Medical Personnel Presentation

1

Supply of Healthcare Personnel

June 30, 2004

Report to

AEED

Committee

Presented by: Martha Anne Dow

2


Committee Members

Martha Anne Dow, PresidentOregon Institute of Technology

Sally Henry, Executive DirectorOregon Pacific Area Health Education

Gail Pincus, Project ManagerCommunity College HealthcareAction Plan

Kent BallantyneSenior Vice PresidentOregon Association ofHospitals and Health Systems

John Moorhead, M.D.Oregon Health and Science University

Dr. Elizabeth Goulard, VP Academic ServicesChemeketa Community College

Chair

Diane Vines, CoordinatorGovernor's Healthcare Workforce Initiative

3


Nature of Problem

Critical shortage of Healthcare workers in Oregon

100,000 healthcare professionals currently employed

Need additional 48,000 health care workers by 2012

26% growth projection from 2002 to 2012

4


Current Outlook

2010- Demand for registered nurses will exceed supply by 22%

2010- Demand for allied health professions

• medical and clinical lab – 55%• medical imaging – 51%

• Radiology• Sonography• Other Specialties

• Dental Hygiene – 42%• Physicians – need 3000 additional MD graduates by 2015

• 2020 – shortage of 85,000 nation wide

5


Oregon Employment Dept. – Sept 2002 Survey

Hospitals reported:

1700 unfilled registered nursing positions

117 open radiology positions

77 unfilled LPN positions

2004 – these numbers have increased by approximately 10-15%

6


7

Supply of Healthcare PersonnelOregon Healthcare Sector – Employment Initiatives

OREGON’S overall goal is to increase the number of Healthcare Workers in targeted occupations

Radiologic technician/

technologist

Medical assistant

Medical records clerk

Pharmacist

Registered nurse

Dental hygienist

Dental assistant

Dentist

Licensed practical nurse

Certified nursing assistant/

medication aide

33.5%

30.4%

28.1%

17.2%

15.4%

14.0%

14.0%

13.8%

11.3%

10.3%*

2,100

3,800

1,100

2,400

25,600

2,800

4,000

1,100

3,500

13,200

Oregon’s Targeted OccupationsProjected Growth

2000-2010Employment

In 2000

*Many analysts think these projections are low.

8


SUPPLYOF

HEALTHCAREWORKERS

Growing Demand Accelerating Attrition

Resu

lt: Da

ng

erou

s Sh

ortag

es

Result: Affects Quality of Care

9


Factors Creating Healthcare Shortage

aging population increasing demand for services

more healthcare workers are retiring than new healthcare professionals are entering the field

education programs have reached capacity (physical facilities, faculty and staff, and equipment)

skilled workers are leaving healthcare because of working conditions

difficult to align educational and training programs to promote upward career mobility.

regulations for staffing and certifications

rural issues

10


11


12


Major Issues - Barriers

Recruitment Limitations Outreach: new and non-traditional students marketing for in-demand occupations connection to K-12

Capacity Limitations classrooms supply of qualified faculty clinical experience accommodations for students with special needs program cost and state support distance education opportunities for rural students

Education/Training Limitations financial aid distance and alternative learning and telecommunications availability retention

13


Healthcare Workforce Players

AHEC – Area Health Education Centers

ONLC – Oregon Nursing Leadership Council

OHCC – Oregon Health Career Center

OAHHS – Oregon Association of Hospitals and Health Systems

NWHF – Northwest Health Foundation

Community Colleges-Universities

14


Initiatives

2003 Legislative HB 2577 & HJR48 SB800 - HB3353 Statewide Simulation Alliance

Governor’s Healthcare Conference Initiative

Oregon Consortium for Nursing Education (OCNE)

OAHSS Workforce Liaison Group

Community Colleges Healthcare Action Plan

OHCC Grant Projects

HB2577 Work Groups

ORTCC Health – Education Committee

HB3353-Healthcare Workforce Task Force

State Board of Higher Education/Academic Excellence and Economic Development Committee

OWIB – Healthcare Section Initiative

Oregon Health Workforce Project OHSU Area Health Education Centers

15


Governor's Healthcare Workforce Initiative

Vision to expand quality and quantity of healthcare workforce

Statewide Simulation Alliance

Governor’s top priority for Federal funding

1. Create a statewide network of simulation centers.

2. Ensure that the existing telecommunications capacity

around the state is operational, accessible, and affordable.

