As a national leader in healt care employment, Johns Hopkins Health System was awarded an exciting new federally supported program to boost the job skills and advancement opportunities of its existing workers. We coordinated this effort through Project REACH (Resources and Education for the Advancement of Careers at Hopkins).
Since July of 2004, more than 400 Hopkins employees entered this innovative program and are well on their way to better paying, more rewarding positions throughout our system. The following is a retrospective on this project, highlighting its design and implementation throughout Johns Hopkins Health System.
Questions regarding this project should be addressed to: Yariela Kerr-Donovan, Project REACH Grant Manager, Department of Human Resources, 550 N. Broadway - Suite 401, Baltimore, MD 21205, 410-502-2200.
- 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 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 & program provided GED training; departmental trainings such as: surgery technician, lab tech 1s, pharmacy technician, nursing (LINC); math & reading for college entrance exams; medical terminology, and computer skills.
Also, the office of Organizational Development & Training (OD&T) 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).
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, state & city agencies uncovered in-house & 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 & waiting area; manager's office; two coach offices, which were shared by the coaches; an assessment facilitators' office shared by the facilitators; a computer room, where computerized assessments, skill development, and some training activities took place; and multipurpose room, where paper & 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 is 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 is 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 institutions 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 & 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 webpage (www.hopkinsmedicine.org/jhhr/reach) 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 Associates 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.
The market served by this grant were primarily entry level incumbent workers with an interest in acquiring the knowledge to fill critical skill shortage positions within the Johns Hopkins Health System. The positions identified were gathered from current chronic openings and projected openings researched by the institution’s Career Services Departments and from the Maryland Hospital Association. Also, the positions identified varied to some degree among the different affiliates within the Health System.
Outreach to the projects community partners varied. One major partner was the MOED. This office provided the project with two assessment facilitators, who planned and conducted the assessments used during the project. Members of the HR department met with the Mayor’s Office and had originally arranged for JHH to hire one lead career coach and two assessment facilitators to serve as contractors on the project. However, the coach secured employment elsewhere and the project didn’t replace the coach position with another person from the Mayor’s office. Working with a state government agency takes at the very minimum six months to develop a plan and possibly up to nine months to finalize contracts and other agreements. When working directly with governmental agencies one should keep in mind the extended timeframe in finalizing agreements. The project team found that there are extra layers of authority and approval, which is not always found in the industry sector through which these agreements must meet approval before completion.
As highlighted in the Planning & Infrastructure phase an initial meeting was held with HR & departmental representatives from all the affiliates to review the grant concept paper. Each department and affiliate received an initial contact form requesting information on the skill shortage positions they were seeking to fill. This information, together with the position shortage forecasting information developed by Career Services, helped to provide a comprehensive picture of the institution's shortages.
A series of detailed meetings were later held to understand each affiliates operating procedure so that a master operational plan could be developed. During these meetings the affiliates and departments were given a position needs form, which they were to use to provide more detailed information on the critical shortage positions that could be filled within the next 18 months, which was the original grant term. Once those forms were completed individual meetings were held with each area. This meeting served as an opportunity to discuss their critical shortages, learn more about the position and the requirements for filling them, and discuss the grant training process.
Some of the program processes needed to be flexible to accommodate the varying policies at the affiliates. For example, some affiliates do not advance tuition support. Therefore, the project had to advance the tuition and the affiliate repaid the program at the end of the semester. Also, some affiliates had varying levels of tuition support. The project supported the cost of tuition above the affiliates tuition support limit. Some affiliates consider 32 hours a week to be full-time, and, as a result the project developed a sliding scale for salary release support. Lastly, some of the same positions had different titles and wages at different affiliates. This required the staff to be very careful when meeting with employees to make sure that they were talking about the correct position and wage.
While everyone's time is very precious it is important that the coaches attend the department and affiliate meetings at least once a month. This would provide the departments and affiliates with updates on how their employees are faring throughout the process, and it would provide the coaches with a better understanding of departmental and affiliate issues that may affect the employees in training.
It is important to stress that this opportunity is a privilege and not a guaranteed right. While being a Johns Hopkins employee is a basic criterion, others must be met. Therefore, the project does have the right to deny participation in the program. As a result employees had to complete an application and their managers had to complete a manager recommendation form in order to be considered for this opportunity.
A series of recruitment sessions were held among the affiliates by their HR personnel. Also, the Project office developed a telephone query sheet for the multitude of calls that came in from employees expressing interest in the project. This form highlighted their first steps, and described the process individuals would be expected to follow in order to be considered.
