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Supply of Healthcare Personnel
June 30, 2004
Report to
AEED
Committee
Presented by: Martha Anne Dow
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Supply of Healthcare Personnel
Committee Members
Martha Anne Dow, PresidentOregon Institute of Technology
Sally Henry, Executive DirectorOregon Pacific Area Health Education
Gail Pincus, Project ManagerCommunity College HealthcareAction Plan
Kent BallantyneSenior Vice PresidentOregon Association ofHospitals and Health Systems
John Moorhead, M.D.Oregon Health and Science University
Dr. Elizabeth Goulard, VP Academic ServicesChemeketa Community College
Chair
Diane Vines, CoordinatorGovernor's Healthcare Workforce Initiative
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Supply of Healthcare Personnel
Nature of Problem
Critical shortage of Healthcare workers in Oregon
100,000 healthcare professionals currently employed
Need additional 48,000 health care workers by 2012
26% growth projection from 2002 to 2012
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Supply of Healthcare Personnel
Current Outlook
2010- Demand for registered nurses will exceed supply by 22%
2010- Demand for allied health professions
• medical and clinical lab – 55%• medical imaging – 51%
• Radiology• Sonography• Other Specialties
• Dental Hygiene – 42%• Physicians – need 3000 additional MD graduates by 2015
• 2020 – shortage of 85,000 nation wide
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Supply of Healthcare Personnel
Oregon Employment Dept. – Sept 2002 Survey
Hospitals reported:
1700 unfilled registered nursing positions
117 open radiology positions
77 unfilled LPN positions
2004 – these numbers have increased by approximately 10-15%
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Supply of Healthcare Personnel
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Supply of Healthcare PersonnelOregon Healthcare Sector – Employment Initiatives
OREGON’S overall goal is to increase the number of Healthcare Workers in targeted occupations
Radiologic technician/
technologist
Medical assistant
Medical records clerk
Pharmacist
Registered nurse
Dental hygienist
Dental assistant
Dentist
Licensed practical nurse
Certified nursing assistant/
medication aide
33.5%
30.4%
28.1%
17.2%
15.4%
14.0%
14.0%
13.8%
11.3%
10.3%*
2,100
3,800
1,100
2,400
25,600
2,800
4,000
1,100
3,500
13,200
Oregon’s Targeted OccupationsProjected Growth
2000-2010Employment
In 2000
*Many analysts think these projections are low.
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Supply of Healthcare Personnel
SUPPLYOF
HEALTHCAREWORKERS
Growing Demand Accelerating Attrition
Resu
lt: Da
ng
erou
s Sh
ortag
es
Result: Affects Quality of Care
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Supply of Healthcare Personnel
Factors Creating Healthcare Shortage
aging population increasing demand for services
more healthcare workers are retiring than new healthcare professionals are entering the field
education programs have reached capacity (physical facilities, faculty and staff, and equipment)
skilled workers are leaving healthcare because of working conditions
difficult to align educational and training programs to promote upward career mobility.
regulations for staffing and certifications
rural issues
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Supply of Healthcare Personnel
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Supply of Healthcare Personnel
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Supply of Healthcare Personnel
Major Issues - Barriers
Recruitment Limitations Outreach: new and non-traditional students marketing for in-demand occupations connection to K-12
Capacity Limitations classrooms supply of qualified faculty clinical experience accommodations for students with special needs program cost and state support distance education opportunities for rural students
Education/Training Limitations financial aid distance and alternative learning and telecommunications availability retention
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Supply of Healthcare Personnel
Healthcare Workforce Players
AHEC – Area Health Education Centers
ONLC – Oregon Nursing Leadership Council
OHCC – Oregon Health Career Center
OAHHS – Oregon Association of Hospitals and Health Systems
NWHF – Northwest Health Foundation
Community Colleges-Universities
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Supply of Healthcare Personnel
Initiatives
2003 Legislative HB 2577 & HJR48 SB800 - HB3353 Statewide Simulation Alliance
Governor’s Healthcare Conference Initiative
Oregon Consortium for Nursing Education (OCNE)
OAHSS Workforce Liaison Group
Community Colleges Healthcare Action Plan
OHCC Grant Projects
HB2577 Work Groups
ORTCC Health – Education Committee
HB3353-Healthcare Workforce Task Force
State Board of Higher Education/Academic Excellence and Economic Development Committee
OWIB – Healthcare Section Initiative
Oregon Health Workforce Project OHSU Area Health Education Centers
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Supply of Healthcare Personnel
Governor's Healthcare Workforce Initiative
Vision to expand quality and quantity of healthcare workforce
Statewide Simulation Alliance
Governor’s top priority for Federal funding
1. Create a statewide network of simulation centers.
2. Ensure that the existing telecommunications capacity
around the state is operational, accessible, and affordable.