3. Increase the number of healthcare faculty.

4. Encourage regulatory flexibility.

5. Encourage shared use of facilities and equipment.

6. Ensure the articulation of healthcare pre-requisite

courses among public and private colleges and universities.

Coalition of major statewide provider, educator, and trainer organization

Six key elements

16

Issues > Players > Solutions2003 Legislative ResponseHB 2577 & HJR 48SB 800

Governor’sCoordinator Healthcare Workforce Initiative

StatewideSimulationAlliance

OTCC HB 2577HC-EDWork Group

OCNE Oregon Consortium for Nursing Education

CCHAP Community College Healthcare Action Plan

OHCC Grant Projects

State Board of Higher EducationAcademic Excellence &

Econ Dev Committee

OAHHSWorkforce LiaisonGroup

Legislature’sHB 3353 TaskForce Governor’s/

OWIBHC Sector

Initiative

OCNOregonCenterfor Nursing

DCCWDHC WFGrants

OHCCOregon HealthCareer Center

OAHHSHC Website

OAHHSSurveys

NWHFReport

ONLCReport

AHECProfiles

HealthcareWorkforceShortages

Community College Healthcare Action Plan

17


Postsecondary Education Contributions

Community College Health Related Programs

Community Colleges w/Allied Health Programs

Blue Mountain

Central Oregon

Chemeketa

Clackamas

Clatsop

Klamath

Linn-Benton

Mt. Hood

Umpqua

Rogue

Oregon Coast

Portland

Tillamook

Treasure Valley

18



Community College have admitted an additional 475 health occupation students since 2001

235 nursing

4 dental hygiene

31 medical assistants

39 radiological techs

24 paramedics

10 sonography

50 CNA

2 respiratory care

19

Oregon Institute of Technology has a current enrollment of 750 students in allied health programs and expects to double that by 2010 if resources areavailable.



Center for Health Professions

20


Current Enrollment is at Capacity

Pre-Medical Imaging

Radiologic Science

Nuclear Medicine

Diagnostic Medical Sonography

Vascular Technology

Pre-Dental Hygiene

Dental Hygiene

Health Science

Pre-Nursing

Nursing

Pre-Clinical Laboratory Science

Clinical Laboratory Sciences

Emergency Medical Technology

Total

120

95

39

64

59

41

54

71

73

37

653

4

41

24

69

12

8

12

9

41

132

103

39

64

71

41

63

71

73

37

4

41

24

763

OIT Current Enrollment KlamathPROGRAM Falls Portland Other Total

Allied Health at OIT

21

OHSU Nursing Consortium

OHSU – Medical School

OHSU – Dental School



22

Oxygen Nursing Leadership Council (All working Directors – ONLC)

Oregon Nursing Education Consortium (ONEC) – public, private universities and community colleges


OHSU Initiatives

23

Nursing

Radiation Therapy

Dietetic Internship


OHSU Initiatives

Baccalaureate Programs

24

Medical informatics articulation with PSU

Bachelor of Science -- Computer Science

Masters of Science -- Medical Informatics

Medical Records • Partners – community colleges


OHSU Initiatives

Academic programs under development

25

Medical informatics

Public Health

Clinical


OHSU Initiatives – Graduate Programs

MD -- physicians

DMD -- dentists

Masters Level Doctoral Level

Activities - MD – increasing class size slowly – 90 to 108

Activities - plan for a new building - current class size – 74 - developing regional programs

26


Unique Partnerships

Between:

community colleges

higher education

private medical industries

• hospitals

• clinics

• equipment providers

27

Supply of Healthcare PersonnelExample of Workforce Initiatives Outside of Oregon

WICHE West: Meeting workforce demands in mental health through regional partnerships.