Also, establishing a wage range for participation is crucial to your financial planning, as well as, supporting the spirit of this project. The project did receive one or two applications from individuals who were earning over $25.00/hour, and while they were interested in filling a critical skill shortage area, they had the resources to pursue that training without the kind of support that the grant provided. Additionally, they worked in a department and held a position that afforded them flexibility with their schedule. The REACH staff provided them with career counseling and helped them realize that this opportunity would not be appropriate for them.
The project team found that there were employees who had a myriad of issues (i.e. childcare, attendance, or transportation). The departments that recommended these employees recognized their potential, and wanted to support them believing that the services and training that this project provided would help them. As these individuals were assessed and worked initially with a coach those issues or the extent of their problems did not surface right away. Sometimes it came out during training and then the project staff spent a great deal of time helping them through training. The project's recommendation to this is to make sure that the project reviews all applicants with the Human Resources and Labor Relations Consultants department. The REACH staff could have supported employees who fell into this situation with some targeted support before enrolling them in training. It is important to note that the project accepted people in the program who have had problems, but they had demonstrated an ability to deal with those problems. This is critical as acceptance into this educational project can sometimes place additional pressures on individuals that may exacerbate their existing issues.
Complete applications were accepted on a rolling basis in order to make sure we were able to meet the number of employees committed to each training segment outlined in the concept paper. A completed application included the biographical form and an approved manager recommendation form. Initially, the applications were to be submitted to one office, while the manager recommendation form was submitted to another. This was designed to maintain the confidentiality of the department recommendation, and was also a function of necessity because the Project’s staff had not been hired yet. However, it proved to be a bit cumbersome as the timing of receiving both forms never coincided - the project had several applications submitted without manager recommendations or vice-versa; requiring constant follow-up with department and participants. In reality, when an employee submitted the application packet to the departments both forms were filled out at the same time and then given back to the employee who would then submit it to the Project office
We found that while some departments filled out the manager recommendation forms even if they recommended that the employee not be considered for the project. This may be attributed to the fact that they didn’t want to compromise their relationship with their employees, or submit their recommendation in a timely fashion, or they believed that this particular employee would benefit from training, but their current performance didn’t meet the guidelines set forth by the project guidelines.
- Explore & Pre-Test Tools
- Develop Schedules & Administer Tools
- Analyze Results & Discuss with Applicant
The decision to work with the Mayor’s Office of Employment Development was in part a result of a study that the Mayor's office conducted to explore assessments used primarily for adult education. The project relied on their analysis of various assessments to determine the ones used for this project.
The assessments initially recommended for this project were: TABE, CASAS (already used by the institutions Skill Enhancement Program), Wonderlic, and CareerScope/VRII (paper pencil version of CareerScope). These assessments were to be administered to every participant. It was later recommended that Qwiz Reveal, and a series of Qwiz assessments for specific trainings be used to make sure that employees had the specific aptitude for some of the skills required of the specific position they were hoping to fill. For example, we used Qwiz assessments that uncovered employees’ knowledge of the use of the Internet and the computer (numerical and alphabetical dexterity on the key board) because one of the trainings had an on-line course segment. As the project progressed, the assessment facilitators recommended the use of BESI (Barriers to Employment Success Inventory), which would aid in the uncovering of barriers (career, emotional, financial, physical, and educational) that the employees may not be aware of or were not ready to reveal. In retrospect, if we had enough time a survey should have been developed during the pre-planning stages and administered to a sample set of employees. This survey should include questions that would provide the following information: length of time out of school, assessments already taken, work hours, the best time to take assessments, and how employees would fare on the assessments.
Once a completed application was received, one of two things occurred: the employees would call to confirm receipt of their application and would be forwarded to the assessment facilitators to schedule a time to conduct the assessments, or the assessment facilitators would call those employees once the application was complete.
Initially, the project tried to set pre-scheduled times for employees to come and conduct the assessments. However, this became impractical because the assessments if taken at one time might take up to 2.5 hours, and most employees conducted their assessments during their lunch hours or after their shifts. Usually, they didn’t have enough time to complete all of the assessments at one time; therefore, it was necessary for employees to come back to our offices to complete all of the assessments.