3. Increase the number of healthcare faculty.
4. Encourage regulatory flexibility.
5. Encourage shared use of facilities and equipment.
6. Ensure the articulation of healthcare pre-requisite
courses among public and private colleges and universities.
Coalition of major statewide provider, educator, and trainer organization
Six key elements
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Issues > Players > Solutions2003 Legislative ResponseHB 2577 & HJR 48SB 800
Governor’sCoordinator Healthcare Workforce Initiative
StatewideSimulationAlliance
OTCC HB 2577HC-EDWork Group
OCNE Oregon Consortium for Nursing Education
CCHAP Community College Healthcare Action Plan
OHCC Grant Projects
State Board of Higher EducationAcademic Excellence &
Econ Dev Committee
OAHHSWorkforce LiaisonGroup
Legislature’sHB 3353 TaskForce Governor’s/
OWIBHC Sector
Initiative
OCNOregonCenterfor Nursing
DCCWDHC WFGrants
OHCCOregon HealthCareer Center
OAHHSHC Website
OAHHSSurveys
NWHFReport
ONLCReport
AHECProfiles
HealthcareWorkforceShortages
Community College Healthcare Action Plan
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Supply of Healthcare Personnel
Postsecondary Education Contributions
Community College Health Related Programs
Community Colleges w/Allied Health Programs
Blue Mountain
Central Oregon
Chemeketa
Clackamas
Clatsop
Klamath
Linn-Benton
Mt. Hood
Umpqua
Rogue
Oregon Coast
Portland
Tillamook
Treasure Valley
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Supply of Healthcare Personnel
Postsecondary Education Contributions
Community College have admitted an additional 475 health occupation students since 2001
235 nursing
4 dental hygiene
31 medical assistants
39 radiological techs
24 paramedics
10 sonography
50 CNA
2 respiratory care
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Oregon Institute of Technology has a current enrollment of 750 students in allied health programs and expects to double that by 2010 if resources areavailable.
Supply of Healthcare Personnel
Postsecondary Education Contributions
Center for Health Professions
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Supply of Healthcare Personnel
Current Enrollment is at Capacity
Pre-Medical Imaging
Radiologic Science
Nuclear Medicine
Diagnostic Medical Sonography
Vascular Technology
Pre-Dental Hygiene
Dental Hygiene
Health Science
Pre-Nursing
Nursing
Pre-Clinical Laboratory Science
Clinical Laboratory Sciences
Emergency Medical Technology
Total
120
95
39
64
59
41
54
71
73
37
653
4
41
24
69
12
8
12
9
41
132
103
39
64
71
41
63
71
73
37
4
41
24
763
OIT Current Enrollment KlamathPROGRAM Falls Portland Other Total
Allied Health at OIT
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OHSU Nursing Consortium
OHSU – Medical School
OHSU – Dental School
Supply of Healthcare Personnel
Postsecondary Education Contributions
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Oxygen Nursing Leadership Council (All working Directors – ONLC)
Oregon Nursing Education Consortium (ONEC) – public, private universities and community colleges
Supply of Healthcare Personnel
OHSU Initiatives
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Nursing
Radiation Therapy
Dietetic Internship
Supply of Healthcare Personnel
OHSU Initiatives
Baccalaureate Programs
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Medical informatics articulation with PSU
Bachelor of Science -- Computer Science
Masters of Science -- Medical Informatics
Medical Records • Partners – community colleges
Supply of Healthcare Personnel
OHSU Initiatives
Academic programs under development
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Medical informatics
Public Health
Clinical
Supply of Healthcare Personnel
OHSU Initiatives – Graduate Programs
MD -- physicians
DMD -- dentists
Masters Level Doctoral Level
Activities - MD – increasing class size slowly – 90 to 108
Activities - plan for a new building - current class size – 74 - developing regional programs
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Supply of Healthcare Personnel
Unique Partnerships
Between:
community colleges
higher education
private medical industries
• hospitals
• clinics
• equipment providers
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Supply of Healthcare PersonnelExample of Workforce Initiatives Outside of Oregon
WICHE West: Meeting workforce demands in mental health through regional partnerships.
