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School of Medicine
- Identify institutional needs
- Program model
- Plan process steps
- Identify resources
- Plan facilities
- Plan hardware & software
- Set up tracking database
- Plan & recruit staff
- Plan governance
- Working with the legal department
- Working with the union
- Marketing plan
- Sustainability plan
A thorough environmental scan of the institutions skill shortages is critical to a workforce development plan. Project REACH used a several pronged approach to the environmental scan. This process should begin a least one year in advance of a budget year. It may take this long to get all of the institutional needs identified with such a large hospital health system and such a big project. This includes: sharing information about the grant and its goals; pre-planning the program structure; building business cases for the executive leadership; negotiating for space; talking and developing other resources for funding that would represent the institutional match; and begin conversations with partners.
Meetings with department administrators took place to discuss the future plans for departmental development, such as expansions or consolidation of department responsibilities, new technology that would require skilled staff, or other changes the departments may foresee in the future. This would be the best time to develop an Operations Committee of department leaders that will serve as advisors for the project. (See Plan Governance.)
Staffing projections conducted by the Human Resources Career Services Department (HRCS) is another critical source of support and information when determining institutional need. JHHS HRCS is the gatekeeper for the institution. They work closely with departments to fill their vacancies, and determine future staffing needs. In addition, CSD plays a critical role in the internal transfer process within the institution, which will impact the incumbent trainee’s placement.
The staffing needs should be the basis by which the determination of the number of incumbent workers that will be served should be made, as well as, the types of trainings that will be needed. This will then enable a rough financial cost projection to be formulated.
Working with affiliate and divisional VPs early on in the planning process will set the foundation for the level of cooperation and support that the project will receive during the execution phase. This is extremely important as financial/budgetary decisions will need to be supported by this group. This group should make up the project’s Steering Committee, which will provide ongoing strategic direction.
Arrangements with Local 1 Stop Centers for a variety of services (backfill pool, assessments, life-skills support referrals) should be established at this time, even if exact numbers of employees served is still a rough estimate.
The structure of the model was driven by the concept paper and two main factors: utilizing already existing systems within the HR department and the time frame approved by the Department of Labor for the grant lifetime.
The decision to weave the program model into already existing policies, procedures and practices was crucial to marketing the program and gaining the support of affiliates and departments, a critical factor in getting participants; making the process seamless to current employees; not creating system changes where they were not needed, however, there were some changes made to established practices within HR as a result of the grant; adhering to the grant life span, a critical factor in addressing the business reality of this endeavor; and most importantly, ensuring the possibility of sustainability.
This grant had an 18-month life span. The institution learned of this grant and applied for it very close to the end of the application deadline. With this in mind, weaving the program model into existing programs also made logical sense. In addition, using existing programs supports sustainability after the grant expires. It is known that the work of the following departments demonstrated that the Institution was committed to workforce development, and this addition support provided by the grant would bring these programs to scale and enhance and further the work already accomplished.
Fortunately, Johns Hopkins had already been supporting entry level training programs like those highlighted in the grant concept paper, but on a smaller scale through the HR departments Office of Community & Educational Projects (OCEP), which housed the Skills Enhancement Program. This office and program provided GED training; departmental trainings such as: surgery technician, lab tech 1s, pharmacy technician, nursing (LINC); math and reading for college entrance exams; medical terminology, and computer skills.
Also, the office of Organizational Development & Training (ODT) in HR partnered with the city’s community college to provide additional developmental and first year courses on-site. These courses provided employees with an opportunity to start their college experience in a familiar environment with the goal of completing a degree at the college. This office also provides training and development for management (leads, supervisors, and managers). It is critical for entry level employee success to have those in management positions to be well trained and connected to the needs of their entry-level staff members.
Additionally, for college-based training Johns Hopkins’ existing Tuition Assistance Program was utilized to pay for tuition costs for Associate Degree bearing programs. This feature of the program was the institutional match to the grant funding stated in the concept paper. Tuition assistance varied among the affiliates: the amount of support, which trainings were supported (degree or certificates), and the advancement of tuition or only reimbursement. The program/project made adjustments in their process for each of these. (See process document.) <project_reach_process_0805.pdf>
The different stages of the grant plan required a process that complemented already established institutional procedures (i.e., tuition assistance, on-site skill development services, internal transfers, HR/departmental policies, etc). This ensured cooperation from departments and sustainability. During the course of developing the process for this type of project one may find that a policy or practice should be updated or changed completely. If there is true institutional support at all levels of the organization a plan for making a system change can be initiated. It is also helpful to develop a diagram or flowchart to assist in visualizing how each stage of the process can easily be adapted to current organizational practices. This project developed a grant process and participant flowchart to assist with this task.
Several meetings conducted with affiliate/divisional VPs, Department administrators, and state and city agencies uncovered in-house and external resources for the program. The meetings held within the organization enabled the project to identify staff members who would serve as contact people for the project; and resources that can be shared, such as the office space secured for the project. The state and city agencies provided the project with information on possible training providers, assessment tools, backfill and other community service resources. As a result of these meetings the project was able to secure contracts for the following services: assessments with MOED, training with Maryland Center for Arts and Technology, medical coding training with MC Strategies and HP3, surgery technician training with Baltimore City Community College, anesthesia critical care technician training with the Community College of Baltimore County, and pharmacy technician training with Baltimore City Community College.