In addition, based on the Department of Labor's assessment practices it isn’t advisable to have employees take multiple assessments all at once for a long period of time as their ability to perform diminishes as time progresses. Also, it is recommended that employees are in the right state of mind when taking these assessments. Employees who came in during their lunch hours may still have work issues on their mind and also be pressured by the limited amount of time they have to complete the assessments. We, therefore, tried to schedule the shorter assessments during lunch hours, and the longer ones for folks who could come after their shifts. We adjusted the assessment facilitators schedule to accommodate those assessments that would be taken after the standard work day hours (evenings & weekends by appointments).
The schedules for assessments conducted off-site at the affiliates were coordinated by the assessment facilitators and the HR departments of those affiliates. In this instance, it was possible to pre-schedule set times for individuals to conduct these assessments. The departments at the affiliates worked out arrangements with the employees work schedules. It was necessary to conduct more than one visit with these employees. For those affiliates that were off-site, but still within a reasonable travel distance the employees came to our offices during their own time for their second visit. However, for the affiliate that was farther away, the assessment facilitators made second and possibly third visits to their location.
The analysis of results includes the actual raw score/results of the assessment and the informal interview with the assessment facilitators. The raw scores of the assessments provided the project with information on the basic skill level and aptitude for training in the position they are seeking to fill. However, there is an informal interview that provided additional information that must be considered when determining if someone would be successful in training and in the new position they were seeking.
The interview began with the responses the employees provided to the short essay question as to why they were in the program and the particular position. There are not a set of questions that are predetermined during the informal interview as this is the time for the employee to talk with someone casually, and not as if they were in an interview. However, there are general areas that the assessment facilitators needed to gain insight. The responses to the questions answered in the application provided insight to: an employees' motivation for the new position, their feeling about where they are currently in their professional and personal lives, possible issues that may be barriers to their success, the personality of the employee. Additionally, knowledge of the culture the new department the employee is seeking to enter is a foundational aspect of determining if there is a positive match between the employee and the opportunity this project presented. It is important to note at this stage that even though the project encountered individuals who were not ready for this opportunity. These individuals were advised on ways to better prepare themselves for training and were provided with insights as to what it would take to pursue and achieve those interests. This empowered the participant to make their decisions fully informed of their capabilities, hidden and transferrable skills and interests, and the specific quantitative and qualitative aspects of the desired position listed on their application.
Once the assessments and informational interview were conducted the assessment facilitators met with the coaches assigned the participants/departments to discuss their findings. The informational interviews then continued with the coaches. At this time the coaches shared with the employees the components of the training (how long, where, etc.), further introduction to the new department and position, and the process involved in applying for the new job.
When working with a defined time frame it might have been more expedient to assess employees for their basic reading and math skills prior to the start of the application process. Also, this would have helped to project team manage the expectations of the employees better, and would have provided the department with more timely information on who was eligible for training and who needed skills brush-up. Also, the would have made management of the varying levels of skill development services needed earlier.
Project REACH Career Coach Profile
The coaches for Project REACH were almost all internal candidates.
- One coach was an employee who had worked with the Nursing Department at the Hospital.
- One coach worked in HR as a career coach for several years
- One coach worked in HR as a Skills Enhancement Instructor
- One coach came from outside Hopkins, but previously worked closely with the institution as a union representative.
The formal and informal knowledge of the institution that this team brought to the project was extremely helpful. Also, the trust that the employees had with these individuals was a little easier to develop as they had worked with them for the most part in one capacity or another. It is important to note that coaches should have had some counseling experience, and of course strong computer skills, which was needed for managing the database and the variety of computerized skill development programs.
The career coaches’ role with this project included more than case management responsibilities. This made setting time aside each day or week for file maintenance critical. The coaches were assigned departments that were categorized as participant departments where te participants currently work and destination departments where the new jobs exist.
Their role with the participant departments involved working with those employees from those departments who were seeking training and new positions. Departments and affiliate were asked a series of questions that would provide more insight as to how to manage the applicant pool from those areas. Additionally, they worked with the supervisors of those employees to explain how the release time process would work. For some of the larger departments it was necessary to develop a tracking sheet the provided a running account of the completed applications from their department and those employees who earned an assessment score that indicated their readiness for training. Therefore, a readiness for training letter and a listing was developed and sent to departments. It was often difficult for larger departments to keep track of all of the supervisor/manager recommendation forms they received and returned, and this listing provided them with a reminder of which employees they allowed to participate in the program, and where those employees were in the process. Sometimes the departments had to make a decision as to which employees could start training and which ones had to wait for the next training session given the amount of work the department had to complete.
Their role with the destination departments were to learn more about the nature of the openings, coordinate meetings and facilitate training structure decisions with the training providers and the departments, and relay information pertaining to the results of those meetings to the participants.
