BEYOND HEROISM: CHANGING THE TRAJECTORY FOR FRONTLINE HEALTHCARE WORKERS

The country has been shining a well-deserved spotlight on healthcare workers during this pandemic. Unfortunately, the “hero” label has overshadowed any conversation of how we prepare and educate the next generation of healthcare workers. Volta Learning Group (VLG) recently explored this topic with MJ Ryan (MJR), Sr. Director, Workforce Development & Economic Opportunity at Mass General Brigham (formerly Partners HealthCare). The largest private employer in Massachusetts, Mass General Brigham is a system of hospitals, physicians’ offices, healthcare centers, rehabilitation facilities and urgent care clinics, employing 78,000.

The shortage of frontline healthcare is not a new phenomenon. Expected gaps in home health aides (over 400,000), nursing assistants (95,000) and lab technologists and technicians (nearly 100,000) by 2025 have been projected. But now, COVID-19 has brought these shortages into stark relief with hospitals and nursing homes desperately looking to fill open positions.

VLG: What do you see as the greatest challenges to meeting the healthcare workforce needs over the coming months and years?

MJR: Over the next two years there will be an ever-increasing need for entry-level frontline direct care workers–CNAs, home health aides and others. These physically demanding jobs require long hours and carry a high level of responsibility yet are among the lowest paid. While direct care provision can be a very rewarding role, it is important to develop clinical pathways for those wishing to advance in their careers, while still caring for patients. Currently, moving to the next level often requires a big leap in training and certification. This path to advancement could be simplified by adding more steps and options for growth.

If we are to attract and retain these workers, we’ll need to change the trajectory by thoughtfully building pathways and support for advancement. This will involve establishing stackable, modular, competency-based learning opportunities that are flexible, feasible and affordable for learners. In this way, these frontline roles can be seen as the first step into a career. These positions need to be converted into careers not jobs. 

VLG: What else are you seeing?

The shortage of clinical training slots is a huge challenge that has only increased due to the pandemic. The healthcare industry will need to leverage remote and online learning, as well as a greater use of simulation, AI, and other tech-augmentation for clinical training. While these modalities can’t replace face-to-face, hands-on learning, they can be used to help expedite and complement in-person work with patients, possibly reducing clinical training timelines.  

VLG: The pandemic has highlighted the need for a flexible, resilient and adaptable healthcare workforce. How do we make that happen?

MJR: Reimagining training delivery models in the clinical areas would be the first step. We should have a basic core curriculum with needed essential skills–resilience, adaptability, critical thinking, and information processing–as well as patient care principles and practices. On top of that we need to create modular programs focused on specific specialties or roles. These shorter-term credentials would allow us to quickly prepare staff so they are ready to engage in various patient care roles, while remaining adaptable and flexible.

Also, hospitals and other providers should consider staff rotations to create a wider understanding of patient care from a team care perspective. This will promote patient-centered care and delivery and increase understanding and collaboration across disciplines to improve the continuity of care.

VLG: The virus has hit communities of color in staggering numbers, exposing a lack of healthcare more broadly in those same communities. How can that be addressed?

MJR: There is no question that the COVID-19 crisis has shown a light on the inequities in healthcare delivery. The country will need community and population health experts as well community health workers and patient navigators if we are going to eliminate those inequities. We need a global understanding of the social determinants of health to ensure that patient care is delivered in a holistic, proactive manner. Practitioners and providers at every level should be on alert for risk factors or red flags.

VLG: Many of these challenges will require cross-sector solutions. What can employers, colleges and policymakers be doing to address the challenges?

MJR: Colleges learned a great deal leaping to remote learning this spring. Building on that start, they will need to create robust remote/online solutions, both synchronous and asynchronous, which are engaging, flexible and accessible. They will have to adopt new delivery models that are competency-based, stackable and portable, and designed to address articulated labor market needs. Strong higher ed-employer partnerships will help to inform those requirements. They should be transparent about program outcomes, including placement rates, earnings, and opportunities to advance into the next-level credential or degree. 

Employers should review and update job descriptions to ensure they reflect ACTUAL requirements and define “must haves” vs. “nice to haves.” This includes reconsidering when degrees are truly required for specific roles. They should join college advisory and/or curriculum committees to ensure there is alignment of skills and competencies needed with those being taught, and jointly devise internships, apprenticeships and clinical training opportunities. And they should be considering new kinds of credentials, looking at competency standards to expedite hiring and providing “just-in-time skills.”

Policymakers can support the success of frontline healthcare workers by updating licensing and credentialing standards. Simplifying the process for apprenticeships would increase the opportunities for workers to work and learn, thus opening up opportunities to those who currently can’t afford to train to advance their careers. Finally, they should direct financial assistance for wraparound services for under/unemployed candidates making going to school more affordable.

Our frontline healthcare professionals have come through for all of us during the COVID-19 crisis. Let’s give them a heroes’ welcome by ensuring they have the opportunity to grow and flourish in their careers.

 

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This Interview with MJ Ryan of Mass General Brigham is part of our Innovative Ideas in Healthcare Education and Training Series. The Series highlights the work of thought leaders who are working to build a skilled, more flexible healthcare workforce. Volta Learning Group works with higher education institutions, healthcare providers, employers, and associations to research, develop, and implement innovative learning strategies that address current and future labor market needs in healthcare and other critical sectors.

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