Innovative Solutions in Tough Times:
Tackling the Health Care HIT
Workforce Crises
We Will Inform You About:
• Northern Virginia Health Care Workforce
Alliance
• PricewaterhouseCoopers Study
• GWBOT Health Care Task Force
• NoVaHealthFORCE Strategies & Action Plan
• GWBOT Study Recommendations
• Northern Virginia Workforce Investment Board
Northern Virginia Health Care
Workforce Alliance
Why the Northern Virginia Health Care
Workforce Alliance?
Regional health care worker shortage
• Current regional shortage obvious but not
quantified
• Projections call for worker demand to
continue growing over next 30 years
• Current capacity of training & education
system inadequate to meet projected
demands
What is the Northern Virginia Health Care
Workforce Alliance?
• Private sector, business, government,
community, health care and educational
leaders
• Mission: establish a long-term,
business-driven, sustainable strategy
to address the Northern Virginia health
care worker shortage
Outcome: A Business-driven
Sustainable Strategy
• Concept of “business-driven” is key
• Businesses must see themselves
as having a vested interest
• Health care workforce shortage
must be seen as more than a
hospital problem
Outcome: A Business-driven
Sustainable Strategy
• Solution must provide upward mobility
for “New Americans” and
underemployed
• The solution must address workforce
utilization in health care industry
• Solution must be self-perpetuating and
out-live the Alliance
What Did The Alliance Do:
• Commissioned
PricewaterHouseCooper Study
• Develop comprehensive regional
strategies
• Changed Name to NoVaHealthForce
PricewaterhouseCoopers Study
The Health Care Workforce Shortage:
An Analysis
of the Scope
and Impact
PricewaterhouseCoopers was engaged by the
Northern Virginia Health Care Workforce Alliance, a
Coalition of business, academic, and community
leaders to:
•Identify the issues
•Analyze the scope and impact of the health care
workforce shortage on Northern Virginia.
Objectives and Approach
The objectives were to identify:
• current and future Northern Virginia health care workforce
needs for 24 selected health care professions
• current and future gaps in the health care workforce and the
driving forces leading to these gaps
• training and education, recruitment, and retention best
practices within Northern Virginia and other regions of the
country.
The approach included:
• a quantifiable independent survey of a sample of health care
providers in Northern Virginia
• interviews with local health care providers, academic institutions
and economic development authorities
• a literature search
Health Care Professions Studied
Professions Studied
RNs
Medical Records/ HIT
Medical and Nurse Managers
Dental Hygienists
Radiologic Techs
Physical Therapists
Occupations Therapists
CT Scanning Techs
MRI Techs
Pharmacy Techs
Surgical Technologists
Phlebotomists
Nursing Aides
Dental Assistants
Home Health Aides
EMTs/Paramedics
LPNs
Physical Therapist Assistants
Respiratory Therapists
Medical and Lab Technologists
Speech Language Pathologists
Pharmacists
Medical and Lab Techs
Surgical Techs
Northern Virginia is a Dynamic Community
 Demographics pose specific challenges and
solutions:
• High growth rate
• Low unemployment rate
• Highly educated
• High levels of employment
• High salaries (comparatively)
• Ethnically diverse
• Large percent of foreign born
• Growing focus on life sciences
• Large information technology focus
-- President - Large
Northern Virginia Medical
Technology Foundation
Advancement
“The greater DC Metro
Area and Northern Virginia
are poised to be the one of
the world’s primary centers
of biotechnology. The
region sits at a crossroads
between world class
education and research
with a foundation of drivers
to advance discovery and
the implementation of new
technologies.”
Research
Northern Virginia: A Medical and Health
Care Information Technology Incubator
Key Findings
• A shortage of health care workers exists in Northern
Virginia
• Estimated shortage of about 2,800 professionals in the 24
occupational categories
• Average vacancy rate of about 10 percent
• Without interventions, vacancy rate is anticipated to grow
to over 41% by 2020
Key Findings (cont)
• Anticipated vacancy percentages are estimated to
range from 27 - 56% depending on the profession
• RNs dominate the current and projected shortage,
with more than 1,000 current vacancies
• Other hard hit professions are medical records and
health information technicians and imaging
• The forecasted growth will continue to put immense
strain on the availability of health care workers
through 2020. Without interventions, vacancies will
increase to 16,600 positions with a total demand of
over 40,000 positions
Future Demand is High
Current and Estimated Demand by Health Care Occupation Through 2020
Current
Employment
Occupation
Current
Shortage
Current
Demand
Demand
2010
Demand
2020
Estimated
Shortage
2010
Estimated
Shortage
2020
Registered nurses
(includes CRNAs, nurse
practitioners and nurse
midwives)
9,100
1,000
10,100
12,100
15,400
3,000
6,300
Nursing aides, orderlies,
certified nurse assistants,
attendants
3,200
300
3,500
4,300
5,400
1,100
2,200
Medical records and
health info technicians
1,300
200
1,500
1,900
2,500
500
1,200
Dental assistants
1,100
20
1,120
1,400
1,900
300
800
Medical and nurse
managers
1,100
100
1,200
1,300
1,700
200
600
Note: “Estimated Shortage” calculation assumes no change related to increased retirements, etc.
