staffing issues

The March
Your hospital staff in 2025:
The same, only different

FRAMING
THE ISSUE:
• By2025, Millen-
\ niais will make up
; the majority of the
! workforce.

• Hospitals need to
: ramp up discus-
; sions about how to
: attract and retain
I Millennials.

The 2025 workforce

will need more col-
laboration, relaxed
rules and improved
face-to-face com-
munication. Medi-
cal professionals
will have to be
technologically
nimble.

Increased sched- f ith their immediate future dominated by Every chance he gets, Meyer talks up projected vacancies to
uling flexibility, patient satisfaction surveys, reducing read- the 250 University of Kansas premed students who volunteer
sabbaticals and missions, reporting on quality measures at his hospital every year.
phased retire-
and coming to terms with new financial In one telling sign of the changing times, Lawrence Memo-
ments will be
more and more and payment realities, looking ahead to the rial deliberately avoids meddling in employees' use of social
appealing to both year 2025 might seem like a luxury no hos- media, even though all that Facebook and Twitter time can tax
hospitals and pital executive can afford. But at Lawrence (Kan.) Memorial the hospital's bandwidth. "We're probably being more liberal
employees. [with social media policies] than we should," says Meyer. "But
Hospital, Chief Executive Officer Gene Meyer and his col-
Social media leagues say gearing up for a dozen years from now is hardly a we've been reluctant to ban any of that simply because this is a
is important to waste of time, especially when it comes to workforce issues. way of life for so many of the folks who work for us."
younger employ- With a fiood of boomer retirements on the horizon, the Thinking ahead to a workforce that will look very dif-
ees. But it changes
hospital has launched an "emerging leaders" group for employ- ferent from today's is essential, says Jaciel Keltgen, a health
so fast, who knows
what it will be like a ees in their 20s and 30s. And it's positioning itself as a go-to care workplace consultant and assistant professor at Augustana
decade from now. place in the intensifying competition for primary care doctors. College in South Dakota who specializes in hiring, training and

ABOUT THE SERIES: H&HN's "Generations in the Workplace" series

focuses on the challenges of four generations working side by side: the
conflicts that arise, the need to prepare future leaders and the difficulty
recruiting young trustees. In November's final story, eight hospital lead-
GENERATIONS ers reveal one thing they did to improve inter-generational relations.
IN THE WORKPLACE

38 H&MH / SEPTEMBER. 2013 / www-h Photography by iStockphoto

retaining Millennial employees. By 2025, Millennials — a gen-
eration that currently ranges from middle school-age to their
early 30s — will dominate the workforce, perhaps as much
as 75 percent, according to a 2011 study by the Business and
Professional Women's Foundation, The size of the Millennial
generation is double that of its immediate predecessor. Genera-
tion X, And its members will be filling a gaping void left by
retiring baby boomers.
Learning how to recruit and retain Millennials is "one
more wrench thrown into the works" for hospital leaders
already dealing with multifaceted disruption in their field,
Keltgen says. Hospitals are "going to have to figure out what
Millennials expect, and what they can do to attract them to their
institutions and keep them there,"
Human resource departments will have a lot of ground to
cover in the coming years, acknowledges Stephanie Drake, exec-
utive director of the American Society for Healthcare Human
Resources Administration, "They've started talking about how
they're going to attract and retain Millennials," she says, "But no
one's there by any means. And there really isn't a lot out there to
guide them,"

Jobs will change, too

There's one more factor that will complicate matters: Some
significantly different kinds of skill sets wiU be needed to meet
the demands of a transformed health care system.
The push toward patient-centered medical homes puts Email? Facebook?
primary care front and center; to make up for the shortage of
primary care physicians, the need for advanced practice nurses
That's Grandpa's social media

win surge, A July report in Medical Care predicted the number
of nurse practitioner jobs will climb from 128,000 in 2008 to
244,000 in 2025,
Hospitals vdU be compelled to hire more community health
care workers to increase outreach, promote Wellness and reduce
unnecessary emergency department visits and readmissions.
With population health a growing hnperative, employees
with expertise in data collection and analytics combined with an
understanding of health care vdll be in high demand,
A mandate to keep patients out of the hospital and in
their homes means clinical and nonclinical staff with advanced
telehealth skills will be sought.
None of this takes into account the aging of the patient popu-
lation and the need for many more staff members with geriatric
training. Or advances in genomics to better predict disease and
personalize ti-eatments that will require a specialized knowledge
base. Or the head-spinning advances in information technology
that will continue to revolutionize health care in ways no one can
precisely predict, but that somebody in the hospital had better be
able to assess and, if appropriate, implement.
Rick Sherwood, a senior consultant at Towers Watson who
advises health care clients, says the most desirable employees will
be nimble in areas that in the past haven't been lumped together —
for instance, having the clinical skills of a nurse, but also expertise
in using electi-onic health records and handheld devices.
I
f they want to recruit younger employees, hospitals whose social media
policy consists of posting on Facebook a few times a week will need to step
it up, says Jill Schwieters, president of Pinstripe Healthcare, a talent man-
agement and recruiting firm. "We all need to learn how to communicate and
interact with Millennials. These are young people who are used to talking with
six different people while playing Xbox. This is a workforce that's been com-
municating on Facebook. They don't text anymore; they certainly don't send
and receive emails. Everything's two- and three-word answers."
She advises hospitals not only to devote more resources to external social
media, but to turn their gaze inward, as well, so people can communicate effi-
ciently within the organization. "Look at internal communications and tech-
nologies that you're investing in, so you've got a platform where people can be
communicating department to department or hospital to hospital," she says. "If
you think about a health system, how many different departments, how many
different hospitals, how many different venues will there actually be? You need
to make sure you've got the right digital platform to support real-time accurate
and effective communication. And as it advances, keep up with those advances."
What will social media comprise in 2025? With communication tools
changing constantly and quickly, trying to foresee that is an exercise in futil-
ity, Schwieters says. "My son would say, 'Grandma ruined Facebook, so we're
doing Instagram now.'"
She advises hospitals to stay connected to area colleges and bring young
job interns into the organization to stay current. "Those will be the folks who
keep you in sync with what the trends and the best modes of communication
are," she says. - LAURA PUTRE •