Once the department/affiliate position needs form was completed, and it was determined across the Health System what positions needed employees, coaches selected which areas they would support. This, in addition to the coaches' experiences with some of the departments, determined for the majority of the time the participant departments that the coaches would support.
The Project developed a guideline for coach visits. This guideline included basic topics that should be covered during the initial visit. They include:
1. an explanation of the project and its benefits,
2. a description of the process and participant guidelines,
3. a review of the formal assessment results (if available) and informal interview with assessment facilitators.
4. a review of the available training opportunities
5. a review of the program forms.
It is important that the coaches understand the guidelines for this visit as it is an essential part of gaining and sharing valuable information with the employees. Again, coaches should conduct these meetings in a private space given the potentially very private information the employees might share.
When meeting with the coach for the first time the employees would fill out an initial contact form, which allows the employee to write out areas of concern, strengths, interests, etc. This assists the coach in starting a conversation with the employee and reinforces the items that the employee may have shared with the assessment facilitators. Also, the employees completed a release form, which granted permission to the coaches to contact the employees department and training provider as a part of their role in supporting the employee through the program. This form was the basis of what is the project called "the communication triangle."
During this meeting the coaches reviewed the initial contact form and the results of the employee assessments, if the battery of assessments were completed by this time. Sometimes, employees requested an informational meeting with coaches prior to starting the application process. Again, the focus of this meeting was very similar to that of the meeting with the assessment facilitators: building trust, learning more about the employees interest and motivation, and learning about barriers to the employees success. The additional goal of these meetings is developing an educational plan that will help the employees gain the training needed to fill open positions.
There are two categories of employees that the coaches are meeting with at this time: those who have earned scores on the assessments that indicate that they are ready for training, and those who require skills brush-up before starting a training program. Both of these groups will have an educational plan that will follow a timeline and are broken into segments. Some segments that require immediate attention may include: getting the required background educational paperwork in order for the training provider or educational institution; taking short-term skills brush-up courses, such as college readiness or college entrance exam prep courses; or focusing on support services for any non-academic barriers that may impede their success in training. Other segments that are more long-term include: planning out each semester until completion; estimating when they will start to apply for their new job and scheduling a time to review the on-line application process; and future scheduling of resume writing and interviewing workshops.
For those employees ready for training, the coach and the employee would begin to develop an educational plan that will help them acquire the training or education they need to fill the position they are seeking. As the coaches also have responsibilities to facilitating the set-up of the trainings, they have current training information and procedures that has been decided upon by the training institution and the hiring or destination department. Additionally, the grant program process is reviewed so that the employee will know what information they must have prepared, what information they will need to share with their current supervisors, and when they may be needed to attend informational meetings with the hiring department or the training provider. At this time, the coach will also review the service commitment that the employee agrees to adhere to as a result of the support they received through the grant. It is at this time that the employee would sign the service commitment agreement. If an employee was accepted into a training program that wasn't assigned to their original coach the employee had the option of switching coaches.
It is at this time that the realities of what the employees are about to undertake sinks in, and some employees may begin to feel apprehensive. The two main concerns expressed are the length of training and the coursework they will have to take. The coaches' role at this point is to reassure the employees that they can complete the work successfully as long as they are really motivated for this particular position. Also, they encourage the employee to discuss in further depth any barriers that they believe will hamper their success in this endeavor. If employees seem strongly resistant due to the non-academic barriers and concerns they have, the coaches will first begin to explore support services that will help the employee overcome them, and then lay out the educational plan. For those employees who have not earned scores that indicate their readiness for training, the coaches will review skill enhancement services that will bring their scores up. Also, if there are non-academic barriers that are shared, the coaches will explore services that may provide support to the employee.
The most important part of these meetings is developing a rapport with the employee. This rapport is critical to the uncovering of any barriers that may inhibit an employees’ success in training and in their new department. Given the grant timeframe coaches must be able to assess the personality of the employee and communicate to them in a manner that fosters trust, yet conveys knowledge and firmness. To achieve this, the coach and the employee may need to have several interactions before the employee is cleared to proceed to the training list. Ultimately, the coaches worked to help the employees empower themselves and to take control of their education and career advancement. This meant helping the employees understand the services that were available to them, both within the institution and outside, and understand the policies that affected their employment.