Seattle Community College District Healthcare Education Institute coordinates allied health programs between campuses
Milbank Memorial Fund and Reforming State GroupsStrategies for State Policy
Increase supply – effective recruitment Improve quality of care Promote effective delivery system Limit increasing costs Create a more culturally, diversified workforce Improve quality of working environment Career ladder Labor serving technologies and improved information systems
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Supply of Healthcare PersonnelExample of Workforce Initiatives Outside of Oregon
How states have responded to nursing strategies - WICHE
2001-2003 legislative initiatives focused on the educational pipeline attracting a more diverse pool
Western States:
California – standardizing nursing programs Colorado – legislation for admission policies and a career path program New Mexico – Nursing Licensure Compact Nevada – Nursing loans Oregon – Nursing Services Program OSAC – pay part of student loans NLC – double enrollment by 2004 – redesign nursing education Wyoming – Internet Courses
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Supply of Healthcare Personnel
Return on Investment Economic Development
Healthcare Industry -- An Engine for Economic Growth
Employs over 100,000 people -- Generates $4 billion dollars annually
Oregon’s hospitals employ – 40,000 annual payroll $1.85 billion
Average salaries - $48,000 + $13,000 benefits
Health occupations will be 11% of job growth by 2012 – adding 15,000 jobs.
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Supply of Healthcare Personnel
Solutions – Prescription for Success
Increase educational capacity and pipelineFill enrollment in key jobs
Nursing – ADN and LPN pharmacists dentists dental hygienists radiologic techs medical records assistants
Increase availability of qualified Faculty
Scholarships – coordinates with ASSET initiative
Partnerships with healthcare
industries
Employers
Tele education
GOAL: 1
Assure that public and private educationalinstitutions have adequate financial resourcesto offer healthcare programs.
Assure faculty salary scales to recruitqualified teaching faculty.
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Supply of Healthcare Personnel
Solutions – Prescription for Success
Increase clinical capacity
GOAL: 1 continued;
Assure rural and underserved areas have access to facilities.
Provide incentives to employers to increase clinic capacity
Plan, fund and design simulation centers
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Supply of Healthcare Personnel
Solutions – Prescription for Success
Enhance the quality of educational experiences
GOAL: 2
Assure rural and underserved areas have access to facilities by 2003
Focus on competencies
Increase learning opportunities
• distance learning
• flexible scheduling
Provide stable funding for community colleges and universities that accounts for the higher costs in healthcare programs
Develop partnerships among education and private sector associations
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Supply of Healthcare Personnel
Solutions – Prescription for Success
Enhance Retention and WorkEnvironment
GOAL: 4
Develop legislative initiatives withimplementation plans
GOAL: 6
Build a Centralized Workforce and Education database system
GOAL: 5
Improve Recruitment ofHealthcare Workers and students
GOAL: 3
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Supply of Healthcare Personnel
Potential Partners for Resources
Dept. of Education Dept. of Labor Dept. of Human Services
Federal Funds
Community colleges/universities Hospitals Equipment companies Other health related industries
Public/private Partnerships
OHSU Nursing Consortium Center for Allied Health Professions
• OIT/Community Colleges/hospitals
Pilot projects
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Supply of Healthcare Personnel
Return on Investment -- Economic Development
To Make A DifferenceShort-term strategy
(1-5 years) Provide investment dollars for expanding enrollment in nursing and allied
health education programs to double graduates.
Coordinate recruitment efforts traditional and non-traditional students
Support the development of key partnerships (public/private)
Support better workforce data and medical information systems
Recommendation:Investment to support academic program expenses to double enrollment and graduates
• faculty
• physical facilities
• medical information system programs (education and industry)
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Supply of Healthcare Personnel
Return on Investment -- Economic Development
To Make A Difference
Medium-term strategy(5-10 years)
Incentives for graduate programs for new faculty in healthcare
Improve efficiency of healthcare systems to meet challenge of rising medical costs Develop information systems
Develop legislation that facilitates incentives for employer-funded endowments targeted scholarships for health professions programs
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Supply of Healthcare Personnel
Return on Investment -- Economic Development
To Make A Difference
Long-term strategy
Stabilize funding for healthcare education
Develop a culture of public/private partnerships
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Supply of Healthcare Personnel
Supply of Medical Personnel for
Academic Excellence/Economic Development
Key Initiative
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OREGON BELIEVES IN DREAMERS
A Dream Come True!