It is never too early to locate a space for administrative and training purposes. The start of this program and the negotiations for facility space occurred simultaneously. The manager had an office in the offices of ODT initially until an office space was finalized. There is a scarcity of extra space for meetings and training in most institutions, and given the nature of this type of program there are some specific needs, as far as, facilities are concerned that should be considered. The program office should be centrally located to the department/employees that it will be serving. Ease of access will impact the number of employees who will participate in an ongoing manner.
The project eventually secured space, but it was shared with another department. The space secured consisted of: a receptionist and waiting area; manager's office; two coach offices, which were shared by the coaches; an assessment facilitator office shared by the facilitators; a computer room, where computerized assessments, skill development, and some training activities took place; and a multipurpose room, where paper and pencil assessments, information sessions, classes, and other project activities were held. The project shared a conference room with another department. The project's staff assistant maintained a usage calendar of this room with the other department and scheduled the project's staff and training development meetings in this space. For the most part this arrangement worked, however, for privacy reasons it would have been beneficial of the coaches to have separate offices where they could conduct their meetings with employees. Most often the coach moved to a free space if they had a meeting while their office mate was using the office.
Also, when working with affiliate organization that may be a distance from the main office, it is imperative that an on-site location be determined at those affiliates where employees may be able to access services if a face to face meeting is necessary. To address the distance issue some services were provided on site at the affiliates. In addition, coaches maintained contact with employees and their departments electronically.
If assessments are done on site, there should be enough space for physical comfort and privacy. The project had two separate locations set aside for assessments: one for computerized assessments and the other for paper/pencil assessments. Additionally, the assessment location should have proper lighting, maintain a comfortable temperature, and should be in a quiet low traffic area. Given our space limitations, we had employees taking computerized assessments in the same room as employees utilizing computerized skill development programs. This was not the ideal situation as there were inevitably interruptions by either groups using the room that may have affected the other. The project developed a policy of monitoring the room once it was in use so that there was a staff person available if a question arose about the assessments or programs the employees were using.
The space requirements will not be an issue if assessments are conducted by the One Stop Centers. However, accessibility to the 1 Stop by the incumbent workers is a high priority. Their ability to take assessments will be greatly impacted if they have problems with transportation etc.
The decision to go wireless made for ease of the staff (assessment facilitator) to conduct work off-site with affiliates that were located a distance from the central office. The wireless option also was the most timely and cost effective choice. The time and cost associated with wiring the offices would have delayed the project's ability to move in to that space. The project purchased Dell computers, and were provided with the software and access used by the rest of the Human Resources department. Program documents were stored on a shared drive with the rest of the Human Resources department. The use of the shared drive made it easy for the departments this project worked with to share information. Some of the affiliates were not connected to the same system, and, therefore, other technological means were used to share information. The sharing of information would have been much easier and timely if all affiliates were connected technologically with a shared system.
The project used an excel database to track the employees’ progression through the project. The use of an excel database was made based upon timing of need. The project explored other options already used by the institution, which took a great deal of time to negotiate due to the magnitude of the tracking needs of the project. A better tracking program that was readily available may have been Microsoft Access.
The immediate project staff consisted of: 1 staff assistant, 4 career coaches, 2 assessment facilitators (contracted with the Mayor's Office of Employment Development (MOED)), 1 evaluator (contracted with Johns Hopkins University), and 1 manager. The coaches and staff assistant were internal hires, and had a familiarity with the institution’s culture, department managers, and policies. They also were familiar to the incumbent employees, which was helpful in establishing a comfortable rapport sooner. Also, the project had members of the finance and legal departments assigned to work on those issues. It is recommended that a project coordinator position be included. This position would serve as a training coordinator and handle the maintenance of the database.
A project of this magnitude requires a great deal of institutional support. However, for it to be support that is effective and not cumbersome it is important to make sure that the right individuals participate, and that the number of people are managed. This became somewhat of a challenge. Select these individuals as early as possible. Given that a project of this kind should be governed through an institutions Human Resource department, the VP of HR should be the point person from the executive level of the organization, and there should be a key financial person, manager, and evaluator. The selection of a core group of individuals (assessors, career coaches, and administrative support) who will implement and execute the project should be the very next group selected. Another position that should be included that is not reflected in the organizational chart highlighted below is a project data coordinator. This person would be responsible for the data input of participant information, financial tracking, etc. This would ensure the integrity of the data, and that there is one point person when there is need for information verification. This group should assist with every aspect of the project from planning & infrastructure to continuous improvement.
Two committees were established to assist with the management of this grant: a steering committee and an operations committee. The steering committee is comprised of Presidents and Vice Presidents of the participating Hopkins affiliates and major divisions, and met on a quarterly basis. This committee’s scope and purpose are as follows:
Scope: To advise the REACH project leadership and staff regarding the strategic aspects of the project initiative.
