St. Joseph to prepare staff for new roles under health reform

September 15, 2013



Leaders of St. Joseph Health of Irvine, Calif., know that under health reform, their operating strategy will shift, with more care delivered outside of the hospital walls, under a population health model. Clinicians used to practicing in an inpatient environment will need to develop new skills to adjust to the change.

That's why St. Joseph is bolstering the capabilities of its Talent Planning and Resource Center to anticipate how the system's workforce will need to evolve under reform, and to prepare employees for jobs outside of inpatient acute care.

"As we looked at our what our strategy was going to be over the next five years, we thought there would be a lot of transitions for our employees, we thought there would be some jobs that would be eliminated … We asked, 'Couldn't we be more conscious about our development of the talent we would need and couldn't we be more responsible for helping any displaced employees find work?'" explained Deborah A. Proctor, president and chief executive of St. Joseph. Proctor challenged her human resources and mission integration departments to better support employees transitioning to the new roles.

New roles, new skills
Part of St. Joseph's strategic plan calls for the health system to work proactively with high-risk, medically complex patients to help them manage their conditions at home and keep their health status from deteriorating. St. Joseph is creating what it calls CARE Connect Teams, or interdisciplinary groups that include nurse care managers, social workers, physicians, pharmacists and health coaches, who will build relationships with these patients and work with them in outpatient settings to improve their health.

To adapt to the new structure of care delivery, clinicians are trained in the nuances of the outpatient environment, which include caring for the patient along the continuum of care, not just for episodic care. Clinicians — particularly experienced hospital nurses who are skilled at treating patients in acute health crisis — will need to become adept at helping patients proactively manage their health to avoid hospitalizations.

Jacque Maples, St. Joseph senior consultant for talent and organization effectiveness, explained that effective team health care requires that the nurse know when to contact the social worker, pharmacist or physician and how to link the home health care patient to community resources. Nurse care managers also will need to know how to build long-term, trusting relationships with patients.

Also, Maples said, nurses in the outpatient setting must be adept at assessing mental, nutritional and physical health for proactive health planning and work with patients to set health goals.

This is "somewhat of a different skill set than what exists in the inpatient setting," Maples said.

Support during transitions
The Talent Planning and Resource Center opened at the St. Joseph system office in May 2012 as an answer to Proctor's call to support displaced employees and employees whose roles will change under health care reform.

The center offers skill building and job search coaching to staff who have received notice that their jobs will be eliminated. The coaches assist employees with goal setting and resume-writing. Employees also get spiritual and emotional support. Displaced staff throughout St. Joseph's 14-hospital network can use the services for 90 days after their positions have been eliminated. The coaches help individuals locate positions inside and outside of St. Joseph.

This year and next, the center is focused on developing "talent development services" to prepare employees for the new roles that are evolving under health care reform. It is building up its internal training programs, partnering with universities and boosting its education reimbursement program for employees, so they can be ready for the future. For instance the center will help hospital nurses assess their skills and job options and help them access training specific to care coordination to prepare for new roles, according to Kate Wilhelm, vice president of talent and organization effectiveness for St. Joseph.

From 2014 to 2018, the center will broaden its scope, according to Wilhelm. It will expand its involvement in workforce planning beyond the CARE Connect Teams, develop regional centers in California and Texas to support employees in transition and partner with more schools to create specialized curriculum for employees. Currently St. Joseph is outsourcing some of the center's work to a vendor; it plans to bring much of the work in house in this third phase of its development.

Crucial question
Wilhelm acknowledged there are challenges inherent in the center's anticipatory approach to workforce readiness. "One of the most crucial questions is who will be impacted — which areas, skills, numbers of jobs, et cetera —" by the changes St. Joseph is making in how it delivers care. It can be difficult to pinpoint who could most benefit from the center's services.

Wilhelm said it can be hard to create the structure and detail needed for training programs when health care is changing so quickly. Additionally, there can be a loss of productivity in a current role while employees are training for a new role. It also can be difficult to explain to employees why their roles are changing and why it is urgent for them to adapt.

But, she said, St. Joseph is committed to preparing its staff in this way because it recognizes "the intrinsic value for retaining people with a passion" for St. Joseph's mission.

Proctor said during an Innovation Forum session at the 2013 Catholic Health Assembly that described the philosophy and function of the Talent Planning and Resource Center that that some of her hardest decisions as a chief executive are the ones that directly impact the workforce, even though those decisions are made for the right reasons. She said proactively preparing employees for the evolution of health care delivery is the compassionate thing to do.

Proctor said the concern for helping staff prepare for the future of health care is tied in with the Catholic social teaching on the dignity of work. "We have an extra responsibility" in Catholic health care to help staff adjust to the rapidly changing health care environment, she said.


Copyright © 2013 by the Catholic Health Association of the United States
For reprint permission, contact Betty Crosby or call (314) 253-3477.

Copyright © 2013 by the Catholic Health Association of the United States

For reprint permission, contact Betty Crosby or call (314) 253-3490.