Photograph b y Steve Woit www.hhnmag.com j SEPTEMBER, 2013 / H&HN 39

staffing-issues
Because of the increasing complexity of health care as a
business, Sherwood says managers will need training in skuls
borrowed from other industries, like Lean principles from
manufacturing and management-consulting principles from
financial services.
However, experts caution, before hospital executives
decide to create new positions or redeploy staff for future con-
tingencies, it would behoove them to understand how younger
professionals differ from their elders temperamentally and oth-
erwise, and how that will impact the organization in the future.
As noted in earlier installments of Hospitals & Health Net-
works' Generations in the Workplace series, Mülermials tend to
be hungry for praise, impatient with certain processes, super-
connected to IT, eager to advance and insistent on a balance
between their work and their personal lives. They will balk at
long meetings and excessive paperwork. They will flout work-
place rules they view as rigid and still in place "just because
that's how we've always done it."
Not even the most hidebound hospital executive should be
surprised to know that Millennials vnll look to IT to communicate
with colleagues and patients, to place and fill medical orders, and
to find answers to almost any question that may arise — even
before they consult with their more experienced elders.
I Social media is 'an everybody thing*
Jay Kuhns, the high-energy vice president of human resources
at All Children's Hospital in Tampa, Fla., doesn't pretend to
know what the health care workforce of 2025 will look like. But
that doesn't mean he can't start preparing now.
Everyone talks about an ongoing nursing shortage in the
next 10 years that only will become more dire. His take: "There
are plenty of nurses. I just need to make sure they're working
at my hospital."
H&HH / SEPTEMBER. 2013 / wivtv./t/lnmiis.com
The best way to get that done, Kuhns figures, is to make
sure the right people bump into All Children's repeatedly on all
the social media channels. And the content should be engaging
— telling stories with words, photos and videos.
"'Career-minded, self-starter,'" Kuhns scoffs, conjuring job
board jargon. "ITiat stuff just bores me to death."
At All Children's, a new nurse blogs about her experiences
behind the scenes. The transport team writes a periodic series
about their adventures. The hospital home page features "Shift
Change," a one-minute video with action music that includes
fast-paced scenes from a single day at AU Children's mixed with
shots of Central Florida night life and beach sunsets.
The hospital also has a Pinterest site that includes patient
stories; a hip-hop hand-washing video produced internally that
won a public service Emmy; and a picture of cute kids participat-
ing in the hospital-sponsored Walk to School Day.
Social media isn't a "young person's thing," Kuhns insists.
"It's an everybody thing." Nevertheless, the hospital staff defi-
nitely skews young. Though Florida has the highest 65-and-older
population in the cotmtry, the average age of an All Children's
employee is in the low 40s right now, "and we continue to attract
younger and younger employees," he says.
Hospitals also should bring social media into their internal
communications strategy, says Jeanne Meister, a corporate consul-
tant who writes about the future workplace for Forbes. For instance,
a platform called Yammer allows administrators to quickly survey
employees, lead discussions on creative solutions to problems, and
find out how new vendors or hospital policies are working out.
"Companies are beginning to research different generations
of employees the way they would research a new product or
service," Meister says. "In many hospitals, they have a culture
survey or a vision-and-values survey. One of the things they're
starting to do is add a generation screen to understand the differ-
P h o t o g r a p h s u p p l i e d h yAll Children's Hospital
staffing*issues
ent needs for the delivery of training." There's
less interest in classroom training among young-
er employees, she notes, and more use of mobüe
devices and online games as teaching tools.
^ AU staffing needs are local
In northeastern Ohio, training a new generation
of workers is especially chaüenging because more
Millennials are moving out of the region than mov-
ing in, says Elliott Kellman, chief human resource
officer for University Hospitals. "The statistics are
working against us," he says. "Our population's
gefting older, not younger."
To keep their employee pipelines fiowing,
four competing hospital systems in Cleveland
- UH, MetroHealth, the Cleveland Clinic and
St. Vincent's — have struck up a collaboration.
Using a $50,000 grant from a local foundation,
they've hired a consultant to put together a
report on what the future health care needs of
the region wül be and what the existing resourc-
es are at area colleges.
Once the report is complete, they'll partner
with the colleges to make curriculum changes
that better fit their needs. Two universities —
Case Western Reserve and Cleveland State —
already have signed on.
"If we're going to make this successful, we
have to cooperate with the schools and cooper-
ate with each other to grow the workforce for
the future," Kellman says. "Our intention here is
to do a good workforce assessment — not on 100
jobs, but get down to two or three or four jobs
that we know are going to be in short supply."