Seattle Community College District Healthcare Education Institute coordinates allied health programs between campuses

Milbank Memorial Fund and Reforming State GroupsStrategies for State Policy

Increase supply – effective recruitment Improve quality of care Promote effective delivery system Limit increasing costs Create a more culturally, diversified workforce Improve quality of working environment Career ladder Labor serving technologies and improved information systems

28

Supply of Healthcare PersonnelExample of Workforce Initiatives Outside of Oregon

How states have responded to nursing strategies - WICHE

2001-2003 legislative initiatives focused on the educational pipeline attracting a more diverse pool

Western States:

California – standardizing nursing programs Colorado – legislation for admission policies and a career path program New Mexico – Nursing Licensure Compact Nevada – Nursing loans Oregon – Nursing Services Program OSAC – pay part of student loans NLC – double enrollment by 2004 – redesign nursing education Wyoming – Internet Courses

29


Return on Investment Economic Development

Healthcare Industry -- An Engine for Economic Growth

Employs over 100,000 people -- Generates $4 billion dollars annually

Oregon’s hospitals employ – 40,000 annual payroll $1.85 billion

Average salaries - $48,000 + $13,000 benefits

Health occupations will be 11% of job growth by 2012 – adding 15,000 jobs.

30


Solutions – Prescription for Success

Increase educational capacity and pipelineFill enrollment in key jobs

Nursing – ADN and LPN pharmacists dentists dental hygienists radiologic techs medical records assistants

Increase availability of qualified Faculty

Scholarships – coordinates with ASSET initiative

Partnerships with healthcare

industries

Employers

Tele education

GOAL: 1

Assure that public and private educationalinstitutions have adequate financial resourcesto offer healthcare programs.

Assure faculty salary scales to recruitqualified teaching faculty.

31



Increase clinical capacity

GOAL: 1 continued;

Assure rural and underserved areas have access to facilities.

Provide incentives to employers to increase clinic capacity

Plan, fund and design simulation centers

32



Enhance the quality of educational experiences

GOAL: 2

Assure rural and underserved areas have access to facilities by 2003

Focus on competencies

Increase learning opportunities

• distance learning

• flexible scheduling

Provide stable funding for community colleges and universities that accounts for the higher costs in healthcare programs

Develop partnerships among education and private sector associations

33



Enhance Retention and WorkEnvironment

GOAL: 4

Develop legislative initiatives withimplementation plans

GOAL: 6

Build a Centralized Workforce and Education database system

GOAL: 5

Improve Recruitment ofHealthcare Workers and students

GOAL: 3

34


Potential Partners for Resources

Dept. of Education Dept. of Labor Dept. of Human Services

Federal Funds

Community colleges/universities Hospitals Equipment companies Other health related industries

Public/private Partnerships

OHSU Nursing Consortium Center for Allied Health Professions

• OIT/Community Colleges/hospitals

Pilot projects

35


Return on Investment -- Economic Development

To Make A DifferenceShort-term strategy

(1-5 years) Provide investment dollars for expanding enrollment in nursing and allied

health education programs to double graduates.

Coordinate recruitment efforts traditional and non-traditional students

Support the development of key partnerships (public/private)

Support better workforce data and medical information systems

Recommendation:Investment to support academic program expenses to double enrollment and graduates

• faculty

• physical facilities

• medical information system programs (education and industry)

36



To Make A Difference

Medium-term strategy(5-10 years)

Incentives for graduate programs for new faculty in healthcare

Improve efficiency of healthcare systems to meet challenge of rising medical costs Develop information systems

Develop legislation that facilitates incentives for employer-funded endowments targeted scholarships for health professions programs

37



To Make A Difference

Long-term strategy

Stabilize funding for healthcare education

Develop a culture of public/private partnerships

38


Supply of Medical Personnel for

Academic Excellence/Economic Development

Key Initiative

39

OREGON BELIEVES IN DREAMERS

A Dream Come True!

Partnerships with education and medical industriescan make a quality Healthcare system for Oregon.

40

Supply of Healthcare PersonnelReferences and Resources

Clackamas Community College: The WIN Program: Re-entry into the Profession of Registered Nursing.

Community College Healthcare Action Plan (January 2004): Status Report: LinnBenton/Lane Challenge Grant.

Community College Healthcare Action Plan (January 2004) Status Report:Cascades East AHEC (CEAHEC) Nursing Education Project.

Community College Healthcare Action Plan (January 2004): Status Report: LPN Project.

Community College Healthcare Action Plan(January 2004): CCHAP Flash: 2ndUpdate: Simulation Technology Within Oregon.

