Fairview Health Services in Minnesota is joining six other pilot regions as part of Hope Street Group’s Health Career Pathways (HCP) initiative with the White House and Advisory Board. This employer-led initiative will develop competency models and career pathways to increase the number of qualified workers and ultimately improve patient care. What spurred you to sign on as one of the first regions in this initiative and what makes Fairview well-suited as a pilot system?
Fairview’s demand and urgency to find qualified help is immediate and long-term. We’re a large complex organization that works throughout Minnesota. We take pride in offering strategic long-term workforce programs, and we’ve been running these types of programs for 21 years. The HCP initiative seemed like a natural fit. Working together with Hope Street Group and the White House will allow us to examine our ideas and models and the complexity of jobs and jobs families, and combine that with Hope Street Group’s understanding of programs happening across the nation.
We already have a number of pathway programs underway: programs that begin in high school that continue on to community colleges and four year universities, programs for individuals to enroll in while they work, internships and fellowships, scholarship funded programs and apprenticeships. HCP was a natural fit given our goal to ensure we have enough quality healthcare workers that keep up with the diversity and demographics of our communities. New Americans may not know about these healthcare opportunities and need support to increase their awareness. Fairview strengthens our communities by supporting live/work/school initiatives, we review how people live in a community, go to school there, work there, and we try to create programs for these communities right in our backyard. And what I’ve read suggests Hope Street Group has the same approach, looking to see how we can make communities stronger and working with all stakeholders in the community do it.
With our approach to team-based care, there are opportunities for entry-level, middle skilled and highly credentialed individuals and a method of having these credentials stack up. We have some great foundational programs in place and as we work with Hope Street Group, we can build upon them and incorporate best practices from other programs and leverage them across Minneapolis and Minnesota.
This has to be deliberate work and as we do this work, we want an inclusive group. We really value our community college partners, our academic medical center partners and our university partners. We have the K-12 system that you start with, as well as community-based organizations, on top of our work with our community based organizations like the African Development Center, United Way and our constant work with our workforce centers. It’s about taking those key stakeholders and saying, “Here’s where we are and here’s where we want to go.”
Currently, with our medical assistant shortage, we identified those key community colleges to partner with and, importantly, the key populations to target. By working with Hope Street Group, we can share this model across the Twin Cities. While we may be working on a strategy internally, there is a shortage of medical assistants across the Twin Cities, across Minnesota and across the country. We want to create something that others can use because we don’t want to be stealing talent from each other; we want to build the talent for all individuals and help them along their career pathway. At Fairview, we’d like to create the opportunity to take an office worker who could be doing the office functions of a medical assistant and, once they graduate from our program, they can move into the clinical role. The next step would be to develop a pathway beyond the medical assistant role such as medical assistant community health worker, medical assistant scribe, etc. There are many opportunities like that and it takes our academic partners to work with us on that model, it takes Hope Street Group to lead the sharing of best practices and community partners connect with the under- and unemployed students we want to hire. It’s an investment strategy. 80% of our future workforce is investment. When we look at the market, we have 1300 openings, 1000 in our recruitment, 200 in our providers, 70 student positions, and we’re bringing in 250 temps a week. We need grassroots investment to meet these needs and grow these pipelines.
I’m fortunate that I’m in a leadership role in our organization as well as a leadership role in the Twin Cities and at the state level, so I have a joint mission to always share this work. In the Twin Cities, I’m a leader with the Minneapolis Workforce Board, I chair the Governor’s Workforce Development Board and our MnSCU Healthcare Educational Industry Partnership Council. And these groups are all about collaboration. They create models and share them, because that’s not where we need to compete. We all need to develop talent. It’s all about building communities and investing in them so our workforce mirrors our patient population. Some individuals can go to college right away and become a provider, while others need to do a one or two year degree and then, with the support–whether tuition or otherwise–they can move on to other positions. With healthcare, and how long everyone works to live, there are so many opportunities. It’s up to us to continue to create strategies and programs to invest in our employees so they remain with us.
We started our talent acquisition workforce development work 21 years ago and we’ve been running programs that entire time. In Minnesota, we’ve worked for 17 years on convening healthcare workforce development stakeholders. Minnesota really has created the infrastructure that put that model workforce development as a long term strategy, you have to work year after year to develop these programs and refine them.
A critical component of HCP is ensuring employers are meeting their needs by hiring based on what is actually required for a job—competencies—instead of other less accurate metrics. What measures has Fairview taken to move toward competency-based hiring?
We’re currently working on our apprenticeship model so we’re actually looking at competencies right now. When we think of team-based care, you’re never going to have enough doctors or providers. You need every single healthcare team member working at the top of their credential. As an example, we have a huge mental healthcare worker shortage. Fairview is the largest mental health provider in the Midwest and the acuity of the patients is significant, people come in with more than one diagnosis. We hire registered nurses, four year degree psych techs, graduate level clinical social workers and others with psychology credentials and physicians. When examining that model, where you have acute patients that need someone to be with them one-on- one—“sitters”—we had to open that position up and say, “What do we really need?” Because there are mental health worker shortages, it makes no sense at all to take an RN or a person with a 4 year degree and have them be a sitter. We examined the competencies and decided that, to add to our team, we would create a behavioral assistant position. This would be for a person with a two year degree or on the path to a degree, which would allow us to utilize our college and university partners. Someone could be from a two-year Human Services degree program with the competencies, or a Psych, Sociology or any kind of healthcare program and having finished two years of the basics, and we examine their competencies and say, “This is what we need.” And now we have a pipeline of multiple feeder programs. We opened up seven full-time employee positions, and now when we look at programs at different schools, that could be 20 different students. We worked with both community colleges and universities and said, “Here are the competencies we identified, it’s about two years of instruction, and these individuals can come in and become Behavioral Assistants.” If they love that role, they are welcome to stay, but if they go to get their Sociology or Psychology degree, they can then enter a Psych Associate role that requires higher competencies and comes with more pay, and maybe even continue further to a clinical provider role.