Vacancies Could Increase by 2020
Without Intervention
Anticipated Growth in Vacancy Rates for Select Occupations
2004
Vacancy Rate
2010 Estimated
Vacancy Rate
2020 Estimated
Vacancy Rate
RNs
1 0.3 %
25%
41%
LPNs
26%
33%
42%
R a d io log ic , C T ,
M R I techs
12%
26%
42%
M e d ica l re co rd s
a n d info techs
1 1.4 %
29%
47%
M e d ica l an d
n u rse m a n ag ers
6 .7 %
22%
`3 9 %
Other Key Findings
• Access to health care, quality of care, and quality of
life may be negatively affected as a result of the
shortages
• Increased demand for services due to the aging
population
• Concurrent aging of the health care workforce and
resultant retirements
• Shortage of nursing and allied health profession
faculty, schools, and clinical experience sites and the
inability to find replacements
Other Key Findings (cont)
• Concurrent aging of clinical faculty and the resultant
retirements
• Difficulties with having market competitive salaries for
clinical faculty
• Nature of the profession
• Low unemployment rates and high cost of living
Hospitals Expect Biggest Future
Difficulties in Hiring Staff
10
9
All of the Northern
Virginia hospitals
surveyed expected to
either retain their current
workforce or hire
additional workers.
8
7
6
5
4
Number of responses
Nine hospitals reported
that they would grow
their health care
workforce in the year
ahead.
Change in Workforce Needs for
Hospitals
3
2
1
0
Decreased
Stay the Same
Last 12 months
Source: PwC Analysis of Northern Virginia Workforce Survey
Increase
Next 12 months
Gaps Will Be Exacerbated by Lower Supply
Occupations with High Demand and Low Supply
Current
Vacancy
Rate
Expected
Increase
Demand
(20042010)
Registered nurses
10%
51%
Nursing administration
7%
51%
Occupational therapist
16%
51%
Physical therapist
17%
51%
Physical therapist asst.
26%
65%
Dental hygienist
4%
64%
Trend toward more hygienists per dentist leads
to more demand for these positions.
Medical records/info
tech
11%
64%
Coders and other IT professionals currently in
short supply. As hospitals and clinics move to
electronic medical records, need for coders
may slow, but demand for other IT
professionals will increase.
Occupation
Future Demand Scenario
More than 1,000 vacancies currently;
retirements expected to widen the gap;
shortages could lead to more burn-out and
raise current vacancies rates.
Large vacancy rate combined with drop in
graduates could affect access to therapy.
Medical Records and
Health Information Technicians
Increased demand for medical records technicians
will be fueled by:
• Rising health care demand
• Increased scrutiny of medical documentation
• Continued emphasis on the electronic medical record
• Growth will be primarily distributed among physician
offices/clinics, hospitals, and long-term care facilities
Medical Records and
Health Information Technicians (cont)
• Third-party payers and government regulators
are expected to add to the demand
• Issues with quality of the available medical
records staff surfaced repeatedly in the
interviews
More Medical Records/IT Technicians
Will Be Needed
An 11% shortage of medical records technicians or 172 open positions was reported. To
eliminate the shortage and keep up with anticipated demand and population growth,
Northern Virginia will need to add over 363 technicians by 2010 and another 675 by 2020.
An average of seven medical records technicians graduated each year from colleges
between 1999 and 2003. At this graduation rate, an additional 49 technicians will be
added to the workforce by 2010, 314 below market demand estimates.
Medical Records and Health Info
Technicians
3,000
Additional Demand for Workers
(Current and Future)
2,500
2,000
Additional Gap by
2020
1,500
Additional Gap by
2010
1,000
Current Gap
Current Supply
1,200 Positions
500
0
Current Supply
Current
Demand
2010 Demand
2020 Demand
Recruitment and Retention Challenges
Occupation Awareness
Lack of awareness about certain
occupations
• While students may be aware of
what a nurse or pharmacist does,
many are not familiar with the role
of a surgical technologist, speech
pathologist or CT scanner.