Depending on the employee and the training program the frequency of the coach/employee interaction varied. For the most part and at minimum, coaches were in contact with employees at least twice a month. Coaches and employees communicated via: telephone, email, or face-to-face meetings. Sometime the coaches went to the employee's work site or the employee visited our office. The topics discussed also varied greatly: anxiety about workload, either in their department or at school; personal issues; additional skill enhancement resources; or questions about registering for future courses and their progress in their educational plan.
It was difficult to contact some employees, mostly those in entry-level positions in General Services and Security, because they were usually not listed in the email system and didn't have a direct work phone number. Also, the nature of their work kept them mobile throughout the institution. In these cases, the coaches would visit these employees at their work site during shift changes. This was also an effective way to meet with these employee's supervisor. Otherwise, attempts were made to reach employees at their home.
- Skills Enhancement
- Open Houses
- Salary Release & Backfill
- College Readiness & Academic Success
In order to provide the support services of skill development skills (PLATO, and School-at-Work) the office extended its hours: Monday - Thursday 8:30 am to 7:00 pm, and Saturdays 10:00 am - 3:00 pm. Skills enhancement already offered courses throughout the day and evening.
Originally, the project committed to serving 400 employees. However, once employees were assessed it was discovered that many required skills enhancement before entering training. We found that although employees may have a high school diploma or a couple of years of college education, their educational experience took place so long ago that their basic skills would not ensure their success in the training. Therefore, once the employees were assessed and skill development was determined as an immediate path for them they were referred to the institutions Skills Enhancement Program. The Skills Enhancement Program offered the following courses: math & reading booster classes, college prep or Accuplacer (college entrance exam) classes, tutorials, computer classes, and medical terminology classes.
PLATO provided all of the high school subject materials online. Employees took a placement online placement exam, which would determine the modules they needed to work on to bring their skill level up to a training appropriate level. Most employees took the reading or math modules. Employees were advised of PLATO when their assessment results indicated a need to develop their basic reading or math skills. It is recommended that employees who are motivated to work on their own time and have a comfort level with using computers be directed to this type of skill enhancement. The project did have employees who wanted to use this software even though they did not have strong computer skills. Fortunately, PLATO is a user friendly application, and those employees who wanted to use it even though they didn't have strong computer skills learned how to use the application,developed their computer skills and their basic skills at the same time.
Some of the employees were interested in clinical positions and needed to prepare for the classes they would have to take in college. Almost every clinical college based training required Anatomy & Physiology and Medical Terminology. We arranged with School-at-Work to modify their program to allow us access only to those two modules, and required that those employees who were pursuing trainings for clinical positions take those two on-line prep courses. We also purchased extra diskettes of those curriculums and made them available to employees when they wanted to work on their skills.
Once a listing of interested employees ready for training for a specific position was established. The project arranged with the department a series of informational meetings because many employees had limited knowledge about the new department and position. These meetings are instrumental in providing information about the department and the position they employee expressed an interest in filling. First, the employees were required to attend an open house hosted by the destination/hiring department. The employees took a tour of the department, and departmental managers, supervisors, and current department employees filling the interested position presented information about how their department operates, and the requirements of the position. Also, it was at this time that the department interviewed the employee, and for some positions Career Services administered screening tests. Lastly, employees spent half a day shadowing a current employee in the position they are seeking to fill. After these sessions the department provided the project with the names of individuals they think would be successful in training and in the job. This worked very well because this in depth exposure to the department provided the employees with a realistic first-hand view of the position they are interested in, and if they learned something that they didn’t realize or like they often deselected themselves from the training.
A crucial component of this project and its success was the salary release feature. It is very difficult for individuals to pursue training programs while working full-time. Employees received 16 hours/week of paid time away from work to attend classes, which was paid by the grant. This was a career acceleration program so the time paid time away from work was mandatory. Once an employee has been accepted into a training program, a salary release letter is sent to their manager indicating the training, training duration, and the account number that the 16 hours of salary release should be charged to each week.
When the project began manual timesheets were used to record employees work hours by each department. This required that the project provide the departments with the grant account number where the 16 hours of salary release should be charged. This system then became computerized, but we did not have the capability of recording the salary release for all of the participants in the program. Providing the account number to the departments did present extra work because sometimes employees who were not in the program were erroneously charged to the grant, and it took administrative time to resolve the charges. It was stated by some of the larger departments that they needed someone to solely focus on the salary release portion of their payroll.