The final results aren't in yet, but Kellman
anticipates the most immediate need wiU be for
advanced practice professionals, including physi-
cian's assistants and nurse practitioners.
UH also brought in a career coach to work
with employees and increase internal hiring.
"That Gen Y group — and it's not just entry-
level employees — has no idea how to manage
their careers, or write a resume, or manage an
interview," Kellman says.
In the year since the career coach signed
on, internal hiring has increased by 198 jobs.
In Minneapolis, Fairview Health Services
consults statewide demographic information
compüed by the Minnesota Hospital Association to
help determine the needs of its future workforce.
Relying on self-reported information from 107
hospitals, the database tracks workers in 38 dif-
ferent job types. The findings can be eye-opening;
for instance, in 10 job categories, more than 30
42 / SEPTíN\BÍR.20-\3 / www.hhnmag.com
percent of workers are nearing retirement.
"This data can be reaüy powerful because
as a big system, and as a state, we can present the EXECUTIVE CORNER
information to our coüege partners," says Laura
University Hospitals in Cleveland and Fairview
Beeth, Fairview's director of talent acquisition. "So
Health Services in Minneapolis have campuses
if we say, 'We're going to need more nurses,' we
in neighborhoods where people are eager to
have concrete data so they can see how many slots
work, but don't always have the necessary
they have totirainand educate nurses."
education. With training, they can be hired for
entry-level positions and eventually go to col-
How rewarding is a smoothie? lege and move up within the hospital. Elliott
Hospitals may not have the glamour quotient of
Kellman, chief of human resource at UH, and
a DreamWorks Animation, where the workforce
Laura Beeth, director of talent acquisition at
is 20 percent Miuennials, the retention rate is 96
Fairview, shared some of their approaches to
percent and juice trucks parked on campus hand
developing talent close to home.
out free smoothies. What they can offer Miüen-
nials is the chance to make a difference in a big
I What are some of the
way, says leadership consultant Erica Dhawan.
challenges you face?
"To actuaüy connect hospitals together across the
Kellman: We find a lot of folks who are Gen
world and learn and share with each other — that
Xers and Millennials, who want to go to school,
would be something that would reaüy excite Mu-
and then they fail because they're not ready.
lennials, Dhawan says. "Or finding ways to use
We have a program called Bridge to Your Future
social technology to help solve problems and teü
in which we prepare people. One hundred and
stories about patients. Or to connect with patients.
eighty-four employees have gone through the
That would excite Millennials."
program; 51 have graduated from college and
Hospüals actually score weü in a 2013 sur-
27 found jobs at UH.
vey of 9,000 high school and coüege students and
young professionals, conducted by the National
I What sort of neighborhood
Society of High School Scholars. When asked
outreach do you do?
where they would most like to work, respondents
Beeth: We start young. We have initiatives
gave health care organizations seven of the top
with high schools. We're the corporate spon-
20 spots.
sors for their health care programs. We also
Müce Supple, senior vice president for B.E.
do community-type work. We have a week-
Smith, a health care leadership recruiting firm, is
long health care scrubs camp for people who
optimistic about hospital management in 2025,
live in the neighborhood around our largest
with entrepreneurial Gen Xers running the
hospital. We have 74 people in it. They tour
show and plugged-in Millennials right behind
our facility, take classes and learn about the
in middle management positions. "It's a really
different health care professions. We offer
nice combination of having both experience and
a new program called Fellows for people in
youth to bring different innovations and efficien-
community colleges who may not have a
cies to the market," he says.
clinical rotation but want to work in health
Andrew Chastain, managing partner of
care. Instead of working at McDonald's, they
recruiting firm Witt/Kieffer, says, "There are
can work with us in more entry-level jobs
stereotypes of [Gen Xers and Mülermials], about
until they finish their education.
their desire, their work ethics, their priorities. I
don't run into that at all. People who have been
I How can woricers move Into
successful are hardworking and stimulated by
more skilled positions?
the industry they're in. They're no different than
Kellman: We have a program called Pathway
executives at that level 15 years ago."
to PCA specifically to move service workers
Supple agrees. "It really is striking how
into patient care positions. Ten employees
simüar these generations are in regard to what's
have gone through that program. We also
important to them," he says. "They want oppor-
have GED classes and we're partnering with
tunities for advancement. They want work that
the Literacy Cooperative of Greater Cleveland
is chaüenging. They want opportunities to learn."
to teach adult basic literacy. We've been try-
— Laura Putre is a freelance writer in Cleveland. •
ing for the past year and a half to get people
to take the GED, then go to Bridge to Your
Future, then go to our career coach. •
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