Misconception about the
occupations
• Students don’t realize that many
health care careers are “high-tech.”
Said one hospital executive:
“Technology is a large aspect of
health care jobs and will continue to
increase. This is not a particular
awareness that students or
teachers have.”
Access to Training
Inability to Retain
Many training programs are at
capacity
• “There will be a critical shortage of
faculty as the programs scale up.
Presently there is a serious faculty
constraint,” said one education
leader.
• A shortage of clinical training sites
is a critical element in increasing
the number of nursing and allied
health student graduates.
• Educators said that more of their
students are foreign-speaking.
Providing instructors in a
multiplicity of languages is
expensive and difficult.
Low pay
• While some positions pay well,
many lower-level jobs pay
poorly.
Poor hours
• These are “labor intensive jobs
with too much responsibility and
unattractive work hours.”
High turnover
• High turnover becomes a selffulfilling prophesy. Most
employers interviewed cited
burnout as a common problem.
Often, other workers must take
up the slack when their coworkers quit. This burns them
out and leads to more turnover.
• When asked about the
consequences of vacancies, one
employer said: “Nursing staff
must work more hours.”
Workforce Best Practices
Education and Training

Providing health care training to persons new to health care or
encouraging advanced training to persons inside of health care. Most
programs achieve this through free training and education, paid training
and internship opportunities, and accelerated training programs.
• Recruitment

Initiatives aimed at recruiting new workers into the field of health care.
Strategies include awareness programs, enhanced benefits, loan
forgiveness, increased marketing of health care careers, and flexible
work hours. Focus on English as a Second Language.
• Retention

Retention tools often include innovative benefits such as employee
driven scheduling, development of clinical specialist and manager
positions, market rate adjustments, career ladders, child care job
satisfaction, focus on the over-40 worker among others.

Specific challenges are retaining the experienced employees who are
so important in training and mentoring the less experienced employees.
Without mentors, the less experienced professionals are apt to leave.

Creative compensation.
No. Virginia Health Care Providers Adopt
Innovative Ways to Maintain a Strong
Health Care Workforce
 Expand best practices:
Create awareness of the professions
Provide specialized training and on-site training
Focus on retention and job satisfaction
 Encourage new innovative ways to provide health
care services
 Develop a synergy among the health care
providers, the educational institutions, and the
economic development authorities and workforce
planning commissions
Greater Washington Board of Trade
Health Care Task Force
Who Cares? Report Objectives
1. Review national health care workforce shortages
and strategies to address them.
2. Assess Greater Washington’s health care
workforce shortages, current workforce training
efforts, and best practices.
3. Develop recommendations to strengthen
Greater Washington’s health care workforce.
Greater Washington: The Region
• Northern Virginia - Arlington, Fairfax, Fauquier,
Loudoun, Prince William, Stafford and
Spotsylvania (7 counties); Alexandria, Fairfax
City, Falls Church, Leesburg, Manassas,
Manassas Park, Fredericksburg, Vint Hill (7
cities)
• Suburban Maryland - Anne Arundel, Calvert,
Charles, Frederick, Howard, Montgomery, Prince
George’s and Saint Mary’s (8 counties).
• Washington, DC
Methodology
 Gathered Primary and Secondary Data (i.e.
Bureau of Labor Statistics, Dept. of Labor
Occupational Employment Statistics, Maryland
Higher Education Commission and State
Commission on Higher Education for Virginia,
survey Data, etc.)
 Conducted Interviews and focus groups with over
40 individuals throughout the region from the
business, government, academic, and nonprofit
sectors.
 Identified 23 occupations in high demand,
required less than B.A. degree, potential for
career ladders.
Educational Supply & Industry Demand
 Scan of public and private 2- and 4-year
institutions and private education/training
providers in targeted area.
 Graduate numbers are based on 2003-2004 data
from MHEC and SCHEV and self-reported data
from individual institutions.
 Data on number of graduates is only an estimate
for this scan; they should be systemically
validated in future studies.