This feature did present a challenge for departments however because they needed to continue to function. The 16 hours of salary paid for by the grant provided the department with funds that they could use for backfill or overtime. Departments who needed a backfill person were instructed to contact the institution's staffing agency, Intrastaff. This agency then forwarded an assignment request form to that department and then began to recruit someone to fill that request. This agency developed working relationships with a few staffing agencies in the city to aid in this recruitment process. Also, the project worked with the Mayor's Office of Employment Development to secure the entry-level replacement to fill some of the 16 hour a week gap left by the employee in training. This task was sometimes hard to fulfill as some individuals wanted more than just a 16 hour work week. Therefore, careful coordination was required to conduct the backfill process. If a department had more than one person in their area taking courses, they were sometimes able to re-work their schedules to provide a 32 hour per week opportunity for backfill. This coupled with overtime enabled departments to operate as usual. Again, it did require quite a bit of coordination and creative thinking. It is the project's recommendation to work with the departments very early to find out who they would be willing to support in a program of this nature so they can start rearranging schedules early.
Salary release for Howard County General Hospital was arranged differently because they did not have the electronic timekeeping system that the other affiliates used. Therefore, the Howard County General Hospital departments paid for their employees fully, and the grant reimbursed the department at the end of each semester.
Some of the employees who were ready for training had not been in school for many years. It was learned that taking a full load of courses (even with the two day salary release) and working twenty-four hours a week in their departments was quite a challenge. The program developed a workshop on college readiness and academic success to address the issues that those returning to the classroom would face. This workshop provided an orientation to college work as well as tips that would help employees be successful in class and at work.
- Map Destination Occupations to Courses & Scan for Training Providers
- Payment of Trainings
- Track Employee Progress
- Review Career Plan
The project relied heavily on the destination departments when it came to selecting the training providers. It was the project's belief that the leadership of these departments were experts in their fields and also would have a strong feeling about the training the employees should receive. Their level of comfort with the training was paramount to the successful transition of the employees into their department once they completed training.
Additionally, the rapport that some of the departments built with the educational institutions provided additional support for the employees and the project. With this in mind, the project secured the services of the training providers the departments had worked with before and recommended.
The following is the process used by the project to establish a training program:
1. A meeting with the destination/hiring department and Career Services was scheduled to determine position needs and the number of openings, this includes: determining if the positions were union positions.
2. The coaches would then sort the database to develop the participant list, which would include those employees with acceptable assessment scores and interest in the position. The coaches would contact those employees to make them aware of a training possibility and to reaffirm their interest.
3. A meeting with the destination/hiring departments and training provider would be scheduled to determine and review the curriculum, length of training, possible start dates, and other training protocols.
4. The coaches would then work with the destination/hiring department and training providers to set up the open houses. The interested employees participated in the open house process, and based on the information shared during those sessions would make a final decision on their intent to pursue that training.
5. These employees were then interviewed by the department, and the department provided the project with their recommendation.
6. The coaches would then notify the employees current department of their employees selection for training.
There was a process developed for enrolling participants in two main training categories: college-based and customized. The college-based programs were well established and accredited. The project worked closely with the admissions and counseling offices to help the employees get the necessary paperwork filed, and share with counselors the nature of this program. The customized trainings worked in a similar manner, but provided the employees with a cohort experience that provided wonderful support and bonding when the coursework began.
There were five main training components outlined in the concept paper:
1) Business/Soft Skills training for those employees whom their supervisors believed were essentially good employees, but due to work/life issues had fallen into performance infractions that jeopardized their jobs. Most of the employees in this category also required skills development before being able to move forward to training. There were 14 one-month sessions of this course, with a different group of employees attending a different month. Once the training was completed, the employee returned to their department and the coach conducted monthly interviews with the employee's supervisor to determine if the employee's performance improved. The employee had to remain in their current department for three months with good performance reviews before they were eligible to move into training or transfer to another job within the institution. Often times, the department allowed the employee to pursue skill development classes on their own time during the three month period.
2) Accelerated GED classes were conducted by the institutions Skills Enhancement Program (SEP). The Skills Enhancement Program had been conducting GED classes prior to the start of the grant. However, the employees attended those classes on their own time, often after their work shift. The grant enabled those interested in gaining this degree to pursue the coursework during 12 hours of paid work time. Since the Skill Development Program already had a GED program that was well known to employees, many signed-up for the accelerated course through the SEP office. In addition, the SEP office developed a special marketing plan (posters and flyers) to make employees aware of this new accelerated class. The project made sure that the SEP office had applications, and developed a process by which the initial reading and math assessment was conducted by their office, and once a class roster was determined the employees were encouraged to come to the Project REACH office to conduct the other assessments, particularly the career interest and aptitude assessment.