Community College Healthcare Action Plan (February 2004): Status Report: Prerequisite Project.

Community College Healthcare Action Plan(November 2003 and January 2004):CCHAP Linkages.

Community Colleges and Workforce Development (Spring 2002): Health CareEducation and Training in Oregon: The Community College Challenge.

Community Colleges and Workforce Development (January 2002): CommunityCollege Healthcare Action Plan.

Community College Healthcare Action Plan (February 2004): CCHAP Flash: 3rdUpdate: Simulation Technology Within Oregon.

41

Supply of Healthcare PersonnelReferences and Resources continued:

National Academy of Sciences (2002): Unequal Treatment: Confronting Racialand Ethnic Disparities in Health Care.

Northwest Health Foundation (2001): Oregon’s Nursing Shortage, A PublicHealth Crisis in the Making. www.nwhf.org.

Oregon Center for Nursing (December 2003): Technology in Nursing Education.Completed by Loretta Krautscheid, RN, MS and Deborah Burton, PhD, RN.

Oregon Consortium for Nursing Education(March 2004): Update on Progress.

Oregon Employment Department (July 2003): Employment Projections byIndustry 2002-2012.

Allen Dourma: The Cast of Medical CareA Challenge and Business Opportunity

Oregon Employment Department, Workforce and Economic Research (2003):Employment Projections by Occupation 2002-2012. Statewide and Regional.Available at: http://www.qualityinfo.org/pubs/occpro/03/pdf/occproj.pdf

Oregon Employment Department (2001): Labor Market Information. Health CareIndustry Trends. Completed by Lynn Wallis.

Oregon Health Career Center (January 2004): LPN Supply & Demand: TheFuture of Licensed Practical Nurses in Oregon.

Oregon Health & Science University, Area HealthEducation Centers Program (2000): Oregon Health Workforce Project: Registered Nurse Profile.

Oregon Nursing Leadership Council: ONLC Strategic Plan: Solutions to Oregon’sNursing Shortage. http://www.osbn.state.or.us/pdfs/onlcpl_1.pdf

http://www.nwhf.org/

http://www.qualityinfo.org/pubs/occpro/03/pdf/occproj.pdf

http://www.qualityinfo.org/pubs/occpro/03/pdf/occproj.pdf

42

Supply of Healthcare PersonnelReferences and Resources continued:

Oregon Workforce Investment Board (Fall 2002): Health Care Sector Employment Initiative: Taking “AIMM” at a Growing Crisis.

U.S. Bureau of Labor Statistics (November 2001) Monthly Labor Review: Occupational Projections to 2010. Completed by Daniel E. Hecker.http://www.bls.gov/opub/mlr/2001/11/art4full.pdf.

U.S. Government: 1996 National Sample Survey of Registered Nurses.http://bhpr.hrsa.gov/healthworkforce/reports.

U.S. Health Resources and Services Administration (July 2002): Projected Supply, Demand andShortages of Registered Nurses: 2000-2020.

Panel Presentation (May 2004): Oregon’s HealthcareWorkforce Universe: Issues, Players and Solutions

Oregon Health Workforce Project (2002): DentalHygienist Workforce Report

Community College Healthcare Action Plan (February 2004): Healthcare Workforce DevelopmentSolutions: Community College & HealthcareProvider Partnerships

Western Interstate Commission for Higher Education WICHE (September 2003): Rural Mental Health in the WICHE West: Meeting Workforce Demands through Regional Partnership

Western Interstate Commission for Higher Education (WICHE) (June 2003): Registered Nursing Shortages: Public Policy, and Higher Education in the Western States

NEON Nursing Education Access Partnerships Meeting(February 2004)

Milbank Memorial Fund Electronic Reports, TheReforming States Group (September 2003): Making Sense of the System: How States Can Use Health Workforce Policies to Increase Access and Improve Quality of Care by Edward Salsberg.

http://www.bls.gov/opub/mlr/2001/11/art4full.pdf

http://bhpr.hrsa.gov/healthworkforce/reports

Medical Personnel Presentation

Documents

number of healthcare

number of healthcare

new healthcare professionals

health care workers

health systems john

field education programs

demand occupations connection

equipment skilled workers