Washington PMSA: Top 10 Occupational
Projections 2000-2010
(By Annual Total Openings)
Health Care-Related
Occupations
Projected
Employment 2010
Estimated Annual
Percent Change
Annual Total
Openings
Registered Nurses
43,859
1.8%
1,461
Nursing, Aides, Orderlies,
and Attendants
21,856
2.2%
655
Licensed Practical and
Licensed Vocational Nurses
12,302
2.0%
482
Medical Assistants
7,474
3.8%
371
Dental Assistants
6,075
3.2%
242
Home Health Aides
5,708
3.1%
203
Pharmacy Technicians
4,528
2.8%
197
Dental Hygienists
3,784
3.1%
141
Medical Records and
Health Information
Technicians
2,878
3.3%
126
Medical and Clinical
Laboratory Technologists
3,714
0.9%
111
Greater Washington Health Care Workforce:
Educational Supply & Industry Demand
Health-care
Related
Occupations
RNs
Nursing
Aides,
Orderlies,
and
Attendants
LPNs
Projected
Annual
Openings
1,461
655
482
# of
Programs
in Region
Estimated
Annual # of
Graduates
DC: 10
MD: 19
VA: 7
1,444
DC: 4
MD: 11
VA: 1
208+
DC: 6
MD: 6
VA: 1
403+
Notes
Mix of
offerings,
AssociatesLPN
BSN, and
MSN
Mostly noncredit
certificate;
Private career
schools
Certificate;
Private career
schools;
Decentralized
data collection
Greater Washington Health Care Workforce:
Educational Supply & Industry Demand
Health-care
Related
Occupations
Medical
Assistants
Home
Health
Aides
Pharmacy
Technicians
Projected
Annual
Openings
# of
Programs in
Region
Estimated
Annual # of
Graduates
371
DC: 1
MD: 12
VA: 3
203
DC: 2
MD: 2
VA: 0
100-150+
197
DC: 0
MD: 4
VA: 1
33+
43++
Notes
Certificate;
Private
career
schools;
Decentraliz
ed data
collection
Certificate
and noncredit
certificate
level
Private
Career
Schools
Certificate
Greater Washington Health Care Workforce:
Educational Supply & Industry Demand
Health-care
Related
Occupations
Dental Hygienists
Medical Records
& Health
Information
Technology
Medical and
Clinical Lab
Technologists
Projected
Annual
Openings
141
126
111
# of
Programs in
Region
DC: 1
MD: 1
VA: 1
DC: 4
MD: 8
VA: 5
DC: 1
MD: 1
VA: 1
Estimated
Annual # of
Graduates
50+
42+
?
Notes
Associate
and
Bachelor’s
degrees
Mixed
educational
offerings, but
most are at
certificate
level
All programs
are
Bachelor’s
degrees
NoVaHealthFORCE
Strategies and Action Plan
NoVaHealthForce Strategies:
Goal 1: Increase capacity within the
health care education and
training system
Goal 2: Develop and sustain an
ongoing supply of persons
interested in entering health care
career fields
Goal 3: Nurture Innovation
NoVaHealthFORCE Action Plan:
• Action plan developed by eight working
groups
• Working groups consisted of stakeholders
from: education, healthcare industry,
local, state and federal government,
social service agencies and economic
development authorities
Capacity:
• Address the lack of nursing and
allied health faculty
• Address the need for additional
clinical training sites and clinical
faculty
Capacity (cont):
• Address the projected increasing
population in the western and southern
portions of Northern Virginia.
• Ensure optimal resource utilization to
increase capacity and output of
Northern Virginia educational health
care institutions.
Pipeline:
• Increase awareness of the healthcare career
fields
• Improve healthcare career preparedness in
the school systems
• Provide upward mobility opportunities
• Facilitate foreign trained healthcare personnel
to enter the workforce
Innovation:
• Enhance the adoption in Northern Virginia of
Information Technology
• Harness the potential of the healthcare
consumer
• Create innovative approaches in healthcare
human resource management
Innovation (cont):
• Nurture the career fields of tomorrow
• Develop a forum to share best practices
• Designate an organization to coordinate the
implementation of these actions
Greater Washington Board of Trade
Study Recommendation
Study Recommendations
• Raise Awareness: Educate stakeholders throughout
Greater Washington regarding health care workforce
challenges, issues, and potential ways to solve them.
• Convene the Region: Provide a forum for all
stakeholders to address the region’s health care
workforce shortage.
• Advocate for Change: Develop a policy agenda that
supports regional efforts to increase recruitment,
training, and retention of health care workers.
Next Steps
• Working to develop a cross-sector, regional
initiative to create a robust, sustainable health
care workforce.
• Hold a series of focus groups with providers,
educational/training institutions, workforce
investment agencies, and social service
organizations to garner input, build support. (Fall
2005)
The Role of the Northern Virginia
Workforce Investment Board in
Responding to Our Regional
Healthcare Workforce Shortage
Goal of the Public Workforce Investment
System and Local Workforce Boards
• To support business hiring and workforce
retention needs
• To increase the employment, retention, and
earnings of participants, and increase
occupational skill attainment by participants
• As a result, the quality of the regional and
national workforce will improve and enhance the
productivity and competitiveness of the nation
Structure of The Public Workforce System
• 643 state and local Workforce Investment Boards
(WIBs) appointed by local elected officials,
chaired by business leader
• Each board has a majority business membership
(51% ) and includes public workforce partners
• Overseen nationally by the U.S. Department of
Labor and funded primarily by the Workforce
Investment Act
Local WIBs: Composition
• Established in each local workforce investment
area
• Appointed by the Chief Local Elected Officials
(LEOs) using criteria established by Governor
and State Board
• Chair must be private sector/business
• 17 mandatory public partners must also provide
services at the Career Center
Roles of Local Workforce Investment
Boards (WIBs)
• Administer and operate the local public employment
and training system
• Convene public partners (MOU’s) & businesses to
create coordinated responses to the community’s
workforce issues
• Operate nationwide network of One-Stop Career
Centers
NOVA One Stop Employment Centers
NOVA Workforce Board
Vision and Mission
Vision:
A region where every business can attract
and retain highly skilled workers and where
every worker gains the skills they need to
become employable.
Mission:
A system that is demand-side led, meeting
business demands for a highly skilled
workforce and assisting business in
sustaining economic growth. The system
offers world-class preparations to every
Northern Virginia resident throughout his or
her lifetime.
Our Region’s Unemployment Challenge
As of June 2005
Northern VA
Research Triangle
Boston
San Diego
2.8%
4.4%
4.6%
4.4%
5.3%
Denver
Austin
Seattle
4.5%
5.1%
5.6%
Silicon Valley
United States
5.2%
Northern Virginia
Public Utilization of One-Stop Centers
NVWIB has experienced continued strong public
utilization of One Stop Centers throughout region.
While data represents multiple visits, it offers an
order of magnitude ‘snapshot’ of Center use.
2003
2004
2005
59,018
50,513
49,063
One Stop Centers offer universal access to the public,
in addition to specific employment services for eligible
job seekers.
NOVA Workforce Board
Policy Direction
• NVWIB sets policy in areas including:
– Local area’s workforce investment strategic plan
– Developing budget to carry out duties of WIB
– Coordinate workforce investment with economic
development
– Promote private sector involvement
– Select One-Stop Center Operators
– Appoint Youth Council Members along with Chief Elected
Officials
– Identify eligible training providers
– Provide program oversight
– Negotiate local program performance measures
Value of Local Workforce Boards
• Sets strategic direction for use of public workforce
resources
• Creates the infrastructure of the network of
approximately 3,000 One-Stops throughout U.S.
• Access to political leadership, training and other human
capital resources
• Board can be a neutral convener that represents key
community partners addressing workforce development
in a community
• Can leverage strategic resources for workforce
development and training
How Can Healthcare Businesses Engage
Their Local Workforce Boards?
• Make a tangible “ask” for resources and support
•
Create a Value proposition – share data
• Volunteer to serve on the Local Workforce Board of
Directors
• Help local elected officials understand what
systematic and policy changes are needed to support
local healthcare business workforce needs
How Can Healthcare Businesses Engage
Their Local Workforce Boards?
• Share case studies and best practices with private
sector members
• Publish and disseminate business testimonials about
the value to the business bottom line
• Show you understand the big picture of workforce
development
• Know the difference between operations and policymaking
Opportunities to Link with the Region’s
Economic Development Initiatives
• Federal WIA funding can be utilized to support new
business attraction and existing business retention.
Moreover, the Healthcare Industry is identified as a
National High Growth Industry:
– Worker Training Grants (ITA’s)
– On-The-Job Training (OJT) Wage Subsidies
– Incumbent Worker Training Grants
– Regional and National Labor Market Data
Online Resources To Link Your
Business With Free Workforce Services
– National Association of Workforce Boards
www.nawb.org
– U.S. Department of Labor One Stop Center
Directory http://www.servicelocator.org/
– U.S. Department of Labor Workforce One Initiative
http://www.workforce3one.org
– NOVA HealthForce
http://www.novahealthforce.com/
– Northern Virginia Workforce Investment Board
http://www.myskillsource.org
For More Information
David Hunn
Executive Director
NOVA Workforce Investment
Board
(703) 752-1606
(703) 752-1609 (fax)
[email protected]
Conclusion
Questions?
Reference and Contact Information:
www.NoVaHealthFORCE.com
http://healthcare.pwc.com
www.potomacconference.org/healthcare.html
www.futureworks-web.com
www.myskillsource.org/Home/nvwib/index.asp
www.nvcc.edu/medical
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