Lasting Impact for Healthcare Workers: Reflections from Jennifer Craft Morgan
We encounter many inspiring individuals through our work at The Hitachi Foundation. As part of our 30th year reflections, we are reconnecting with those from our network who continue to make a difference in their communities.
This week, we share insights from Jennifer Craft Morgan, lead evaluator for the Jobs to Careers initiative – a collaboration between The Hitachi Foundation and Robert Wood Johnson Foundation (with additional support from the U.S. Department of Labor). Jobs to Careers (J2C) used work-based learning strategies to train over 800 front-line workers, the majority of whom achieved pay increases, professional credentials, or college credits.
Furthermore, J2C served as the impetus for researchers and graduate students to publish papers, extract lessons, and produce dissertations on high performing work practices.
We continue to work with Jennifer as she currently serves as the evaluator for our Care Team Redesign Initiative.
How did Jobs to Careers impact the healthcare sector?
Prior to J2C, frontline healthcare workers were not on the workforce development radar. Employers largely viewed these workers as replaceable rather than as a group with untapped potential. J2C was instrumental in changing that view and demonstrated that these workers were engaged and eager to move up.
It also brought to life the numerous ways these six million frontline healthcare workers add value serving as medical assistants, community health workers, and other patient care providers. J2C focused on ways to create economic mobility for these workers in ways that no other project had.
How did it change the workforce development field?
J2C uncovered an array of ways to advance health worker careers. At the time, little was known about how a combination of education and on-the-job learning could build career paths – and the field had not focused on incumbent healthcare workers.
Workforce development systems traditionally relied upon continuing education credits or on-the-job training, which, if done individually, are unlikely to result in substantial career advancement. A key finding of J2C was the importance of allowing personnel to attain credentials while working.
Today, there is an emphasis on frontline health workers because they are in one of the fast-growing job categories in the U.S. – and these jobs are projected to continue growing. The research that stemmed from J2C helped inform new and better ways to train workers. It also demonstrated that it is effective to build partnerships around incumbent workers – with employers, educational providers, and intermediaries all working collaboratively.
How has J2C remained relevant in light of healthcare reform?
J2C was ahead of its time in many ways. The focus on low-wage, frontline workers is more relevant now because of the healthcare reform climate. The lessons learned from J2C are more applicable now that healthcare organizations are focusing on ways to provide quality care and reduce costs. In the current climate of patient outcomes and prevention, frontline workers – when adequately trained – play a key role within the care team. They can now provide patients with health education and connect them to available resources in an effort to keep them healthy.
J2C also promoted management practices to improve employee engagement and team building. Why were these important?
We learned through J2C that supervisors are essential to the success of work-based learning programs. If managers weren’t on board with the programs, the programs didn’t work.
It was critical to create supervisor buy-in, which was done by getting their input about ways to implement strategies and a team-based culture. We know that managers often serve as gatekeepers for workers as they seek career advancement opportunities. An engaged supervisor will also mentor and advocate for their workers.
What does subsequent research tell us about these management practices?
In anticipation of new payment models, healthcare organizations need to increase productivity and quality without raising the cost of care. Skills training programs are a smart way to advance frontline workers and improve outcome quality.
The Pioneer Employers Initiative showed that employers who really value their front-line workers and invest in them often see impressive returns. Academics have a name for these kinds of employer strategies: “high performance work practices” (HPWP). Research shows that such practices enhance staff motivation, worker empowerment, and leadership support. Research also found that making a visible investment in human capital increases worker satisfaction and overall performance.
Incorporating multiple HPW practices (e.g. staff motivation, frontline worker empowerment) is more effective than focusing on just one HPW practice. The best configuration of HPWP practices that led to high job satisfaction and high quality of care included a combination of supervisor support, performance-based incentives, care team redesign, and team-based work.
When it comes to employee engagement, what are the most important components for management to focus on?
Workers who recognize that they have opportunities for advancement have higher job satisfaction. This suggests that transparent promotional opportunities are an important component of retention and performance. While this is not a new finding, it suggests that HR policies and supportive supervisors are directly linked to higher job satisfaction for workers.
Healthcare worker satisfaction also translates to higher patient satisfaction. This is important for organizations as they work to improve the patient experience. It underscores the need for providers to offer clear career advancement opportunities as a way to motivate frontline staff.
What advice do you have for business leaders looking to implement work-based learning? Where should they start?
Start by looking at the outcomes you want to target for improvement. For example, if you need to reduce shortages in specific occupations, consider investing in a credentialing program. If senior leaders are approaching retirement, a leadership development program that trains leaders from within will serve your organization well.
Make your career ladders as visible as possible. If workers can see a clear path of career mobility, they are more likely to be engaged. Many employers offer tuition reimbursement and are surprised when workers don’t take advantage of it. If tuition reimbursement is part of your training offerings, consider paying for the employee’s tuition costs upfront as frontline workers may not have the funds on hand to cover the tuition.
I also encourage business leaders to engage both supervisors and frontline workers to develop new training programs. There is an untapped fountain of knowledge within these groups that can improve healthcare services. My advice? Tap into it.
Please visit the Hitachi Foundation website for Dr. Morgan’s article and more information regarding the Hitachi Foundation.