Partnerships with education and medical industriescan make a quality Healthcare system for Oregon.
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Supply of Healthcare PersonnelReferences and Resources
Clackamas Community College: The WIN Program: Re-entry into the Profession of Registered Nursing.
Community College Healthcare Action Plan (January 2004): Status Report: LinnBenton/Lane Challenge Grant.
Community College Healthcare Action Plan (January 2004) Status Report:Cascades East AHEC (CEAHEC) Nursing Education Project.
Community College Healthcare Action Plan (January 2004): Status Report: LPN Project.
Community College Healthcare Action Plan(January 2004): CCHAP Flash: 2ndUpdate: Simulation Technology Within Oregon.
Community College Healthcare Action Plan (February 2004): Status Report: Prerequisite Project.
Community College Healthcare Action Plan(November 2003 and January 2004):CCHAP Linkages.
Community Colleges and Workforce Development (Spring 2002): Health CareEducation and Training in Oregon: The Community College Challenge.
Community Colleges and Workforce Development (January 2002): CommunityCollege Healthcare Action Plan.
Community College Healthcare Action Plan (February 2004): CCHAP Flash: 3rdUpdate: Simulation Technology Within Oregon.
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Supply of Healthcare PersonnelReferences and Resources continued:
National Academy of Sciences (2002): Unequal Treatment: Confronting Racialand Ethnic Disparities in Health Care.
Northwest Health Foundation (2001): Oregon’s Nursing Shortage, A PublicHealth Crisis in the Making. www.nwhf.org.
Oregon Center for Nursing (December 2003): Technology in Nursing Education.Completed by Loretta Krautscheid, RN, MS and Deborah Burton, PhD, RN.
Oregon Consortium for Nursing Education(March 2004): Update on Progress.
Oregon Employment Department (July 2003): Employment Projections byIndustry 2002-2012.
Allen Dourma: The Cast of Medical CareA Challenge and Business Opportunity
Oregon Employment Department, Workforce and Economic Research (2003):Employment Projections by Occupation 2002-2012. Statewide and Regional.Available at: http://www.qualityinfo.org/pubs/occpro/03/pdf/occproj.pdf
Oregon Employment Department (2001): Labor Market Information. Health CareIndustry Trends. Completed by Lynn Wallis.
Oregon Health Career Center (January 2004): LPN Supply & Demand: TheFuture of Licensed Practical Nurses in Oregon.
Oregon Health & Science University, Area HealthEducation Centers Program (2000): Oregon Health Workforce Project: Registered Nurse Profile.
Oregon Nursing Leadership Council: ONLC Strategic Plan: Solutions to Oregon’sNursing Shortage. http://www.osbn.state.or.us/pdfs/onlcpl_1.pdf
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Supply of Healthcare PersonnelReferences and Resources continued:
Oregon Workforce Investment Board (Fall 2002): Health Care Sector Employment Initiative: Taking “AIMM” at a Growing Crisis.
U.S. Bureau of Labor Statistics (November 2001) Monthly Labor Review: Occupational Projections to 2010. Completed by Daniel E. Hecker.http://www.bls.gov/opub/mlr/2001/11/art4full.pdf.
U.S. Government: 1996 National Sample Survey of Registered Nurses.http://bhpr.hrsa.gov/healthworkforce/reports.
U.S. Health Resources and Services Administration (July 2002): Projected Supply, Demand andShortages of Registered Nurses: 2000-2020.
Panel Presentation (May 2004): Oregon’s HealthcareWorkforce Universe: Issues, Players and Solutions
Oregon Health Workforce Project (2002): DentalHygienist Workforce Report
Community College Healthcare Action Plan (February 2004): Healthcare Workforce DevelopmentSolutions: Community College & HealthcareProvider Partnerships
Western Interstate Commission for Higher Education WICHE (September 2003): Rural Mental Health in the WICHE West: Meeting Workforce Demands through Regional Partnership
Western Interstate Commission for Higher Education (WICHE) (June 2003): Registered Nursing Shortages: Public Policy, and Higher Education in the Western States
NEON Nursing Education Access Partnerships Meeting(February 2004)
Milbank Memorial Fund Electronic Reports, TheReforming States Group (September 2003): Making Sense of the System: How States Can Use Health Workforce Policies to Increase Access and Improve Quality of Care by Edward Salsberg.