The Skills Enhancement Program held three class terms per year (spring, summer, fall), and held GED practice test sessions near the end of each term. The results of these practice tests provided employees with an understanding of how they may fare on the actual exam, and also provided the Skills Enhancement Department with a preliminary listing of the next term's class roster and which areas needed additional focus. The grant paid the cost of taking the GED test. Employees were required to register and pay for the exam, submit their exam date confirmation and a receipt, and then they were reimbursed for the exam cost. Once they took the exam, the employees were required to submit their results. The educational plan developed for this group consisted of: first gaining their GED, reviewing the career interest/aptitude assessment, and planning the continued training plan for those who wanted to pursue another position. Given the nature of this training employees completed a service contract and amendment.
Most employees will not disclose that they do not have their high school diploma, which made it difficult to identify them and provide them with this support. Coordinating the application and grant enrollment process took quite a bit of coordination as some employees went to the skills enhancement office first, while others came to the program office and after being assessed revealed that they needed their GED. Those individuals were referred to the Skills Enhancement Program, but the timing of their referral didn't always coincide with the start of an accelerated GED class. Also, at first it was a bit confusing for managers because of the split in responsibilities with this training. The projects sent letters to the managers indicating that their employee was enrolling in the accelerated GED classes, and any questions regarding instruction should be addressed to them, and any administrative questions should be addressed to the program. Once the departments received this letter the program sent out a letter informing them of the salary release information.
3) Declining to Emerging Jobs included those employees in department who were facing a reduction in their workforce due to the acquisition of new technology. The Radiology department was transitioning their work processes from manual film clerks to digital ones, and created the on the job training curriculum. The project targeted 38 film clerks and worked with the department to phase them into the Digital Film Clerk 3 training program that they had developed. This in-house training program was created and managed by the Radiology department, which allowed for greater flexibility and full utilization of in-house resources. The release of employees from their daily work schedules and the backfill process was arranged internally. Also, the instructors for this training were selected from internal staff members who had an expertise in their areas. The project assisted this department by assessing and counseling the film clerks, and identifying those employees who may be suitable for other opportunities within the department or institution.
4) Skill Development was a training that was necessary for almost half of the applications received by the project. Employees who needed this training utilized the institutional classes offered by Skills Enhancement on their own time. A referral template was developed that informed the program when a referred employee has reached the assessment levels needed for training. This template was checked and the employee contacted to meet with a career coach. However, due to the volume of those needing this training, the project invested in a few computerized skills development programs: PLATO and School-at-Work. These two programs were very helpful in accelerating the skill development work the employees needed to complete before starting training. These two computerized programs were used in conjunctions with the traditional classes offered by skills enhancement. Therefore, employees could attend a class, and then come by the office and continue to work on their skills at their own pace.
5) Upgrading of Skills for Critical Skill Shortage Positions included all of the customized and college-based trainings utilized to provide the education employees would need to move into their new jobs. The college based trainings were typically two year degrees. However, because many of the employees were new to college or had few college credits the project supported another year of pre-requisite courses. Therefore, someone pursuing an Associates Degree may take three years to achieve their goal. The project experienced some mixed results with this scenario. The project had several employees who have completed their pre-requisites at projects end, and have been accepted into an actual program. However, we have also been faced with the challenge of limited capacity for some of the programs at many of the colleges, and have some employees who are on a waiting list. Also, due to the grant time span, the rolling application acceptance process, and when employees were actually able to begin their training we have many individuals who at this time have completed pre-requisites and are now applying to their programs. Many of the trainings had a didactic and a clinical portion, which required coordination with and the support of the destination/hiring department. For many of the trainings, there had been some training of its kind held in the department before the grant, therefore, they already had individuals identified to serve as clinical instructors who could guide and monitor the clinical lessons.
The following are a listing of all the trainings supported by this program: Laboratory Technician I, Patient Service Coordinator, Clinical Associate, Clerical Associate, Core Services, Ladders in Nursing Careers (LINC), Respiratory Therapy, Radiology Technician, Occupational Therapy, Medical Lab Technician, Medical Technologist, Surgery Technician, Medical Coding, Anesthesia Critical Care Technician, Pre-Clinical Associate and Pharmacy Technician.
