners with other organizations and internal depart-ments to offer a complete career program.

Employees at Norton can:

❏ Use career-coaching assistance and learn more about their skills and the types of health-care jobs that will be in demand in the future.

❏ Apply for loans and grants. Qualifi ed employees can match tuition assistance with other programs, such as the Indi-vidual Development Accounts, a newly acquired federal grant program.

❏ Increase certifi cations and degrees.

Jan HunterEmployment Relations Today DOI 10.1002/ert

30

❏ Help with the Free Application for Federal Student Aid (FAFSA).

Norton’s Office of Workforce Develop-ment also uses advanced techniques such as a workforce forecasting tool to identify trends and future needs within the Norton Health-care system and begin recruiting and educat-ing employees to fill those roles.

In addition, its workforce-development team leverages relationships with more than 100 colleges and other higher-education pro-viders nationwide to help create programs and classes designed to fit the advanced med-ical needs for the future. One such partner-ship with a local community college resulted in the creation of programs for medical-laboratory technicians and a medical-assistant program, among others.

“With Norton Healthcare, there’s been this point-counterpoint relationship over the years,” said Anthony Newberry, president of Jefferson Community & Technical Col-lege. “Over a 40-year partnership, we have developed this close relationship that has translated to programs that are on point, cutting-edge, and responsive to needs of the medical community.”

DEVELOPING A LEARNING CULTURE

CareerSTAT seeks to inform HR practitioners in the health-care industry as to the potential value of developing their frontline workforce and building a culture to effectively support this effort. From the examples provided here, it is clear there are hospitals and health-care organizations that are making strides in work-force-development programs, while others are in the earlier stages. CareerSTAT: A Guide to Making the Case for Investing in the Frontline Hospital Workforce (http://nfwsolutions.org/

Like the health-care field itself, Norton Health-care career education has evolved. The Office of Workforce Development partners with other organizations and internal departments to offer a complete career program.

31The Strategic Imperative for Investing in the Health-Care Industry’s Frontline WorkforceEmployment Relations Today DOI 10.1002/ert

Spring 2014

sites/nfwsolutions.org/files/CareerSTATFINAL.pdf) provides case studies as to hospitals that are effectively developing, measuring, and supporting investments. Also offered to prac-titioners through this guidebook are some recommendations to take HR practices to scale:

❏ Move from “boutique” projects to “business as usual.” Determine strategies for institutionalizing and scaling up good practices in the development of the front-line workforce. For example, hospital lead-ers in the CareerSTAT coalition note that building internal pipelines with measurable impacts takes time, especially when work-ers come in with low basic skills or are not ready for college-level studies. Building an internal pool of candidates for critical posi-tions can take fi ve years or more. There-fore, leaders need to adjust expectations and metrics accordingly.

❏ Don’t reinvent the wheel. Adopt and customize existing templates and practices. Establish common templates and collection tools that are used by other organizations in the region (e.g., community colleges, public workforce agencies, and commu-nity-based organizations). Where partner-ships or consortia exist, arrange to share costs as well as data, where appropriate.

❏ Create rewards for building better metrics. Advocate for the creation of a competition and awards or other recogni-tion for development and application of business metrics to frontline-workforce investment.

❏ Remember that measuring impact is as much an art as a science. Not all benefi ts can be monetized or even quanti-fi ed. The strongest case is usually made with multiple methods, combining hard

data, such as costs associated with reduc-ing turnover, which is compelling, and portraits of individual workers and their perceptions based on interviews or sur-veys as to what makes for supportive career advancement.

❏ Foster a climate of business-to-busi-ness learning. Establish formal and informal learning networks to stimulate the adoption of practices and metrics and cultivate champions.

❏ Move the policy debate. Government and educational systems are key partners with employers in developing the frontline health-care workforce, but much more needs to be done. Build alliances with

education and workforce communities. Incorporate lessons from advocacy for the direct-care workforce (serving elders and persons with physical/mental disabilities).

WHAT IS THE RETURN ON INVESTMENT OF THESE EFFORTS?

Admittedly, measuring the impact of any organizational process, such as assessing the value of investment in workforce devel-opment, can be complex and challenging. Determining what to measure and why when it comes to frontline-workforce development is essential.

In the quest to obtain solid return on investment, internal and external factors such as missing or incomplete data on employee participants, after-program completion, and privacy concerns exist. Also, in some cases, having adequate staff capacity to create and

Determining what to measure and why when it comes to frontline-workforce development is essential.

32 Jan HunterEmployment Relations Today DOI 10.1002/ert

Employment Relations Today

among the employees who are not taking part in the program—because they see the commit-ment the company has to its employee devel-opment. Other benefits include an enhanced corporate and employee brand and cost sav-ings in recruitment, turnover, and even absen-teeism and employee grievances.

apply data metrics may not exist, requiring new or outside funding to support this work.

Yet, like most investments, there are quali-tative and quantitative outcomes, and we find that CareerSTAT partners reap many rewards from investing in their workforces. These include increased employee engagement—even

Jan Hunter leads CareerSTAT, an initiative of the National Fund for Workforce Solu-tions and its implementation partner, Jobs for the Future. CareerSTAT is a national collaboration of hospitals and healthcare leaders promoting employer investments in the skill and career development of frontline workers in health care. In this role, she oversees Health Care Worker Champions, a program that recognizes employers who support these workers. She is a workforce-development expert with extensive experience, most recently as director of workforce planning & outreach at Banner Health and director of workforce planning & organizational effectiveness at John Muir Health. She may be con-tacted at jhunter@jff.org. To learn more about CareerSTAT, visit http://www.nfwsolutions .org/initiatives/careerstat.