That’s a perfect example of how we had to break the job position down to determine what we really needed. And, in the process, we created an entry-level role that saved us from having to pull away middle-skilled individuals that we couldn’t afford to lose. When we all have hundreds or thousands of openings, we have to be certain that a certain credential or degree is really warranted. We’re examining one job family at a time, because, while in some cases the complexity or acuity requires a baccalaureate degree, we must look at the whole team, each member’s role and the corresponding competencies for each position. We’ve done this work for other positions, such as Imaging, where we’re analyzing how the competencies for an MRI technician differ from a Radiation technician, and certainly in healthcare IT where in the past we’ve only hired individuals with baccalaureate degree or above. We’ve taken the IT Ready model and hired people out of 16 week bootcamps to fill entry-level roles, and we’ve used our dual training model to provide individuals with the competencies to work at our help desk and provide web support. We now have a much better understanding of when we need a degreed person and why. What we’ve done in IT alone, we have 24 employees going through dual training for competencies and we’re taking 12 summer interns. We’re taking individuals at different levels and, if students are in town after the summer internships, they can actually continue to work part time. We’re really making an effort to build these opportunities.
In regards to competencies, we also have a Fellows program, usually for individuals who need some support like tuition assistance. Students in healthcare pipeline programs, if they’re in school and want to work with us, we examine their skills and what competencies they should acquire to meet a current job need. This allows them to be a nursing station technician or a rehab aide while they’re in school, which we have seen help with retention rates in schools, and they earn, on average, $5 more than if they were instead working a part time job at a gas station, for instance. And when they finish their program, we can work with them to move them into a higher-level role.
As Fairview and other hospital systems continue to innovate to face challenges within the healthcare industry, what are some of the critical next steps you all are taking modernize the system and its workforce?
We’re an academic medical center, so we’re heavily involved in research and education. We take 7,000 student experiences a year, and we’re very committed to developing that pipeline across all levels, from middle and high school on to MD. Before this interview, I was on a call focused on competencies around safety and quality for the position of certified RN anesthetist, a position for individuals who work in the operating room. When those provider students graduate and then come work for an academic children’s hospital, no one’s prepared for the complexity, because we have some of the sickest kids in the world. We’re working with the academic medical center right now to explore the option of adding a fellowship to ensure quality and safety and create what would essentially be a bridge for graduates into the workforce.
We look for talent locally, though we will also look nationally given the complexity of an academic medical center. In our communities, we do great work to do address the disparities we have seen. While we have one of the lowest unemployment rates in the country, if you look deeper, the unemployment rate is triple for people of color. We have one of the largest East African communities in the nation so we’re doing a lot of work to create an “opportunity hub”. We bring training programs, employment fairs, paid internships at the high school level with our Step Up Program, and we provide scholarships for children to go to scrubs camps to develop their skills, see role models and begin to understand those healthcare career pathways. We do that locally, in our backyard—that program is across from our largest hospital. We have 4,000 Somalis living just in that area, and it probably features one of the greatest unemployment rates in Minnesota. So we’re deliberate about targeting our opportunities to address the under- and unemployment gap, from education through career.
We try to reach the whole family, because that’s what you have to do. We take the time to build trust with face-to- face communication, and we work with an entire generation. We show up every other week to meet and work with the families in our community. And it’s not just us. We have the City of Minneapolis employment representatives there along with Minnesota Department of Employment and Economic Development and African Development Center representatives and funders. We’re working together to make positive change. We have to invest, and we need to provide those pathways. And with our long term care arm, we are able to provide those very first opportunities all the way to the MD level. People can actually spend their entire career in our system. And because we provide great benefits and family sustaining wages, that has made a tangible impact in the communities where we work. Where we have these programs, we have seen our employee diversity increase by 5% to include more East Africans, American Indians and more.
One of the Fellows we recently spotlighted, Michael Jones, was a scrubs camp counselor and was enrolled in community college program. We brought him in to work as a nursing station technician and provided him with a scholarship. He’s one of 25 Fellows last year, and this year we want to hire 50 to 100 more. On top of more than 70 interns starting June 1st. Some of them are in high school, others are in healthcare programs or IT. We are serious about growing these programs, and they makes a difference when it comes to closing disparity gaps and helping people succeed. As these students are in school, we surround them with people who can give them support and answer their questions. And we provide these supports from entry-level onwards because we have positions open at every level, and we need to meet people where they are ready to start. As our population continues to grow and change, especially with the number of new Americans living in the Twin Cities, it’s more important than ever that our workforce mirrors the population it’s serving.