Purpose: To provide executive level support to the project; to review and advise on critical issues and decision points; and, to review project processes and progress that guarantees sustainability and return on investment.
The operations committee is comprised of department administrators and managers from across all affiliates, and met on a monthly basis. This committee’s scope and purpose are as follows:
Scope: To advise the REACH project leadership and staff regarding the operational aspects of the project initiative.
Purpose: To provide support and guidance to the individuals charged with the implementation and execution of Project REACH; to provide assistance in addressing specific difficulties that may arise; and, to help document lessons learned.
A major part of the Planning & Infrastructure stage is working with the institution's legal department. All arrangements made with outside agencies were legally binding and had to be reviewed by the legal department. This at times could be quite a lengthy process depending on the agency. Again, up to six months should be set aside for the back and forth of contract negotiations.
Once the program process has been determined, that plan should be reviewed by someone in the legal department to make sure that there are no violations to labor laws or the union agreement. Also, issues pertaining to the handling of employees who utilize intermittent Family Medical Leave (FML) or who enter into performance infractions at any time during the program process must be planned. Employees who were already taking intermittent FML made special arrangements with their departments regarding their schedule. A schedule that allowed the department to still function, and still allowed supported employees to take advantage of this opportunity was not an easy task to accomplish. However, because the department really supported the employees they were able to come up with a plan, which is a crucial part of the success of a program of this kind.
Lastly, the legal department developed the service commitment contract each employee supported by the grant must sign. The Service contract outlined the institutions commitment to the employees, and the employees' commitment to the institution during and after training. The institution agreed to provide the employee with full salary and benefits during training even though they were only actually working part-time in the department. The employee agreed to remain in good standing with their current department and with their training provider during training, and stay employed with the institution in their new position for a set amount of time post training. For trainings that were less than one year the employee agreed to work for the institution for one year, and for every year of training the employee would work a year. The contracts were then signed by the Vice President of Human Resources, the Director or Administrator of the current employee department, and the employee. Once the employee completed training a copy of that agreement was sent to the new department. It is important to make sure that the current manager also receive a copy of the contract because they will be working most closely with the employee and will need to know more intimately the provision disclosed in the contract.
Working with the union on this program went well. While an in-depth knowledge of the union contract may not be necessary, it is imperative that when working with union employees or training for a union position that we include legal and the Human Resources Consultant for that area. We needed to be aware of a few things when dealing with union positions, however. First, we had to be careful with backfilling of positions. If there were current union employees who were working under hours the department needed to make sure that they offered those individuals the hours before brining someone in from the outside. Also, if someone was brought in temporarily from the outside, but worked longer than three months they automatically became a union person, therefore, making sure of how backfill was handled was crucial.
Also, as union employees went into training they needed to be aware of the fact that the position they are seeking to fill may not be a union position, and, therefore they needed to be aware that their annual increases would depend upon their performance review. Union employees receive an automatic standard pay increase regardless of performance. Lastly, there is a different formula for calculating starting salaries when moving from a union to a non-union position and vice versa. Working with Career Services to make sure that employees understand how their salaries will change was very important.
Informational meetings were held with directors of The Johns Hopkins Hospital departments and with the senior management teams of the affiliate hospitals/divisions. This meeting covered the broad concept of the grant, its long range goals, a managerial fact sheet and frequently asked questions. It also served as a way to gain insight into preliminary concerns or obstacles that needed to be addressed in the planning stages and the establishment of the infrastructure.
Most participants at these meetings were eager to learn of the details on how the grant would operate so that they could advise their departments accordingly. However, these meetings took place too early in the process to be able to fully answer their questions. Therefore, it took several conversations and referrals to department managers to gather a full understanding of how the process would flow for all six affiliates.
We also held a marketing/recruiting blitz with tables in the main corridors of two JHHS hospitals (JHH & JHBMC). This event provided the project team with an opportunity to talk with interested employees in person. We were able to get a sense of career interest and other educational experiences they were willing to share. In addition, the project created a postcard announcement (unveiling our REACH brand) that was circulated with the employee’s paychecks on payday. This proved to be successful; however, the distribution mechanism for paychecks throughout such a vast operation involved some management. For the affiliates that were not on the main hospital's payroll cycle, the project ended up sending their HR offices the announcements for their distribution. Lastly, the project developed a page on the institution's Human Resources website describing the program, and including the application, manager recommendation form, coach assignments and various guidelines.
The basic sustainability plan involved meetings with the operation committee members who believed that there would be need for continued training beyond the grant lifetime due to the severity of their shortages, or expansions in their departments.
Also, it was determined that those individuals selected for trainings that required an Associate's Degree would not complete their training within the lifetime of the grant. The leadership of the Health System would partner with those departments and budget for salary release for those individuals until they completed their programs, which wouldn’t occur until several years after the grant ended. Similarly, those customized trainings for departments with constant shortages would also be considered in the future budget estimates to be requested through the normal budget process to receive institutional funds.