Tuition assistance was used as the institution's match to the grant funded monies supporting this project. For those trainings that were college based the program utilized the institution's tuition assistance program. This program has been well established and known by the employees, which made it easy to get them enrolled from a financial standpoint. Also, the tuition assistance program at the Johns Hopkins Hospital supported only degree programs, while this varied for some of the other hospitals within the health system. The project developed an “intent to pay” letter for the registrars offices of the colleges as sometimes the timing of the tuition support didn’t match the registration payment due date. Payments for customized training were negotiated through the contract and were paid through the grant. In addition, as employees neared the end of their training arrangement were made to pay for any certification exams they may need to take.
For those union employees interested in college trainings that were not degree bearing, nor customized, but provided a certification the project referred them to the union's educational fund for support. This fund is provided by the hospital for the advancement of training and education specifically for union employees, and followed the same process as tuition assistance. Once they received support by this fund the employees started their training and received salary release support through the grant.
There were some affiliates that only have a tuition reimbursement plan. It was difficult for employees to pay for a full-load of courses up front, therefore, the grant made arrangements with these affiliates to pay for the tuition up front and then have the affiliate pay the grant back at the end of the semester. Again, this process was established because the Johns Hopkins Health System's existing tuition assistance program managed by all of its affiliate organizations was the institution's in-kind match to the financial support provided by the grant.
All employees attending college-based trainings were required to submit their grades at the end of the semester and before they could register for the following semester’s courses. This was a requirement of the institutions tuition assistance program, and one that the project adopted. For those employees attending college, it was difficult to gain access to their progress during the semester from their instructors due to the student confidentiality laws all educational institutions followed. Therefore, the project relied on self-disclosure by the employee, which wasn’t always forthcoming in a timely manner. Some college programs were willing to provide us very general information regarding the employee if we were able to send them copies of the release forms the employees signed at the start of the project. Nonetheless, the coaches made sure to contact these individuals at least twice monthly. Conversely, because the project developed a contract with the customized training providers, the instructors were able to provide the project with weekly attendance and performance reports, making it easier to track these employees. Coaches maintained a service record log to track their meetings with employees or contact with departments and training providers regarding the participants progress.
Coaches also contacted the employee’s current department supervisors to make sure that they were not experiencing difficulties in managing their job duties and academic responsibilities. For the most part the coaches served as an intermediary that could help the employees and departments figure out potential scheduling conflicts or address potential issues before they became big problems. It is important to note that employees should refrain from trying to switch jobs while they are in training. The employees ability to attend training is granted by their department, and if they switch department midway through training they will need to get that support all over again. This question has come up a couple of times and more often than not a new manager will not want to hire someone who has made a commitment to be away from work for two days out of the week.
Occasionally, employees wanted to switch programs, mostly from the college-based trainings. For those pursuing college-based trainings this realization became apparent while they were taking their pre-requisite courses. Fortunately, this didn’t present a great problem because many of the pre-requisite courses were transferable to other trainings. The nature of the cohort experience with the customized trainings may be the reason why the project didn’t receive requests to switch trainings in the customized classes.
Approximately one month before the completion of the training, employees were contacted to attend a few informational sessions about their next step in transitioning into their new jobs. They included: cover letter and resume writing, interviewing, and applying for their new positions. It was also at this time that the destination/hiring department and the institution’s Career Services department were contacted. They informed the departments of the successful completion of training by these employees and reaffirmed the application procedures the department wanted to follow.
Employees scheduled time to meet with their coach to review the online application process. It has also been suggested that employees be assigned a peer mentor once they enter their new department. Some departments have a formal system for this in place, and others have a more informal system. Nonetheless, the coach is available to these employees once they start their new positions to provide support and assistance if needed.
There have been several outcomes highlighted in the project's quarterly report, and there will be more as current employees engaged in training complete their education and move into their new departments. The Johns Hopkins Health System has always been committed to the development of its workforce. Continued meetings with the project's steering and operations committee will further develop the sustainability plan for trainings across the health system.
A retention handbook is being developed by the project and will be distributed to those participants in the program. This handbook was designed to provide employees with helpful advice on how to remain successful in their training programs, and in their current and new departments. (SEE RETENTION HANDBOOK)
In addition, the project is developing financial management seminars with Citibank. These seminars are designed to help employees with their finances in order to effectively utilize the pay increases that they may gain with their new positions. Meetings with Citibank representatives are currently taking place, and will focus on helping these entry-level employees manage their finances and provide another avenue for sharing information on the current benefits available to them through the Johns Hopkins Health System benefits package. These seminars will focus on: expense management, credit management, retirement planning, understanding education financing, and investments.
Participant testimonials will provide you with an insight to the background of some of the participants of the program, and their progress through Project REACH. Please enjoy the following Project REACH participant profiles: