Health Care Industry

 

Identifying and Addressing

Workforce Challenges

February 2004 
Prepared by Alexander, Wegner, & Associates and submitted to the 

U.S. Department of Labor, Employment and Training Administration. 

February 2004 
Health Care Industry 

Identifying and Addressing Workforce Challenges 

Table of Contents

Preface ................................................................................................................................1

Executive Summary...........................................................................................................3

Introduction .......................................................................................................................9

I. Background on Workforce Issues.......................................................................10

II. Health Care Workforce Challenges: The View from the Field .......................12

Information Sources.......................................................................................................... 12

Executive Forums.................................................................................................. 12

Interviews with Health Care Industry Providers, Occupational Representatives, 

Educators, Workforce Professionals and Researchers......................................... 13

Identified Challenges ........................................................................................................ 14

Pipeline: Recruitment and Retention................................................................... 14

Skill Development ................................................................................................. 19

Capacity of Education and Training Providers.................................................... 21

Sustainability of the Workforce System: Leadership, Policy, and Infrastructure 23

Do Workforce Challenges Differ Between Sectors?............................................. 26

Workforce Challenges, Clusters, and Themes.................................................................. 26 

External Validation of Workforce Challenges Identified by Key Informants....... 27

III. Potential Solutions for Addressing the Health Care Industry Challenges .....28

The Health Care Industry Responds to Its Workforce Challenges................................... 28 

The High Growth Job Training Initiative: Generating Solutions ..................................... 29 

Process.................................................................................................................. 29

Product.................................................................................................................. 30

Review................................................................................................................... 32

Solutions for Initial Action.................................................................................... 32

National, State and Local Partnerships for Workforce Solutions ........................ 33

Attachments:

1. Health Care Industry’s Solutions Matrix – Full 

2. Health Care Industry’s Solutions Matrix – Condensed

3. 1001 Solutions Generated at the Health Care Industry 

Workforce Development Forums

1

Preface 

The following is a report prepared by Alexander, Wegner, & Associates for the U.S. Department 

of Labor, Employment and Training Administration’s Business Relations Group. This report 

details what the U.S. Department of Labor, Employment and Training Administration (DOL 

ETA) has learned from employers, employees, educators, workforce professionals, and 

researchers about health care workforce challenges and solutions. It provides the basis for 

developing strategic partnerships that include industry, education, and the public workforce 

system. 

At the federal level alone the public workforce system invests over $15 billion each year 

providing employment and training services to people who need them. ETA is always looking 

for more effective and efficient ways to use these resources. The Initiative, of which this report 

is a part, is directed toward forging these partnerships and making these improvements. 

To address workforce needs in health care and other industries, ETA created the Business 

Relations Group. Recognizing that workforce development is part of economic development, the 

Business Relations Group’s focus is on the education, employment, and economic development

partnerships that are needed to fuel our nation’s economy. ETA’s goal is to prepare the 

workforce system to better serve the needs of business, and to connect businesses with the 

workforce system through targeted initiatives. 

Based on ETA’s review of major areas of job growth, the health care industry was selected as 

one of 12 industries for the High Growth Job Training Initiative. 

The reality of the situation allows employers the opportunity to reach out and offer jobs in health 

care that are enticing to potential job seekers. Health care occupations are attractive because 

they are located across the nation, provide a professional work environment, and are portable. 

The health care industry needs greater diversity among its workforce, and therefore may be 

attractive to new labor pools. There is an increased building of career ladders and lattices that 

are available to workers so they can shape their careers. 

Meeting the short-term needs and the projections for the coming decade is only part of the 

challenge. The long-term care sector alone will see an increase of 5.7 to 6.6 million direct-care 

workers by the year 2050.1

 Even the most optimistic hopes for increased technological solutions 

or improvements in the health of Americans will not prevent this increased need for direct care 

workers. 

ETA heard from employers, and others associated with health care, of some of their actions to 

identify challenges and implement effective workforce strategies. ETA heard of the pressures 

they experience to do much more, to do it quickly, and to do it in a way that is sustainable over a 

long period of time. Health care leaders are committed to dealing with major workforce issues. 

 

1

 U.S. Department of Labor. Bureau of Labor Statistics. July 2002. Projected Growth Rates by Industry 

(Department of Health and Human Services, Office of the Assistant Secretary for Planning and Evaluation.) 
2

However, the challenges they face are far too complex for any one institution or sector to solve 

alone. It has never been more important for ETA to build partnerships between employers, 

employees, educators, workforce professionals and government. 

The Employment and Training Administration and the public workforce system will now move 

to partner with industry and education institutions to act on solutions from this report that 

highlight innovative ways that the workforce system can be a catalyst for meeting the health care 

industry’s workforce needs. 

To those who gave generously of their time, effort and other resources for this initial work -- 

thank you for your thoughtful contributions. To those reading about this initiative for the first 

time -- ETA looks forward to your contributions to building a responsive and sustainable health 

care workforce system throughout the country. 

As ETA heard from different industries, it found several workforce challenges that are common 

throughout different sectors. ETA will look to partner to address these workforce problems 

across industries. Solutions will be categorized under the following categories: pipeline, 

competency models, post-secondary and alternative training, new labor pools, retention, 

transitioning/declining industries, and small businesses. 
3

Executive Summary 

A top priority for the Department of Labor’s (DOL) Employment and Training Administration 

(ETA) is serving America’s workers through effectively meeting the workforce needs of 

business. The High Growth Job Training Initiative of ETA and its Business Relations Group 

recognizes that workforce development is not separate from economic development but an 

integral part of it. 

The health care industry was selected as one focus within the High Growth Job Training 

Initiative. Health Services comprised 5.8 percent ($589.9 billion) of Gross Domestic Product in 

2001.2 In 2002, the total employment in health services was 11,529,000.3 The Labor 

Department’s Bureau of Labor Statistics projects that the industry will add 3.5 million new jobs, 

or 16 percent of all wage and salary employment, between 2002 and 2012. Nine out of the 

twenty fastest growing occupations will be in health care. 4 

Significant workforce supply and demand gaps currently exist across the U.S. that affect acute 

care, long-term care and primary care health care provider sectors. These gaps are even more 

significant across all three sectors in rural America. 

This report provides the results of information gathering from key health care informants 

regarding workforce issues as reported by the ‘demand’ side of the workforce. The provider or 

owner/operator associations employing the greatest numbers of health care workers are the 

primary employer informants. Parallel to meetings and interviews with employers, relevant 

workforce reports and information were sought from the DOL Bureau of Labor Statistics, the 

Department of Health and Human Services Health Resources and Services Administration, 

health care workforce researchers, reports of provider associations, educators, public and private 

workforce professionals – including Workforce Investment Boards, and the contacts suggested in 

interviews with members of these sources. 

The initial analysis of the information generated concluded with a clustering of the workforce 

issues or challenges by topic and by sector within the health care industry: 

 

 Pipeline Challenges/Issues: Recruitment and Retention 

o Increasing available labor pool 

o Increasing diversity and seeking workers from non-traditional labor pools 

o Reducing turnover 

 

2

 U.S. Department of Commerce. Bureau of Economic Analysis. November 2002. Gross Domestic Product by 

Industry for 2001.

3

 U.S. Department of Labor. Bureau of Labor Statistics. February 2004. Monthly Labor Review. 4

 Ibid. 
4

 Skill Development Challenge/Issues 

o Entry-level worker preparation 

o Incumbent worker training 

o Need for targeted and specialized areas of skills 

 Capacity of Education and Training Providers Challenges/Issues 

o Lack of academic and clinical instructors 

o Lack of facilities and resources 

o Lack of alignment between employer requirements and curricula, and 

specialized skills areas 

 Sustainable Workforce: Leadership, Policy, and Infrastructure Challenges/Issues 

o Need for sustainable and adaptive workforce partnerships at national, state and 

local levels 

o Opportunities to leverage funding and other resources 

o Planning tools (data, projections, and information systems that are useful in 

projections of demand at the single facility and local levels) 

o Policy issues including those of regulation 

The majority of the workforce issues reported are the same or similar across primary, long-term 

care and acute care sectors. For example, all types of provider groups report that the current 

number one problem in occupational vacancies is for registered nurses. There are, however, 

some identifiable differences among the provider sectors. For example, long-term care providers 

identify a serious concern regarding the current and projected supply/demand gap of senior 

managers, while neither acute nor primary care providers share the same degree of concern. The 

acute care providers’ vacancies include a significant number of direct care workers, medical 

diagnostic and treatment technologists and support workers. The rural health vacancies across a 

wide spectrum of occupations are of continuing concern and made more problematic with the 

current vacancy rates nationally. 

A second step in information gathering and analysis was performed prior to and during the 

course of three Workforce Development Industry Forums held in October 2003. The 126 forum 

participants were selected from a pool developed through nominations from owner/operator 

associations, the National Association of State Workforce Agencies, the National Association of 

Workforce Boards, the American Association of Community Colleges, and other workforce 

leaders from whom project staff had previously sought information. Some of the participants 

represented health care workforce projects currently funded by the Employment and Training 

Administration. Participants were asked to complete a validation tool containing challenges 

gathered in Phase I and invited to suggest additional issues. In addition, at the forums they were 

presented with an overview of the challenges and issues and asked for additional input. No 

changes in the challenges were made. 

Participants in the forums were assigned to one of four groups. They clarified challenges or 

issues, generated 1001 solutions, and ranked the solutions by a voting procedure. For the 83 

highest-ranked solutions, small teams worked to develop a matrix that includes the challenge, the 
5

solution, critical attributes for a successful solution, key stakeholders, resources required, policy 

barriers at the local, state and national or federal level, and any other needed clarifications. 

The highest-ranked solutions include recommendations in the following areas: 

 Issue: Pipeline: Recruitment and Retention 

 Solution: Creating and expanding youth-focused programs to better inform young 

people about health care careers and encourage them to consider health care 

occupations. 

 Issue: Pipeline: Recruitment and Retention 

 Solution: Ensuring that public workforce programs provide adequate preparation of 

entry-level workers in the basic knowledge required to enter many health care 

occupations, adequate social and financial supports during the training period, 

opportunities for work placement, and support during the transition to the workplace 

so these workers can succeed and be retained in the health care industry. 

 Issue: Pipeline: Recruitment and Retention 

 Solution: Marketing health care career opportunities to youth, potential worker pools 

that do not traditionally enter the health care industry, dislocated workers, immigrant 

communities, older workers, and traditional worker pools. 

 Issues: Pipeline: Recruitment and Retention and Skill Development 

 Solution 1: Attracting and retaining workers through significant improvement of the 

“culture” of the health care workplace by implementing shared governance, 

incumbent worker training, career ladders, access to education and training 

opportunities, and other attributes identified by employees, researchers, and from 

exemplary continuous improvement programs. 

 Solution 2: Providing management training and credentialing in long-term care, 

consistent with this type of workplace improvement. 

 Issue: Skill Development 

 Solution: Designing health care occupation curricula that provide the basic 

knowledge and skills needed for effective entry to practice in the high-growth areas 

of employment in primary care, long-term care and acute care sectors. Develop 

curricula so that there is a fit between programs for advancing the careers of health 

care workers (often provided through the workplace) and the requirements of the 

educational institutions. 

 Issue: Skill Development 

 Solution: Examining the state credentialing requirements with the goal of expanding 

less traditional paths to meeting occupational requirements, such as career ladders, 

apprenticeships and other workforce development strategies. Creating “cross walks” 

from practice to educational programs and credentialing requirements based on 

nationally developed measurement of worker skills. 
6

 Issue: Capacity of Education and Training Providers 

 Solution: Addressing the capacity problems (i.e., lack of faculty, resources, etc.) in 

many community colleges and other post-secondary education and training 

organizations where barriers to applicants exist and where there are inadequate 

numbers of qualified applicants for actual or projected demand for some health 

service occupations. Capacity is affected by lack of faculty and other resources. 

 Issue: Sustainability: Leadership, Policy, and Infrastructure 

 Solution: Partnering among a wide range of stakeholders in the health care workforce 

in order to project changes in workforce demand at the local/regional, state and 

national levels and to generate long term, efficient, and sustainable approaches to 

those changes. 

 Issue: Sustainability: Leadership, Policy, and Infrastructure 

 Solution: Developing methods for projection of medium-term occupational needs that 

can be used by a health care entity, such as a hospital or home care agency, as a basis 

for internal planning and for planning with partners in education, workforce 

development and other health care workforce stakeholders. 

 

The Department of Labor Employment and Training Administration’s Business Relations Group 

reviewed the solutions generated during the Workforce Development Industry Forums. The 

purpose of the review was to: 

(a) Identify for referral those solutions that are both the responsibility of other entities and 

not in the domain of the Department of Labor; 

(b) Identify solutions that are jointly in the domain of the Department of Labor and 

another federal department; 

(c) Identify solutions where the Department of Labor or the public workforce system 

already have program commitments; and, 

(d) Identify solutions within the Department of Labor’s domain that if implemented 

effectively and widely will have a significant impact on managing the present and 

future workforce challenges of the health care industry. The latter group of solutions 

was examined by asking the question: “How can the Employment and Training 

Administration best use its resources and influence to have a positive impact on the 

challenges identified by the health care industry?” The solutions selected for initial 

action are ones that can be adapted to many settings, that are built on partnerships 

among stakeholders, that provide other opportunities to leverage resources (including 

funding), and that are relevant to the basic problem of adapting the workforce to 

changing industry needs.

 

The solutions anticipated to have the clearest impact include the following program areas: 

9 Youth-related programs developed and implemented by partnerships that include schools, 

health care employers, post-secondary programs for health occupations, and public 

workforce system entities. 
7

9 Programs focused on non-traditional and traditional pools for health care entry-level 

workers that both broaden approaches to preparation programs and enhance career 

mobility in health care and related industries. Competency models for these programs 

should be developed through a partnership of educators, employers, and workforce 

professionals. 

9 Initiatives that meet the needs for academic and clinical faculty in high-demand health 

care education programs and that are designed to adapt to changing levels of workforce 

demand. 

9 Programs that deal with the community college and other educational organizations’ 

insufficient capacity through innovative partnerships and other approaches. These 

capacity issues include the need for appropriate clinical practice opportunities, funding 

for students, diagnostic and treatment equipment, and laboratory support. 

9 Improvement of health care workplaces by interventions such as management training, 

incumbent worker training, career mobility programs, accessible education and training 

opportunities, and reducing staff fluctuations through workforce projections. 

9 Effective initiatives to build a sustainable national infrastructure with local, state, and 

national elements tasked with continuous balancing of workforce demand and supply 

within the health care industry. 

The majority of the solutions identified by forum participants are not sector specific. However, 

many solutions can be adapted to the particular needs of a sector or a community. 

National, State and Local Partnerships for Implementing Workforce Solutions 

Dealing with workforce challenges in the health care industry requires collaboration at the 

national, state and local levels, and between these levels. Executive and Workforce 

Development Industry Forum participants recommend a national, systemic approach that aligns 

the workforce resources available with the challenges facing the health care industry today and 

well into the future. This direction is consistent with the thinking behind the High Growth Job 

Training Initiative. 

A central role of the Employment and Training Administration is that of identifying and 

communicating effective workforce solutions that can be replicated to respond to national 

challenges such as management training or youth-related recruitment programs. A second aspect 

of that role is the funding of pilot programs, by ETA alone or in partnerships, that are most 

effective in dealing with some aspect of workforce challenges, and that are replicable by other 

entities. At the national level, providers and others also identify the need for a national 

warehouse of sound and effective workforce interventions with a search engine that makes it 

possible for a local Workforce Investment Board, a human resources manager, or others to 

identify solutions that have worked elsewhere. 
8

The actions of state governments and state-level entities are pivotal to any national workforce 

effort. State government decisions direct how some federal funding is used to support some 

workforce programs. For example, the Workforce Investment Act provides funding to states, 

and through the states to local Workforce Investment Boards and workforce-related programs. 

These funds and others, such as Temporary Assistance to Needy Families and Medicaid, are used 

to provide training, support, and placement for many occupations including those in health care. 

It is at the state level that policy and funding decisions are made about higher education, 

licensing and regulation. Medicaid programs that directly affect employment conditions and 

delivery of care, worker training, collection of information for programs and policy 

development, and other initiatives that directly influence the implementation, are among many of 

the solutions recommended in the Executive Forums and Workforce Development Industry 

Forums. A sustainable, adaptive and effective workforce strategy in health care requires strong 

public and private partnerships in every state. Without these partnerships ETA cannot respond 

adequately to current problems or prevent future ones. 

Local partnerships, including Workforce Investment Boards, employers, employees, educators 

and other community members, are needed to implement workforce solutions closest to health 

care delivery sites, and to potential labor pools. Through such partnerships, both the workforce 

demand and supply sides can identify the needs in their own communities. Partners can use their 

state and national networks to find solutions to better manage their particular challenges.
9

Introduction 

The High Growth Job Training Initiative (HGJTI) is a strategic effort to improve the publicly 

funded workforce system’s responsiveness to the needs of the labor market in order for the 

workforce system to become more demand-driven. HGJTI is specifically designed to build 

collaborations among employers, industry leaders, business associations, employees, educators, 

trainers, community- and technical college systems, and the public workforce system. The 

purpose of these partnerships is to support models that demonstrate how a demand-driven 

workforce system can more efficiently serve the workforce needs of business while also 

effectively helping workers find good jobs at good wages.

In collaboration with private and public sector partners, the High Growth Job Training Initiative 

seeks to leverage the publicly funded workforce system more effectively to prepare new and 

incumbent workers with the general and industry-specific knowledge and skills required by 

employers. HGJTI focuses on high growth industries where specialized skills curricula need to 

be developed, or upgraded, to ensure that workers have the right skills for the right jobs at the 

right time. 

The identification of high growth industries was accomplished through research and analysis of 

recognized workforce sources, including the Bureau of Labor Statistics and the Bureau of 

Economic Analysis. Twelve industries were selected for the initial project focus, based upon 

high growth industry projections, economic development needs, and micro-enterprise efforts. 

Health care is one of the industries of focus. 

This report represents an assessment of the health care initiative. It is organized into the 

following sections: 

• Section I – Presents brief background on the larger context of workforce issues.

• Section II - Describes the information gathering and analysis phases of the health care 

initiative concerning workforce gaps, issues and challenges. Gaps, issues and challenges 

identified by informants are presented by sector – acute, long-term, and primary care – 

within health care or by those challenges that include more than one sector. 

• Section III - Describes the information gathering and analysis phases concerning 

solutions to workforce challenges.

• Section IV - Presents the clusters of solutions which are most likely to profit from further 

Department of Labor and public workforce initiatives.
10

I. Background on Workforce Issues 

“The crisis facing America’s labor market is not widely recognized.”5 This same conclusion is 

reflected in many recent reports on U.S. economic development that address adjusting worker 

skills to new technologies in industries, disparities in wages, anticipated needs of an aging 

population, the funding of Medicare and Social Security, and other issues affected by the labor 

market. The “crisis” arises from two primary sources: a significant reduction in people with 

required skills, and the “leveling off” of the number of American-born people available for jobs. 

The slowing of educational attainment and its negative, long-term economic impact is reported to 

be widely ignored in the face of present economic and international concerns. The number of 

workers with high school completion diplomas grew 121% from 1980-2000. The twenty-year 

projections are for a rise of only 25 percent, or an additional 20 million workers, with high 

school diplomas. Moreover, the percentage of the workforce with college degrees is also 

expected to grow very slowly.6

 The most optimistic scenarios project a marked slowdown in skill 

growth. 

In order to assure a strong economic future, workforce initiatives in the United States must 

clearly link economic development, employment and education. For nearly two decades, the 

United States has seen a marked increase in both the size and educational level of the labor force, 

and, as a result, the country has experienced strong economic growth. The depth and breadth of 

the labor pool has been driven by the large numbers of Baby Boomers entering the workplace, 

substantial numbers of women entering the workforce and more than a doubling of the number 

of college-educated workers. 

However, the current reality is that such a growth in the numbers of new and educated 

American-born workers has ended. 

From 1980 to 2000, 26.7 million new, native-born workers age 25-54 provided the 

workforce needed for our dynamically growing economy. From now until 2021, there 

will be no additional native-born workers in this prime age group. None. 

Therefore, any growth in the labor force will simply have to come from older workers 

and immigrants.7

In addition to older workers and immigrants, labor growth could be realized through the 

development of workers from our untapped labor pool. The Department of Labor Employment 

and Training Administration’s (ETA) High Growth Job Training Initiative takes this type of a 

demand-driven approach to workforce issues. During the Executive Forums, ETA asked 

 

5

 The American Assembly, Columbia University. 2002. Keeping America in Business. Advancing Workers, 

Businesses and Economic Growth. p 12. 6

 DT Ellwood. 2001. “The spluttering Labor Force of the 21st Century. Can social Policy Help?” in A Krueger & R 

Solow, editors, The Roaring Nineties: Can Full Employment Be Sustained? New York: Russell Sage. 7

 The Aspen Institute Domestic Strategy Group. Grow Faster Together. Or Grow Slowly Apart. How will America 

Work in the 21st Century. p 11. 
11

employer organizations to provide their current and anticipated demand for workers, their skill 

shortages, their views on the capacity and appropriateness of the workforce pipeline, their 

identification of promising workforce practices, and their knowledge of the existing public 

workforce system at the local, state and federal levels. This is an important part of a demanddriven approach to workforce issues. 

The intended outcomes of the High Growth Job Training Initiative are: 

 Targeted investment of workforce development resources and support for private and 

public sector partnerships to ensure the development of workers’ skills in demand 

occupations based on industry need. 

 Improved integration of community and technical college efforts with business and the 

public workforce system activities to meet the training needs of high growth industries. 

 Increased opportunities for employers to use registered apprenticeship training as a skills 

development method, combining on-the-job and academic training to ensure a pipeline of 

skilled workers. 

 Greater access to career enhancing opportunities in high growth occupations for workers 

By expanding the local workforce system’s capacity to be market driven, responsive to local 

economic needs, and contributing to the economic well-being of the community, the 

Employment and Training Administration is actively promoting workforce quality, enhanced 

productivity, and economic competitiveness. 

The ability to respond to evolving labor market demands will require strong, positive 

relationships between the private and public sectors. It also requires developing and maintaining 

a very complex set of workforce perspectives and resources, both demand-side and supply-side. 

One particularly valuable asset is agreement among key industry stakeholders regarding the 

major workforce challenges confronting the health care industry. Without agreement on these 

challenges, there is little or no incentive to construct solutions through national initiatives. 
12

II. Health Care Workforce Challenges: The View from the 

Field 

The collection and assessment of up-to-date information on the health care industry is an 

important first step for the High Growth Job Training Initiative. It begins with a Health Care 

Industry Environmental Scan. 

The major settings for health care employment are: 

 Private hospitals (39.3% of health services employees. NOTE: When government 

hospitals are included, hospitals employ 45% of industry workers.

8

) 

 Nursing/personal care facilities and home health care services (24.2% of all 

employees). 

 Physician offices (19.7% of employees). 

The major employers are acute care hospital settings, long-term care with facility-based and 

home care settings, and primary care settings based primarily in large and small physician 

practices. (NOTE: The terms acute care, long-term care, and primary care are used in this report 

to refer to these employment settings.) The boards of the largest employer associations served as 

the primary source for representatives of the key workforce and industry leaders in health care 

and were among the attendees for Executive Forums held with Assistant Secretary DeRocco (see 

below). These Executive Forums allow business and industry an opportunity to share their 

current and future workforce needs with the workforce system. 

The information from the Executive Forums is augmented with the results of guided interviews 

with key informants from national-level provider, or owner-operator, associations. Parallel to 

these activities, workforce data and information were obtained from associations, government 

departments, state-level workforce initiatives and workforce researchers. Since the workforce 

issues and gaps are perceived differently by workers, educators, and public and private 

workforce professionals than they are by employers, guided interviews with a small subset of 

these affected groups were also completed. 

Information Sources 

Executive Forums

Assistant Secretary Emily DeRocco of the U. S. Department of Labor Employment and Training 

Administration met with health care sector industry leaders to gather pertinent information about 

critical workforce issues and needs, and to hear their recommendations for how to address these 

issues/needs. In these forums, she had the opportunity to share the Administration’s goals and 

plans to meet the 21st century economy’s needs for a skilled workforce, and to elaborate on the 

current public workforce initiatives. Using this information, ETA, health care providers, and the 

 

8

 U.S. Department of Labor. Bureau of Labor Statistics. January 2002. Career Guide to Industries 2002-2003 

Edition. p 184. 
13

public workforce system can identify the workforce gaps; develop training initiatives and 

strategies to address the needs of business; and foster their alliance so that the publicly funded 

workforce system can respond to the needs of the labor market and become more of a demanddriven system. 

Executive Forums were attended by approximately 200 chief executive officers or senior 

administrators representing the following: 

 The American Hospital Association (AHA) which represents more than 523 

facilities, 200,000 employees and 18,000 managed beds. 

 The American Health Care Association (AHCA) which has 12,000 members of forprofit and non-profit assisted living, nursing facilities, developmental-disabilities and 

sub-acute care providers for 1.5 million elderly and disabled Americans. This board 

has representatives from each state. 

 The American Association of Homes and Services for the Aging (AAHSA) which 

has 5,600 not-for-profit nursing homes, continuing care, retirement communities, 

assisted living facilities, and home and community-based service providers. 

 The National Rural Health Association (NRHA) which has individual and 

organization members providing care to the 61 million Americans who live in rural 

areas and who comprise 22% of the nation’s Medicare beneficiaries. 

 The American Society for Healthcare Human Resources Administration (ASHHRA) 

which has membership from all three health industry sectors and is an affiliate 

organization of the AHA. 

Interviews with Health Care Industry Providers, Occupational Representatives, Educators, 

Workforce Professionals and Researchers 

 

Relevant input was also gathered through telephone or face-to-face interviews with national 

health care provider organizations, selected health care occupation representatives, education 

representatives, workforce professionals, researchers, and health care workforce reports from 

associations9

 and governmental bodies10.

 

9

Examples: American Hospital Association Commission on Workforce for Hospitals and Health Systems. April 

2002.In Our Hands: How Hospital Leaders Can Build a Thriving Workforce. Polisher Research Institute, 

Jenkintown, PA. February 2001. A Report to the Pennsylvania Intra-Governmental Council on Long Term Care 

Pennsylvania’s Frontline Workers in Long Term Care: The Provider Organization Perspective. 10 Examples: Report to Congress. December 2000. The Pharmacist Workforce: A Study of the Supply and Demand 

for Pharmacists. Department of Health & Human Services, Health Resources and Services Administration, Bureau 

of Health Professions. Report to Congress. May 14, 2003. The Future Supply of Long-Term Care Workers in 

Relation to The Aging Baby Boom Generation .Department of Labor and Department of Health & Human Services. 
14

Identified Challenges

The majority of the workforce challenges reported are the same or similar across primary care, 

long-term care and acute care sectors. For example, all types of provider groups report that the 

current number one problem in occupational vacancies is for registered nurses. There are, 

however, some identifiable differences among the provider sectors. For example, long-term care 

providers identify a serious concern regarding the current and projected supply/demand gap of 

senior managers, while neither acute care nor primary care providers shared the same degree of 

concern. The acute care providers’ vacancies include not only a significant number of direct care 

workers, but also medical diagnostic and treatment technologists and support workers. The rural 

health vacancies across a wide spectrum of occupations are of continuing concern and made 

more problematic with the current vacancy rates nationally. 

The agreement on the health care industry’s major issues and gaps is high – regardless of source. 

Although an allied health professional provides a different emphasis on job scope than a nursing 

professional, and a community college executive holds a different perspective on entry-level 

requirements than a workforce professional, we found virtually no disagreement on the issues 

and gaps. 

However, where challenges are identified in only one sector (acute care, primary care or longterm care), those are included in the challenges only for that sector. The challenges are phrased 

primarily as they were reported from the Executive Forums. Interview notes and written reports 

are yet another source of input on challenges. 

The challenges are broken down into four categories: 

 Pipeline: Recruitment and Retention 

 Skill Development 

 Capacity of Education and Training Providers 

 Sustainability: Leadership, Policy and Infrastructure 

Pipeline: Recruitment and Retention 

 

The aging of the nursing workforce was raised as an issue in almost all interviews. 

Workforce forecasters note that the fundamental dilemma is whether the historical rates of 

the workforce demand side will continue, i.e., whether past projection models will have any 

validity in the future. 

Currently, the average age of both the caregiver population and those receiving care is 

increasing and is likely to continue to increase for the long-term future.11 Providers in all 

health care sectors and workforce-related researchers concur that aging and labor market 

changes create a human resource demand that current workforce and workplace approaches 

 

11 U.S. Department of Health and Human Services. Bureau of Health Professionals. bhpr.hrsa.gov. 
15

will not resolve.12 The increase of the average age of the nursing workforce is expected to 

lead to increasing stress and pressure for health care workers from home care to large 

facilities. The median age of direct caregivers with the most physically demanding work, 

and who are the most difficult to attract and retain, is increasing as well. 

1.1 Labor Pool

All Sectors

There are many attractive career alternatives for young people other than health care. 

Increased marketing of health care occupations is a major need. The public’s image of 

careers in the health care field is reported to be less positive than it was a decade ago. 

Public workforce professionals, educators and health care employers identify a need for 

secondary education and experience in a health care sector in order to attract more students 

into health care occupations. 

Labor market changes are reducing traditional sources of health care workers. For example, 

professional occupations such as rehabilitation therapists and dieticians are comprised 

primarily of women. Women are increasingly entering male-dominated professions both 

within and outside of health care. 

Community colleges, workforce professionals and some providers note that certain 

diagnostic and treatment-related occupations, such as respiratory therapy, are finding 

recruitment of students into existing community college programs to be difficult. 

The greatest numbers of current and projected workforce requirements are for registered 

nurses, nursing assistants, and licensed practical and vocational nurses. This “demand” side 

assessment concurs with reports such as Bureau of Labor Statistics Occupational Projections, 

2000-2010, and Projected Supply, Demand and Shortages of Registered Nurses:2002-2020 

(July 2002, DHHS HRSA, National Center for Health Workforce Analysis). The National 

Council of State Boards of Nursing reports that U.S.-educated graduates sitting for licensure 

examinations decreased 31.3% from 1995 to 2002.13 Service occupations (e.g. food workers) 

are attracted to non-health care industry employment because of better compensation, 

working conditions, or both. 

1.2 Diversity and Non-Traditional Labor Pools 

All Sectors

Greater diversity is needed in the health care workforce. Ethnic and cultural diversity 

amongst workers provides improved care where patients and other health care consumers 

benefit from insights and understandings that are culturally based. Greater gender diversity 

 

12R Stone with J Wiener. 2001. Who Will Care For Us? The Urban Institute and the American Association of 

Homes and Services for the Aging. pp. 12-18. 

13 National Council of State Boards of Nursing. www.ncsbn.org. 
16

is also needed according to provider associations. Recruitment of men is a priority as the 

number of women entering traditionally female fields in health care are decreasing. 

Former military personnel are a source of recruitment for health care occupations. 

Recognition of the articulation between military personnel preparation in health care and 

requirements for various occupations is needed. The Advanced Distributed Learning System 

of the Department of Defense training via National Guard facilities is a key player for 

retraining individuals to fill needed occupations, the system may be used for health care 

training. 

There is a need to attract non-traditional workers into health care occupations. However, 

immigration of foreign-educated health care professionals can partially offset the labor pool 

decreases. Immigration issues represent a significant challenge. For example, Foreign 

Language Certification Programs do not seem to work (i.e. assure English language 

proficiency). Also, there are limitations in the number of professional personnel allowed 

entry into the U.S., and there are significant time delays and paperwork involved in admitting 

a foreign health care worker. 

1.3 Reducing Turnover

All Sectors

Workforce “demand-side” spokespersons note the clear relationship between adequate 

numbers and retention of employees and safe health care delivery. This concurs with 

findings reported in Crossing the Quality Chasm. 14 There are significant worker retention 

challenges in the industry. Employers report that the following issues are affecting retention: 

 Competitive compensation (e.g. hospital pharmacists are paid less than retail market 

pharmacists). 

 Incumbent worker training (also associated with improved job performance). 

 Career progression, especially ladders and ‘lattices’, for lower income workers. 

 Employee support in the workplace (e.g. respectful interactions, problem solving 

with clinical experts to help with care problems, conflict resolution training, team 

building, etc.). 

 Programs (and technology) that reduce workplace injuries. 

 The financial struggles of providers who have limited in-house resources to support 

training, preceptor programs and clinical rotations. 

Recent studies on worker satisfaction and performance and patient safety have placed an 

emphasis on the need for the redesign of health care jobs, redesign of physical space and 

development of support systems as highly significant factors. 

 

Hours of work vary among sectors, and since this is a source of dissatisfaction with health 

care careers, it has a differential impact on hospitals versus home care, in-patient health 

facilities versus physicians’ offices, et cetera.

 

14 Institute of Medicine. 2001. Crossing the Quality Chasm. National Academy Press. 
17

Workers need to be continually updated and trained. However, funding for training is often 

limited. The impact of diagnostic, treatment and care technologies, such as telemedicine, 

new medications and medication delivery systems, and new generations of medical 

equipment and techniques require continual updating of education programs and health care 

workers. These training needs require substantial human and other resources. During budget 

cuts, training funds by the employers are often an early target of reductions. 

Providers of care, educators and workforce professionals note the need for information 

technology for incumbent worker training, career development and distance learning 

opportunities to support attracting, retaining and retraining workers. Employees and 

employers need more flexibility in selecting the time and place for learning opportunities. 

Information technology can make training much more accessible and affordable for workers. 

The health care industry needs cross-disciplinary design teams to develop and expand these 

approaches.

One participant reported that in a particular health system, twice as much is spent on 

advertising for position openings than is spent on advertising products and services. 

Acute Care Sector

A high labor demand exists for various levels of health care personnel, including nurses 

(noted above for all sectors), laboratory technicians, rural physicians, pharmacists including 

aides and technicians, respiratory therapists, radiologic technicians, nuclear technologists, 

information technicians, laboratory technologists and technicians, service managers and nonprofessional and technical support staff. State workforce reports include these areas in 

addition to specific state needs. 

The acute care sector in rural areas is experiencing shortages in many occupations and this 

shortage is worsened by the current overall workforce shortages. 

Long-Term Care Sector

Higher worker performance and satisfaction with work are directly and positively correlated 

with low turnover of facility administrators and chief nursing officers. Vacancies and 

turnover of staff have been found to be more highly correlated with director of nursing and 

administrator turnover than any other factors studied.15 The levels of current turnover and 

projected gap in these two positions in long-term care present a serious challenge to this 

sector. 

 

Gaining and retaining nursing home administrators is increasingly difficult because of the 

environmental constraints such as credentialing and regulation. (NOTE: An example of the 

 

15 Personal communication with Dr. V. Tellis-Nyak regarding his research on worker satisfaction and performance 

of nursing homes. April 16, 2003. 
18

nature and extent of this challenge can be found in The Education and Credentialing of 

Nursing Home Administrators in New York State.

16) 

Nursing home administrators, and not hospital administrators, are required to have state 

licensing examinations for licensure. There is growing dissatisfaction with this process.17 

It is difficult to hire new registered nurse graduates who have the competencies and skills to 

meet the needs of a very challenging patient population. Graduates have most often received 

student clinical experience in the acute care sector where there is greater administrative 

support for care within nursing. For both of these reasons, new graduates are not trained well 

enough to contribute quickly and successfully in long-term care facilities or communitybased care. [This is also a skill development challenge.] 

Some long-term care employers are so desperate for staff that they hire new graduates before 

they are licensed. These new personnel may be asked to be charge nurses, although they are 

often unprepared to perform in that capacity. [This is also a skill development challenge.] 

There is a current and projected shortage of geriatricians in the U.S. In long-term care these 

physicians and primary care physicians are required as medical directors as well as direct 

care providers. Disincentives include: reimbursement structures for physicians who must 

visit nursing homes (i.e. be away from their offices); a lack of knowledge about the field of 

practice; a need for geriatric advanced nurse practitioners and physician assistants prepared 

in geriatrics; and other job design factors. 

Within the health care industry long-term care providers report they have greater difficulty in 

attracting and retaining workers compared with the acute care sector. Although there are 

several reasons proposed by researchers to explain this difference, one is that potential 

employees do not find work with the elderly to be attractive. 

The American Health Care Association reports that approximately 70% of nursing homes are 

in rural America. The recruitment and retention challenges are greater in rural areas, as 

noted above. 

Primary Care Sector

According to the American Association of Health Plans, large health care plan organizations 

have “spot” physician shortages. This was not, however, identified as an urgent problem and 

may be a result of health care provider competition in a particular market area. 

Additional challenges, such as the demand for radiographers to meet the increasing need for 

mammograms, and for cytopathology technicians, were also cited. Likewise, dental care 

providers have a substantial and growing need for dental hygienists and, in some areas, for 

 

16 October 2001. The Education and Credentialing of Nursing Home Administrators in New York State. University 

at Albany School of Public Health. chws.albany.edu. 17 Ibid. 
19

dental technicians. Some smaller medical group practices report the need for medical 

secretaries and other support staff. 

In rural areas the challenge is both to gain – and to retain – the physicians and the necessary 

laboratory and office staff to support their practices. Primary care shortage areas are reported 

by the Human Resources and Services Administration for each state and region.18 

Skill Development

All Sectors

The demand for highly skilled incumbent workers and job applicants in the health care 

industry is high. Overall, the skill development challenges are the same across sectors. 

Differences occur among those occupations or skills needed by one sector and not reported as 

needed by another. 

Career advancement and entry-level programs that keep pace with changing technology and 

systems for delivery of safe and accessible health care require continuing skill development. 

Effective skill development programs must be based on evidence-based interventions within 

the scope of practice of each occupation. In addition, both incumbent workers and job 

applicants require basic skills in such areas as basic science, language skills and computer 

literacy. 

Employers, employees and educators reported that testing of skill development through 

credentialing is a major barrier to skill transfer and to articulation between programs. 

2.1 Entry to Practice 

All Sectors

Employers and educators indicate that there is a barrier for many post-secondary students and 

incumbent workers seeking to enter health care occupations. The prospective workers need 

to have better preparation in science, computer literacy, human ethics and language skills. 

Specifically, limited proficiency in English is a challenge for many Hispanic employees and 

trainees as well as other “new” immigrants. The industry needs to help develop additional 

training in English-as-a-second-language skills because the workplace requires oral (e.g. 

patient care interactions) and written (e.g. patient care records) English. 

Training programs for employment skills such as arranging work schedules, transportation, 

child care, budgeting, funding (e.g. Temporary Assistance for Needy Families), and other 

‘soft’ skills need to be more available in high-demand locations. Moreover, entry-to-practice 

educational requirements for a number of professional and technological health care 

occupations are increasing. A minimum of a baccalaureate degree has been required of all 

health professions except registered nurses. An increasing number of professions are moving 

 

18 U.S. Department of Health and Human Services. Bureau of Health Professionals. bhpr.hrsa.gov. 
20

to more advanced degrees for entry-level. [It is not clear whether employers think this is 

unnecessary or that it is a problem only to the degree it lengthens the time to prepare people 

for health care occupations.] 

Long-Term Care Sector

Nurses often need to use supervisory skills even in beginning registered nurse, and some 

licensed practical nurse, positions. Few supports are in place, particularly for new graduates, 

to gain competence in these skills. 

Unit charge nurses, a managerial position, often have limited management skills and (from 

research reports on certified nursing assistants19) contribute to the high turnover among 

nursing assistants. 

Many faculty members are not fully equipped to teach long-term care skills and may need 

continuing education for this. In addition, long-term care employers noted the need for 

faculty who both practice and teach nursing. 

2.2 Incumbent Worker Training

Providers and human resource administrators report a need for skill training by distance 

education and/or computer-assisted learning that is available at times and places convenient 

to all workers, regardless of work shifts or distance. 

Distance learning could assist all sectors in incumbent worker training, particularly in the 

rural areas. 

Competency models and career ladders need to be clearer in order to provide career 

development opportunities for incumbent workers and potential health care workers. 

While most professional and technical programs include medical ethics material, providers 

also need to provide this content as part of continuing education for employees. 

There are significant gaps in employment and training for information systems in health care. 

 

19 Example: B Bowers, S Esmond, & N Jacobson (In press). Turnover reinterpreted: CNA’s talk about why they 

leave. Journal of Gerontological Nursing. 
21

2.3 Targeted and Specialized Skills Areas

Specialized skills programs are needed. For example, nursing assistants who receive training 

in the care of people with dementias can become highly skilled or specialized within their 

occupation. For example, long-term care administrators report a need for education and 

experience that improves patient care and helps retain skilled staff. 

Targeted workforce occupations, such as dental hygienists, can build needed skill 

development on prior experience such as being a dental assistant. This skill building can be 

facilitated by competency models that can assess prior learning. 

Capacity of Education and Training Providers 

Adequate funding is a key challenge for those colleges and universities providing health care 

programs. Some private organizations, such as providers and foundations, financially 

contribute to scholarships, joint-appointments for teaching, etc., in return for students 

agreeing to work/provide care in their organizations or in another health care entity for a 

period of time following graduation. Some vendors of diagnostic and treatment technology 

have partnerships with post-secondary programs. 

Community colleges report that as the majority of state budgets are reduced, more expensive 

programs, such as those requiring diagnostic equipment, supervised clinical and laboratory 

experience, are subject to disproportionate cuts when compared with less costly programs. 

They also report that some providers are less willing to accept students in clinical areas 

except under stringent conditions for supervision, or not at all. 

Providers say they need to communicate persistently to community colleges that there is a 

need to deal with waiting lists for health care program applicants. 

3.1 Academic and Clinical Instructors

Across the country, there are not enough available qualified nursing faculty in the nation’s 

technical schools and community colleges. Community colleges also suffer shortages of 

qualified academic and clinical faculty to teach other health care-related occupational skills. 

Currently, the largest gaps are preventing the admission of applicants in nursing. However, 

as programs are attempting to expand in other health care occupations, the lack of both 

faculty and equipment is now being widely experienced.20

At present, faculty salaries are not, in many areas, competitive with those in clinical practice 

settings. The American Association of Colleges of Nursing reports that graduate nurse 

programs are experiencing a marked decline in students preparing for teaching careers, 

although there is an increase in those planning to practice in direct patient care areas. 

 

20Example: LE Berlin & KR Sechrist. “The shortage of doctorally prepared nursing faculty: A dire situation”. 

Nursing Outlook. 2002:50-56. And interview with Dr. K Sigler, Provost for Operations, Miami-Dade Community 

College, Florida. 
22

Accreditation standards for registered nurse education include requirements for faculty to 

hold graduate degrees in their field. The smaller proportion of graduate students in 

university nursing programs developing a career in education versus clinical practice 

preparation is reducing the faculty pipeline to colleges and universities.21

3.2 Facilities and Resources

As noted above, higher education administrators report that with declining state resources, 

the more expensive programs, such as those requiring costly equipment and supervised 

laboratory and clinical practice, are much more subject to cutbacks. Once closed, programs 

are almost too expensive, and too difficult, to replace. 

Access to clinical practice appears to be a complex, local issue. On the one hand, we hear 

reports of widespread difficulty in securing clinical placements for students because 

providers are less willing to take them (the reasons are primarily related to risk management), 

while on the other hand, we are told that clinical providers want more students but that the 

educators are not placing them in acute care settings, rural areas and long-term care facilities. 

3.3 Alignment between Employment Requirements and Program Curricula 

All Sectors

There are at least two major issues: the ‘intake’ end of the pipeline and the ‘outflow’ end. 

Flexible ‘intake’ points for education and training programs are needed for career ladders and 

‘lattices’. Providers, employees and workforce professionals identify significant barriers at 

these entry points, such as the requirement for full-time study and traditional academic 

requirements when the next step on a career ladder is a certificate or degree program, while 

continuing employment. Students graduating from some curricula (i.e. “outflow”) are seen 

as not well prepared for employer expectations of basic performance in their positions. [The 

latter is also a Skill Development issue.] 

Long-Term Care Sector

Assessment skills of the licensed practical/vocational nurses coming through the colleges are 

often not sufficient to meet the needs of the long-term care profession. For example, longterm care nurses need competency in basic assessment skills to provide safe care because 

long-term care staff rarely have physicians available 24 hours a day. [This is also a Skill 

Development issue.] 

In a study of alignment between what long-term care administrators are taught, what is tested 

in certifying examinations, and their actual job requirements, respondents reported that what 

is taught and examined has little to do, for example, with what state surveyors expect them to 

do. They spend the most time at work in some areas for which they are the least prepared.22

 

21 Ibid. 

22 October 2001. The Education and Credentialing of Nursing Home Administrators in New York State. University 

at Albany School of Public Health. chws.albany.edu 
23

Sustainability of the Workforce System: Leadership, Policy, and Infrastructure 

(Note: Some of the challenges included here duplicate a few of those listed above. They are 

repeated because of their relevancy to this particular challenge) 

Shifting demographics are creating a long-term demand and supply problem which the health 

care industry has not previously experienced. The average age of the population receiving care 

and of caregivers is increasing now and for the foreseeable future.23 Providers and workforce 

researchers concur that the aging population and labor market changes create a human resource 

demand that current workforce and workplace approaches are not likely to resolve. 24 

4.1 Leadership

Long-term, systemic change is essential if the U.S. is to have the workforce it requires to 

provide the quality and quantity of health care it seeks. Leaders in health care 

owner/operator associations note a lack of national long-term planning for health care 

workers in this country. One leader observed that there is a lack of vision nationally about 

the career potential of the health care professions in contrast to that evidenced in the area of 

information technology. This lack of leadership and direction was also emphasized in other 

interviews and conversations. The broad consensus among industry leaders was that public 

and private national workforce agendas need to connect. 

4.2 Policy 

All Sectors

The need for long-term, sustainable national leadership and direction to deal with workforce 

challenges is great. Limited resources at national, state and local levels require a strategy to 

allocate and align resources in the best way to meet identified workforce gaps and changes in 

new and evolving workforce competencies. 

Policy challenges are multiple and diverse and include, among other issues, funding, 

immigration, licensing and regulation. 

Community college funding, particularly for capacity building for occupations in health care, 

is a pervasive challenge. It affects faculty, facilities and the students’ clinical experience. 

State funding is limited and/or is being reduced, the Workforce Investment Act funding for 

capacity building is likewise limited, and the Carl Perkins vocational/technical funding is 

primarily directed to secondary schools and not to community colleges. In fact, the Perkins 

Act is supposed to provide $1.5 billion annually to fund vocational training programs, and 

community colleges are supposed to be the focus of the funding, but this is NOT happening. 

 

23 U.S. Department of Health and Human Services. Bureau of Health Professionals. bhpr.hrsa.gov. 24 For example: R Stone with J Weiner. 2001 Who Will Care For Us? The Urban Institute and American 

Association of Homes and Services for the Aging. pp12-18. 
24

It is imperative that a change be made to the Perkins funding process so that colleges can 

gain access to these funds. 

Training dollars, too, are described as being in short supply for new workers and incumbent 

worker programs. Providers mentioned the recent funding of the Nurse Training Act as a 

positive benefit to the workforce support. Workforce Investment Act funds, however, are 

hard to secure for long-term care “unless members serve on the Workforce Investment Board 

so they receive funding”. Also, rules for the use of employment and training funding from 

various sources are seen as quite restrictive. 

Immigration issues also represent a significant challenge. For example, Foreign Language 

Certification programs do not seem to work. Also, there are limitations in the number of 

professional personnel who are allowed entry into the U.S., and there are significant time 

delays and paperwork involved in getting foreign health care workers, from such locations as 

the Philippines. Additionally, it appears more difficult to get medical professionals from 

Mexico than from Canada, for reasons that seem unclear. 

There are a number of challenges involving state licensing boards and reciprocity between 

states. Licensing boards too often have requirements that create barriers for non-traditional 

learners seeking to further develop their careers, such as faculty credentials and program 

design. Moreover, the regulations promulgated by state boards of nursing (the licensing 

bodies), are reported to be barriers to keeping up with the workforce needs faced by 

providers in many states. 

State Boards of Nursing can present obstacles in piloting innovative approaches to having 

more nursing clinical instructors. (An example is given in Executive Forum with the 

American Society for Healthcare Human Resources Administration.) 

There are a number of challenges involving state licensing boards and reciprocity between 

states. 

Finally, regulatory requirements at the state and federal levels often result in considerable 

paperwork and excessive time demands on direct caregivers. This regulatory burden needs to 

be reduced. 

Long-Term Care Sector

The lack of sustainable funding for an adequately large workforce was an issue mentioned by 

long-term care leaders. One interviewee said: “Some argue there is too much money in the 

system. If that is true then where is it going? There are profitable services: the money shifts 

there”. He recommended the need to consider a utility model for the health care delivery 

system as opposed to the current market model. 

Tort law in many states treats acute and nursing home organizations differently. This has 

resulted in a plethora of litigation against nursing homes. The results are not only high costs 

in settlements or court decisions, but also the escalation of premium costs, or complete loss 
25

of insurance coverage, and diversion of scarce resources away from care and management of 

care into risk management and legal activities. 

Medicaid and Medicare regulations and the processes of oversight (e.g. state surveyors who 

interpret and apply state and federal regulations) are making long term-care less and less of 

an attractive workplace. These oversight processes are rarely applied in acute care settings. 

Criminal background checks required of employees are cumbersome and their effectiveness 

is questionable. The objection does not concern the necessity of doing criminal background 

checks but rather the process used. [An alternative suggested by one interviewee is to 

explore the physician national-tracking system.] 

4.3 Infrastructure

Both the workforce demand- and supply-side organizations note the need for more shared

information about workforce practices that are feasible, effective, and transferable to other 

settings. A recurrent suggestion was for a national electronic link or website that makes such 

information available for users. 

There are significant gaps for employment and training in the field of information technology 

systems within health care delivery organizations. Data systems used for funding of care 

need to be more up-to-date and integrated across federal, state and local platforms. 

Health care executives state that, in general, they have limited knowledge and experience in 

collaborating to anticipate and plan for changes in workforce needs with one another, with 

public and private workforce professionals, and, to some extent, with educational institutions. 

Workforce Investment Boards need to be better known by the health care industry and more 

engaged in the process of filling health care jobs. They also need to be further engaged in the 

process of helping to find and implement solutions that will increase the available labor pool 

for health care occupations. 

Workforce intermediaries, a number of whom have effective employee/employer 

collaborative programs for new and incumbent health care workers, have serious and 

continuing funding challenges. As a result, much of their time is spent in seeking or 

managing reporting requirements of funders. Most of the intermediaries’ work across 

industries is directed at recruiting and training lower-income workers, and addressing career 

progression in the workplace. 

Planning for the complex health care occupation curricula in post-secondary education would 

be considerably more adaptive to workforce needs if health care providers at the single 

organization or company level could perform medium-term projections of their occupational 

needs (ETA was provided the name of one acute care health care system that uses such 

projections in their partnering with a community college). The problem of medium-term 

projections is rendered greater by unstable funding from public and private health care 

payers. 
26

Do Workforce Challenges Differ Between Sectors? 

Most of the workforce challenges reported are the same or similar across primary care, long-term 

care and acute care sectors. For example, all types of provider groups reported that the current 

number one problem in occupational vacancies is for registered nurses. There are, however, 

some identifiable differences among the provider sectors. For example, long-term care providers 

identify a serious concern regarding the current and projected supply/demand gap of senior 

managers, while neither acute care nor primary care providers shared the same degree of 

concern. The acute care providers’ vacancies include not only a significant number of direct care 

workers, but also medical diagnostic and treatment technologists and support workers. The rural 

health vacancies across a wide spectrum of occupations are of continuing concern and made 

more problematic with the current vacancy rates nationally. 

The agreement on the health care industry’s major issues and gaps is high – regardless of source. 

Though an allied health professional provides a different emphasis on job scope from a nursing 

professional; a community college executive may provide a different perspective on entry-level 

requirements from a workforce professional; and the Bureau of Labor Statistics’ projection of 

occupational needs may use different analytic tools than an employers’ association. 

Workforce Challenges, Clusters, and Themes

The next steps in the health care industry initiative’s data and information collection require 

validating the clusters of challenges and identifying solutions for the challenges. Since the 

clusters contain too many different types of issues for decisions to be made by people involved in 

the next steps, each of the four clusters, drawn from the challenges identified during the 

Executive Forums and other sources, was re-analyzed for sub-issues within the four major areas. 

The sub-issues are ones that are directly relevant to the health care industry workforce. They 

provide the classification of challenges and sub-issues within them. This framework is used for 

information gathering activities to validate the challenges and to generate potential solutions. 

 Pipeline Challenges/Issues: Recruitment and Retention 

o Increasing available labor pool 

o Increasing diversity and seeking workers from non- traditional labor pools 

o Reducing turnover 

 Skill Development Challenge/Issues 

o Entry-level worker preparation 

o Incumbent worker training 

o Need for targeted and specialized areas of skills 

 Capacity of Education and Training Providers Challenges/Issues 

o Lack of academic and clinical instructors 

o Lack of facilities and resources 

o Lack of alignment between employer requirements and curricula, and 

specialized skills areas 
27

 Sustainable Workforce: Leadership, Policy, and Infrastructure Challenges/Issues 

o Need for sustainable and adaptive workforce partnerships at national, state and 

local levels 

o Opportunities to leverage funding and other resources 

o Planning tools (data, projections, and information systems that are useful in 

projections of demand at the single facility and local levels) 

o Policy issues including those of regulation 

External Validation of Workforce Challenges Identified by Key Informants

The most critical question to be addressed before undertaking a major workforce initiative is 

whether the current shortages and projected demand for health care services occupations seen by 

employers are consistent with the findings of workforce professionals and researchers. The short 

answer is, “yes.” 

There is a high degree of consistency between employer reports, and national and state public 

workforce reports. The exceptions occur where a particular state labor need, such as 

phlebotomists, was not reported by national employer associations. Salsberg 25 notes that the 

major short-term factors contributing to occupational shortages include: 

 Competition for workers during a full economy in an industry growing even faster 

than the rest of the economy. Some program enrollments are now increasing where 

there is capacity to do so. This increase may also be due to an economic slowdown. 

 Educational capacity takes time to build. A program of studies takes time to 

complete. “Lack of good data and good forecasts of supply and demand contribute to 

slow responses by the education and training sector.” 

 Rising demand for health care during the 1990’s and rising demand for specialized 

professionals. 

 A decreased interest in health care occupations. 

The most widely recognized source for labor data and projections is the Bureau of Labor 

Statistics. The occupational employment projection from 2002 to 2012 for the health care 

occupations is 28.8% in contrast to 13.8% for non-health care occupations. New job openings 

are projected to be 2.9 million. Projected replacements for departed workers are 1.8 million. The 

largest single number of workers needed is for registered nurse employment.26

There is sufficient demographic information about predicted health care needs and labor market 

projections to support a concentrated workforce effort in health care. 

 

25 E. Salsberg. 2003. Making Sense of the System: How States Can Use Health Workforce Policies to Increase 

Access and Improve Quality of Care. New York: The Milbank Memorial Fund commissioned report for The 

Reforming States Group. pp 14-15. 

26 U.S. Department of Labor. Bureau of Labor Statistics. February 2004. Monthly Labor Review. 
28

III. Potential Solutions for Addressing the Health Care 

Industry Challenges

The Health Care Industry Responds to Its Workforce Challenges 

As ETA gathered information from executives in the health care industry, it learned of exciting 

and effective workforce initiatives already taking place across the country. The solutions are 

often directed at improving the quality of health care delivery through improving the workforce. 

Examples of successful interventions are described in an American Hospital Association 

document addressing the opportunities to “build a thriving workforce”.27 Programs to increase 

retention and improve the quality of care in some elder care settings are supported through a 

growing movement to change the culture of aging in long-term and other care settings.28 Some 

state and federal workforce system programs are being directed toward health care issues and 

gaps.29 Some interventions are being implemented by post-secondary education institutions in 

partnerships with employers.30 Research on workforce interventions is being initiated in a multisite study.31 

It is clear that employers, employees, educators, workforce professionals and others in many 

communities are seeking ways to improve the number and quality of health care workers. 

However, it is also clear that leaders in the health care industry experience a lack of national 

workforce leadership and direction. They know that past “crises” in health care have been met 

by a flurry of initiatives followed by a drying up of support and resources to continue them at the 

first sign of budget cuts or an economic downturn. Few previous workforce “crisis 

interventions” survived.32 During Executive Forums, health care leaders said they had little 

awareness of the public workforce system, how it could be of use, or how to access the system. 

They note the need for a much greater knowledge of effective initiatives implemented elsewhere. 

They welcome the High Growth Job Training Initiative and support going beyond workforce 

challenges to solutions in a much more systematic and effective way. They are sensitive to many 

of the complexities of gaining and maintaining an adequate health care workforce system and the 

support required. Leaders frequently pointed out the need for much broader collaborative efforts 

to deal effectively with health care workforce challenges. 

 

27 American Hospital Association Commission on Workforce for Hospitals and Health Systems. July 2002. In Our 

Hands.

28 Pioneer Network. www.PioneerNetwork.net. 29 For an overview of state actions see: bhpr.hrsa.gov. 30 Source: Colleagues in Caring Project, American Association of Colleges of Nursing with the funding of the 

Robert Wood Johnson Foundation. www.aacn.nche.edu/CaringProject/index.htm. 31 Source: Better Jobs, Better Care Project, American Association of Homes and Services for the Aging with the 

funding of the Robert Wood Johnson Foundation and The Atlantic Philanthropies. www2.aahsa.org. 

32 An example would be the American Nurses Association Magnet Facilities Credentialing Program. 

www.nursingworld.org/ancc/magnet/facilities.html. 
29

The High Growth Job Training Initiative: Generating Solutions 

The High Growth Job Training Initiative (HGJTI) specifically seeks collaboration with 

workforce and industry partners to resolve the industry’s workforce needs. Partnerships require 

a shared understanding, not only of the challenges, but also of potential solutions. Thus, the next 

phase of the HGJTI effort involved participants from four groups: 1) health services employers; 

2) health care giver and medical diagnostic and support occupations; 3) educators; and 

4) workforce professionals. The goals of these engagements were to provide a process to assure 

a shared understanding of health care workforce challenges by participants, to generate solutions 

for these challenges, and to select the higher priority solutions and describe them more fully. 

Process

The goals were met by a second step in information gathering and analysis, performed prior to 

and during the course of three Workforce Development Forums (WDF) held in October 2003. 

The 126 forum participants were selected from a pool developed through nominations sought 

from owner/operator associations, the American Association of Community Colleges, the 

National Association of State Workforce Agencies, the National Association of Workforce 

Boards, the Department of Labor, and other workforce leaders from whom project staff had 

previously sought information. Some of the participants represented health care workforce 

projects currently funded by the Employment and Training Administration. 

Prior to the forums, participants were asked to complete a validation tool containing challenges 

gathered while collecting information in the earlier part of the initiative, and invited to suggest 

additional issues. In addition, an overview of the challenges and issues was presented at the 

forums. Participants were asked for additional discussion, areas of disagreement, and input. 

Although they made some clarifications, the participants made no changes to the challenges. 

 

Participants in each of the forums were assigned to one of the four challenge clusters (i.e., 

pipeline, skill development, etc.). Each group was assigned a facilitator trained in the Nominal 

Group Process.33 Participants clarified issues on which their group was working and generated a 

list of solutions and ranked the solutions by a voting procedure. 

During the lunch break, participants were invited to visit the other rooms to review the work of 

the other groups. Each room had a flip chart entitled: “Did you think of this?” which enabled 

participants to suggest solutions to challenges to which they were not assigned (these solutions 

are identified in Attachments 3). 

In total, 1001 solutions were put forward from the group work (see Attachment 3). A number of 

solutions are similar to one another in response to a particular issue. The participants were 

 

33 A.L. Delbecq, A.H. Van de Ven & D.H. Gustafson. 1975. Group Techniques for Program Planning: A Guide to 

Nominal Group and Delphi Processes. Glenview, Illinois: Scott, Foresman & Company. 
30

unaware of solutions generated at other forums. Therefore, some solutions were developed 

further by more than one group. (See footnote34) 

 

For the 83 highest-ranked solutions, small teams worked to develop a matrix for each solution 

(see Attachment 1 and 2). Each matrix is identified by the overall challenge (e.g., Skill 

Development), the issue (e.g., Targeted/Specialized Skills Areas), and the suggested solution. 

The teams then identified critical attributes for a successful solution, key stakeholders, resources 

required, policy barriers at the local, state and national level, and any other needed clarifications. 

Product

 

The products of the workgroups can be found in Attachment 1 and 2.35 The collected and 

collated group matrices were reviewed to determine the types of solutions identified by 

participants in response to the workforce challenges. The highest-ranked solutions include 

recommendations in the following areas: 

 Issue: Pipeline: Recruitment and Retention 

 Solution: Creating and expanding youth-focused programs to better inform young 

people about health care careers and encourage them to consider health care 

occupations. 

 Issue: Pipeline: Recruitment and Retention 

 Solution: Ensuring that public workforce programs provide adequate preparation of 

entry-level workers in the basic knowledge required to enter many health care 

occupations, adequate social and financial supports during the training period, 

opportunities for work placement, and support during the transition to the workplace 

so that these workers can succeed and be retained in the health care industry. 

 Issue: Pipeline: Recruitment and Retention 

 Solution: Marketing health care career opportunities to youth, potential worker pools 

that do not traditionally enter the health care industry, dislocated workers, immigrant 

communities, older workers, and traditional worker pools. 

 

34 The large number of solutions is useful for readers who have a workforce challenge and who are seeking a range 

of ideas for solutions. In Attachment 3, a small set of interesting or unusual solutions have been placed in the 

opening portion of Attachment 3. These solutions were not expanded upon by the Workforce Development 

Information Forum work groups. 

35 The reader should note that the challenge Sustainability: Leadership, Policy and Infrastructure has only three 

solutions developed by one team in each forum. In Washington, we learned the interventions required participants 

with knowledge and experience in implementing a solution at the state level. Participants with this background were 

identified from all three of the groups and asked to form a fourth group to develop a solution. During the Salt Lake 

City and Chicago forums the teams were selected in advance for their prior work at the national or local level. These 

two teams were not involved in the generation and ranking of solutions in contrast to all other groups. They focused 

only on completing the matrix for a national or a local workforce infrastructure. 
31

 Issues: Pipeline: Recruitment and Retention and Skill Development 

 Solution 1: Attracting and retaining workers through significant improvement of the 

“culture” of the health care workplace by implementing shared governance, 

incumbent worker training, career ladders, access to education and training 

opportunities, and other attributes identified by employees, researchers, and from 

exemplary continuous improvement programs. 

 Solution 2: Providing management training and credentialing in long-term care, 

consistent with this type of workplace improvement. 

 Issue: Skill Development 

 Solution: Designing health care occupation curricula that provide the basic 

knowledge and skills needed for effective entry to practice in the high growth areas of 

employment in primary care, long-term care and acute care sectors. Develop 

curricula so that there is a fit between programs for advancing the careers of health 

care workers (often provided through the workplace), and the requirements of the 

educational institutions. 

 Issue: Skill Development 

 Solution: Examining the state credentialing requirements with the goal of expanding 

less traditional paths to meeting occupational requirements, such as career ladders, 

apprenticeships and other workforce development strategies. Creating “cross walks” 

from practice to educational programs and credentialing requirements based on 

nationally developed measurement of worker skills. 

 Issue: Capacity of Education and Training Providers 

 Solution: Addressing the capacity problems (i.e., lack of faculty, resources, etc.) in 

many community colleges and other post-secondary education and training 

organizations, where barriers to applicants exist and where there are inadequate 

numbers of qualified applicants for actual or projected demand for some health 

service occupations. Capacity is affected by lack of faculty and other resources. 

 Issue: Sustainability: Leadership, Policy and Infrastructure 

 Solution: Partnering among a wide range of stakeholders in the health care 

workforce, in order to project changes in workforce demand at the local/regional, 

state and national levels and to generate long term, efficient, and sustainable 

approaches to those changes. 

 Issue: Sustainability: Leadership, Policy and Infrastructure 

 Solution: Developing methods for projection of medium-term occupational needs that 

can be used by a health care entity, such as a hospital or home care agency, as a basis 

for internal planning and for planning with partners in education, workforce 

development and other health care workforce stakeholders. 
32

Review 

The Department of Labor Employment and Training Administration’s Business Relations Group 

reviewed the solutions generated during the Workforce Development Forums. The purpose of 

the review was to: 

(a) Identify for referral those solutions that are both the responsibility of other entities 

and not in the domain of the Department of Labor; 

(b) Identify solutions that are jointly in the domain of the Department of Labor and 

another federal department; 

(c) Identify solutions where the Department of Labor or the public workforce system 

already have program commitments; and, 

(d) Identify solutions within the Department of Labor’s domain that if implemented 

effectively and widely will have a significant impact on managing the present and 

future workforce challenges of the health care industry. The latter group of solutions 

was examined by asking the question: “How can the Employment and Training 

Administration best use its resources and influence to have a positive impact on the 

challenges identified by the health care industry?” 

Solutions for Initial Action 

The solutions recommended for initial action are ones that can be adapted to many settings, that 

are built on partnerships among stakeholders that provide other opportunities to leverage 

resources (including funding), and that are relevant to the basic problem of adapting the 

workforce to changing industry needs. 

The solutions anticipated to have the clearest impact include the following program areas: 

9 Youth-related programs developed and implemented by partnerships that include schools, 

health care employers, post-secondary programs for health occupations, and public 

workforce system entities. 

9 Programs focused on non-traditional and traditional labor pools for health care entrylevel workers that both broaden approaches to preparation programs and enhance career 

mobility in health care and related industries. Competency models for these programs 

should be developed through a partnership of educators, employers, and workforce 

professionals. 

9 Initiatives that meet the needs for academic and clinical faculty in high-demand health 

care education programs and that are designed to adapt to changing levels of workforce 

demand. 

9 Programs that deal with the community college and other educational organizations’ 

insufficient capacity through innovative partnerships and other approaches. These 

capacity issues include the need for appropriate clinical practice opportunities, funding 

for students, diagnostic and treatment equipment, and laboratory support. 
33

9 Improvement of health care workplaces by interventions such as management training, 

incumbent worker training, career mobility programs, accessible education and training 

opportunities, and reducing staff fluctuations through workforce projections. 

9 Effective initiatives to build a sustainable national infrastructure with local, state, and 

national elements tasked with continuous balancing of workforce demand and supply 

within the health care industry. 

9 Creation and maintenance of a national source for accessible information about 

innovative and effective workforce initiatives for high growth industries, including the 

health care industry. 

The majority of the solutions identified by forum participants are not sector specific. However, 

many solutions can be adapted to the particular needs of a sector or a community. 

National, State and Local Partnerships for Workforce Solutions 

Dealing with workforce challenges in the health care industry requires collaboration at the 

national, state and local levels, and between these levels. Executive and Workforce 

Development Industry Forum participants recommend a national, sustained and systemic 

approach that aligns the workforce resources available with the challenges facing the health care 

industry today and well into the future. This direction is consistent with the thinking behind the 

High Growth Job Training Initiative. 

A central role of the Employment and Training Administration is that of identifying and 

communicating effective workforce solutions that can be replicated to respond to national 

challenges such as management training or youth-related recruitment programs. A second aspect 

of that role is the funding of pilot programs, by ETA alone or in partnerships, that are most 

effective in dealing with some aspect of workforce challenges, and that are replicable by other 

entities. At the national level, providers and others also identify the need for a national 

warehouse of sound and effective workforce interventions with a search engine that makes it 

possible for a local Workforce Investment Board, a human resources manager, or others to 

identify solutions that have worked elsewhere. 

The action of state governments and state-level entities are pivotal to any national workforce 

effort. State government decisions direct how some federal funding is used to support some 

workforce programs. For example, the Workforce Investment Act provides funding to states, 

and through the states to local Workforce Investment Boards and workforce-related programs. 

These funds and others, such as Temporary Assistance to Needy Families and Medicaid, are used 

to provide training, support, and placement for many occupations including those in health care. 

It is at the state level that policy and funding decisions are made about higher education, 

licensing and regulation. Reanalyzing the Medicaid programs that directly affect employment 

conditions and delivery of care, worker training, collection of information for programs and 

policy development, and other initiatives that influence the implementation, was among many of 

the solutions recommended in the Executive Forums and Workforce Development Forums. A 
34

sustainable36, adaptive and effective workforce strategy in health care requires strong public and 

private partnerships in every state. Without these partnerships the health care industry cannot 

respond adequately to current problems or prevent future ones. 

Local partnerships, including Workforce Investment Boards, employers, employees, educators 

and other community members, are needed to implement workforce solutions closest to health 

care delivery sites, and to potential labor pools. Through such partnerships, both the workforce 

demand and supply sides can identify the needs in their own communities. Partners can use their 

state and national networks to find solutions to better manage their particular challenges. 

 

36 Note: In a recent survey of states and territories regarding health care workforce activities, 44 of 50 states 

reported only temporary responses. U.S. Department of Health and Human Services. Bureau of Health 

Professionals. bhpr.hrsa.gov. 

 
Attachment 1 

Health Care Industry’s 

Solutions Matrix – Full 

Health Care Industry’s Solutions Matrix - Full 

A1-1

Health Care Industry’s Solutions Matrix - Full 

Health Care Critical Attributes Key Stakeholders Shared Resources Policy Barriers Issue/Challenge: Recruitment and Retention Issue: Ensuring the Skills of Entry-Level Workers Solution 1 from Washington DC To develop a competency-based instructional and assessment system that covers all paraprofessional employees that leads to national standardized certifications and requirements. Overall Solution 1 

 Applied research 

component that links competencies with quality of jobs and quality of patient care. 

 Skills are anticipated.  People acquire skills that 

enable them to provide superior patient care. 

 The instructional system 

is broken into modules that do not require a set sequence. There are many modules common to many jobs. 

 Allows people to 

progress within that job and/or other related jobs. 

 Credentials are portable 

to other settings and across states. 

 Assessment supports 

individualized learning and provides information to support hiring, promotion, and further education. 

 Uses technology for 

assessment and instruction where appropriate. 

 Builds upon best 

practices in other industries (ETS, 

 DOL  DHHS: Health, Welfare  Department of Education  DOD  Organized Labor  Consumer Organizations  Health Employees  Community colleges and other 

educational providers 

 Nursing organizations  Associations: AHA, 

AHSHRA 

 Licensing Boards  WIBs and State WIBs 

 Dedicated funding stream 

for development and implementation 

 Association summit and 

agreements so that they might advocate with their members 

 System of skilled trainers 

to manage and deliver 

 Experts who have 

developed similar systems 

 Communication systems – 

website, newsletter 

 Labor market analysis 

 WIA (Senate) 

restricting to community colleges should be broadened to include others 

 Workfirst 

philosophy should be refocused to emphasize training 

 Revenue decline 

of workforce training dollars 

 Support 

legislation that support training allied health moving the Nurse Reinvestment Act 

 Promote 

integration of HHS, DOL, & DOE systems and resource at the national and state levels 

 Promote 

integration of the various healthcare employment and 
Health Care Industry’s Solutions Matrix - Full 

A1-2

Manpower) for both instructional method and assessment – National demonstration of integrating health care, workforce and education systems. 

association. 

Issue: Ensuring the Skills of Entry-Level Workers Solution 2 from Washington DC The DOL will exercise leadership in identifying the needs and finding ways to implement and institutionalize skills training for entrylevel health care workers at the national, state, and local level. Overall Solution 2

 DOL provides political 

and administrative leadership on the healthcare initiative. 

 Help White House, as 

well as other federal partners, and state and local operations take this as a priority. 

 DOL will establish goals 

and analyze at least on an annual basis and publish health care industry report card on the workforce a quarter of end of the fiscal year. 

 DOL will establish 

discretionary Grant Healthcare Initiative. 

 DOL:  National  State  Local/WIB  White House 

 DOL Funding  Leadership  Data  Convener  Communication Channels:  Political 

Administrative System 

 Agenda 

 Interagency 

coordination/ 

 Communication 

among DOL, DHHS ... (to prevent “warfare”) 

 Staffing at 

federal level 

Issue: Employment & Working Conditions Solution 3 from Washington DC To enhance the public image and awareness of employment opportunities in the health care profession Overall Solution 3

 Coordinated nationwide 

marketing effort publicizing full range of health care opportunities. 

 Buy-in by key 

professional organizations and associations. 

 High quality national 

marketing/advertising organization. 

 Ensure outreach to a 

diverse non-traditional audience. 

 Designed programming 

for long-term effort. 

 DOL  HHS  Elected Officials  Professional organizations and 

associations 

 Providers  State and local workforce 

boards 

 Funding  Donated resources  Informational resources to 

prepare advertising tracking methodology to determine impact/intake and diversity 

 Stakeholder forums for 

support of the effort 

 Funnel inquiries through 

One-Stop centers 

 None 
Health Care Industry’s Solutions Matrix - Full 

A1-3

Issue: Employment & Working Conditions Solution 4 from Washington DC Continuous problem solving involving all levels to improve the working environment in order to increase retention. Overall Solution 4

 Buy-in by all levels  Adequate preparation and 

training at all levels: Communication, problem solving 

 Incentive system to 

support participation 

 Open, honest discussion 

without fear of retaliation 

 Method to validate 

change in environment 

 CEO to entry-level workers  Trainers 

 Time to train people  Time to carry out problem 

solving 

 Development of training 

materials 

 Guidelines/parameters  Staff person to ensure 

accountability of the process 

 Union contacts  Medicaid 

funding 

 Internal 

organization and rules and roles 

 State laws 

regarding licensure and certification 

Issue: Employment & Working Conditions Solution 5 from Washington DC Identify successful cultural change initiatives to provide “models” to institutions that are struggling with how to improve their working environment. Overall Solution 5

 Criteria to identify 

successful models (best practices) 

 Method to catalog 

existing change initiatives 

 Distribution channel to 

communicate “models” 

 Determine a 

methodology to set a reasonable turnover rate for health care jobs 

 Public and private funders and 

providers 

 Experts in change modeling to 

direct the efforts 

 Train-the-trainer  Funding to identify 

successful models and catalogue 

 Resources to develop 

turnover goals 

 Could be policy 

barriers identified in certain programs 

 Potential liability 

issues 

Recognizing that the current supply of workers will not be adequate to meet future health care demands, we need to identify solutions to recruit non-traditional workers (such as, but not limited to: men, older adults, and 

 Market research to 

determine what messages will interest diverse populations in nursing and allied health careers. 

 Marketing research on 

how to project an image that will appeal to nontraditional workers to enter the industry. 

 Social marketing people  Leaders in nursing and allied 

health to support the effort and validate the information. 

 Money (grant) to do the 

research. 

 Pilot the program  Media advertising 

 None 
Health Care Industry’s Solutions Matrix - Full 

A1-4

individuals from culturally and linguistically diverse communities.) Solution 6 from Washington DC Design of a national marketing campaign to sell nursing and allied health careers and give information on career entry. Overall Solution 6Issue: Recognizing that the current supply of workers will not be adequate to meet future health care demands, we need to identify solutions to recruit non-traditional workers (such as, but not limited to: men, older adults, and individuals from culturally and linguistically diverse communities.) Solution 7 from Washington DC To expose people, beginning in elementary school thru post-secondary. Overall Solution 7

 Development of a tested 

tool kit on how to recruit non-traditional workers (young workers and older workers) into nursing and allied health. 

 Identification of 

champions and ambassadors with a sustainable commitment to health care careers ... exposure and career opportunities, and retaining of the workforce. 

 National clubs and 

organizations 

 Public and private school 

systems 

 Associations  Industry partners  Private employers  School systems (vocational 

counselors and teachers) 

 Department of Education, 

federal and state 

 Department of Labor, federal 

and state 

 Chambers of Commerce 

 Community colleges 

(nursing programs and allied health programs) 

 Federal “train-the-trainer 

and implementation grants 

 Support form key decision 

makers in local communities 

 Bilingual and bi-cultural 

resources 

 Lack of local 

funding 

 Overcoming 

security issues with getting students out into health care environments 

Issue: Recognizing that the current 

 Identification and 

replication of what works 

 Targeted and/or board 

coalitions of CB & Faith-

 Social marketers  Coordination w/state, local 

 Support for nontraditional 
Health Care Industry’s Solutions Matrix - Full 

A1-5

supply of workers will not be adequate to meet future health care demands, we need to identify solutions to recruit non-traditional workers (such as, but not limited to: men, older adults, and individuals from culturally and linguistically divers communities.) Solution 8 from Washington DC To develop targeted recruitment and retention strategies with communitybased organizations (EMS Volunteer services programs, e.g., fire department, area aging agencies) nursing and allied health workers and faith based organizations. ONLY EXAMPLES.Overall Solution 8

 Developmental grants to 

identify community leaders who can help a coalition of key players to the table as program participants 

 Trained individuals who 

represent the communities that are in or they are going to ... to motivate individuals 

based organizations funding 

 Targeted resources, 

training and counselors for non-traditional workers 

workers to make the choice (e.g., wage, transportation, training resources tailored to that non-traditional worker) 

Issue: Incumbent worker training Solution 1 from Salt Lake City Solution: Increased flexibility of educational program provider offerings 

 Identify and secure public 

and private providers 

 Staffing availability/ 

flexibility 

 Multiple delivery 

program delivery systems (web, satellite, traditional classrooms, etc.) 

 Employers  Vendors  Academic institutions  Faculty/staff  Faculty  Employers  Employees 

 Instructional/training staff 

program/administration money 

 Money for staffing  Distance learning program 

offerings from vendors 

 Educational institutions  Trade associations 

 Public/private, 

e.g., boards of regents 

 Accrediting 

bodies 
Health Care Industry’s Solutions Matrix - Full 

A1-6

Overall Solution 9Issue: Incumbent worker training Solution 2 from Salt Lake City Solution: Create a learning culture that provides time, access, and compensation for learningOverall Solution 10

 Employer provided 

flexible scheduling and/or educational leave 

 Reasonable workloads to 

allow for access for training 

 Provision of adequate 

learning space, equipment and learning materials 

 Active employer 

promotion of programs 

 Making career counseling 

available to employees at not cost regarding growth opportunities within the institution/organization 

 Maintain payment of 

salaries while attending learning activities 

 Create flexible and 

creative plans to provide elective and temporary growth and development opportunities (based on personal circumstances) 



 Employers  Department managers  Employees 

 PRN staff and money to 

pay 

 Technical – technological 

equipment to support efficient work processes 

 Money, equipment, 

printed materials 

 Professional/skilled career 

counselor and money to pay 

 Money 

Issue: Incumbent worker training Solution 3 from Salt Lake City Solution: Incentives for employee growth, development and continuing education Overall Solution 11

 Needs assessment system 

(for employee) 

 Improved parity of wage 

and salary program among professions with equivalent education and training 

 Employee commitment to 

assisting/contributing to employees continuing education costs 

 Employer providing 

interim staffing when 

 Representatives of employee 

groups, HR/Staff development coordinators 

 Individual practitioner groups  Management/managers/admin

istration. 

 Human resources  Employer (finance division)  Employees  Employees and department 

managers 

 Academic institutions  Employers 

 Data analysis consultant or 

expertise 

 Market surveys: 

national/regional wage and salary info 

 Information on wage 

requirements 

 Need dollars  Implementation plan  PRN (as needed) staff and 

dollars to pay 

 Degree granting 

institutions 

 Internal 

assumptions 

 Accrediting 

bodies 
Health Care Industry’s Solutions Matrix - Full 

A1-7

employee is absent for learning purposes 

 Recognize and accept 

experiential learning as credit toward degree completions 

 Employer publication and 

marketing of program offerings 

 Employer providing 

employee opportunity to assume additional responsibilities (e.g., project management, training, etc.) 

 Employees 

 (No special demands on 

resources except for cost of credit review by Academic Institution) 

 PRN (as needed) staff and 

dollars to pay 

Issue: Targeted specialized skills areas: How to help retain/orient new hires Solution 4 from Salt Lake City Solution: Create mentoring opportunities to acculturate new staff to the department or company Overall Solution 12

 Adopt apprenticeship 

model of using industry mentors to help orient new hires to promote retention. 

Issue: Targeted specialized skills areas: Filling specialty jobs Solution 5 from Salt Lake City Solution: Develop system to identify, project and match/map 

 Take experience into 

account: give credit toward academic degrees/certificates 

 Collaboration across 

disciplines to identify competencies and build training (educators, managers, recruiters, workforce planners, labor) 

 Frontline managers  Educators (industry and 

academic settings) 

 Recruiters  Workforce boards  Healthcare administrators  Labor  Students 

 Assessment tools  Funding to conduct 

competencies and gap analysis 

 Incentives for industry to 

consider training nontraditional students 

 Innovative solutions (build 

on what’s out there) 

 Educational 

institutions not recognizing or providing credit for experiential learning 
Health Care Industry’s Solutions Matrix - Full 

A1-8

competencies for roles within health care and across industries to identify matches and skill gaps. Create training to bridge the gap. Overall Solution 13

 Use assessment tools 

(e.g., work keys) individuals’ skill level in confidential setting 

 Educational institutions 

willing to approve innovative or pilot training programs 

Issue: Targeted specialized skills areas: Staff skills necessary to develop into management and supervisory roles Solution 6 from Salt Lake City Solution: Develop management certificate program Overall Solution 14

 Support groups of class 

participants for regular follow-up to reinforce learning 

 Courses offered on 

flexible schedule (on paid time, distance learning/online) 

 Mandatory for those 

going into supervisory roles 

 Evaluation process 

 Administrators  Healthcare professionals  Pre-management staff  Staff of new manager  Partners to help develop 

programs: 

 educators  managers  apprenticeship programs 

 Trainers  Tracking system  Funding to develop, offer 

and sustain training 

 Funding to backfill staff 

while in training and follow-up 

 Training materials 

 Industry 

leadership buy in to offer it and make it mandatorymake it happen 

 Examples of 

training skills components: 

 listening  communication  budget/ 

accounting finance 
Health Care Industry’s Solutions Matrix - Full 

A1-9

 understanding 

the business (competition, regulation, strategy, vision) 

 how to give 

performance reviews 

 delegation  HR: regulations 

and labor law 

 Workers comp 

process 

 OASH and other 

regulators 

Issue: Entry-level worker preparation Solution 7 from Washington DC Solution: Provide English as a second language programs to develop language skills and meet minimum job requirements Overall Solution 15

 Identify training facilities 

and develop program partnerships 

 Locate appropriate 

populations 

 Identify areas of 

employment where bilingual employees are preferred or desirable 

 Guarantee employment if 

program is completed successfully through sponsor or placement services 

 Appropriate basic skills 

instructors – GED, EDS, etc. 

 For marketing efforts  Partnership with local media 

outlets 

 Partner with local churches  Community champion – major 

or other official 

 Qualified instructors  Program sponsor for 

financial needs- hospital 

 Human resources 

coordinator for oversight of program and for placement 

 Citizenship 

status for employment 

 Background 

checks 

Issue: Entry-level worker preparation Solution 8 from Salt Lake City Solution: Increase exposure of students to health care workforce environment in junior high and high schools 

 Partnerships between 

health care institutions and middle and high school to establish mentors for a health care career 

 Utilize a ‘big brother/big 

sister’ program for health care professionals to ‘adopt’ children 

 Introduce applied science 

 Interested health care 

professionals 

 Interested school officials  Interested students  Interested faculty  Business, health care facilities 

to host field trips 

 Location for speakers bureau 

 Committed individuals in 

schools, health care and industry to promote program 

 Local 

educational barriers, re., prescribed curriculum in K12 

 Limitations on 

K-12 students field trips 

 Limitations on 

institutional and 
Health Care Industry’s Solutions Matrix - Full 

A1-10

Overall Solution 16

lesson plans into elementary and middle school curriculum targeting health care science applications, field trips, speakers bureaus, demonstration, and science career days 

 Local champion to act as 

cheerleader 

health care facility permission to spend time on the task 

Issue: Entry-level worker preparation Solution 9 from Salt Lake City Solution: Develop and sustain partnerships between local educational institutions and the health care industry Overall Solution 17

 Willingness to participate 

in initiative 

 Sites for training – 

clinical and classroom 

 Sites for employment  Champion for partnership  Communicate/market 

program to public and potential students 

 Sensitivity to customized 

training needs (flexible and diverse to accommodate community needs 

 Identify students who are 

in the appropriate maturity/interest level to complete training 

 All secondary schools  All higher ed institutions  All health care provider  Local government support  Local chamber of commerce, 

other community leaders 

 Clinical staff  Lecture staff  Overall coordinator  Champion – important 

financial and community supporters 

 Clinical sites 

 Liability 

insurance 

 Funding  Health insurance 

for students 

 Restrictions in 

certain areas 

 HIPAA – age 

appropriateness for certain patient info 

Career Ladder / Lattice Solution 1 from Chicago Develop career paths to accommodate vertical and horizontal moves within the health care field 

 To develop national 

models for unique career ladder issues. 

 Career development 

planning 

 Senior management 

champion 

 National organization 

professionals 

 Educational partners at all 

levels 

 Employees  Management  Patients 

 Existing models  Staff to implement  Apprenticeship models 

 Instructor 

shortage 
Health Care Industry’s Solutions Matrix - Full 

A1-11

Overall Solution 18Issue: Through Development of a Health Corps to Increase the Available Labor Pool Solution 2 from Chicago forum Develop a Health Corps, based on the Peace Corps or Teachers Corps model Overall Solution 19

 Jointly funded/supported 

by federal government and private industry 

 Requires partnerships 

with education 

 Cover all aspects of 

health care in every market 

 Clear understanding of 

outcomes 

 Develop specific criteria 

for participation 

 Oversight group or 

agency 

 Cost effective/cost 

savings 

 Need a snappy uniform to 

wear 

 Health care agencies  Private industry  Education 

 Funding  Sponsorship  Qualified applicants  Oversight agency  Legislative support 

 Lack of choices  Interdepartmenta

l cooperation 

 Funding  No funding for 

career changing 

 Buy-in  Competition 

from other sources 

Issue: Pipeline: Recruitment and Retention Through a Media Campaign to Increase Available Labor Pool Solution 3 from Chicago forum Build A Positive and Effective Media Campaign to increase health care workers Overall Solution 20

 Multi-media  Multi-market  Multi-lingual  Image makeover  Multi-cultural  Coordinated effort  Balanced amongst all 

careers 

 Number of multiple 

contracts in different recruitment strategies 

 Educational institutions  Health care institutions  Job seekers  One Stop/Career Centers  Private Industry  Government 

 One Stops/Career Centers  Marketing Strategies 

 Time  Money  Leadership  Responsibilities  Completion 

Issue: Pipeline: Recruitment and Retention Through Funding to Increase the Available Labor Pool Solution 4 from 

 Uniform approach  Students and faculty  Sufficient equipment  Availability to qualified 

applicants 

 Streamlined process  Must be carefully 

 Private industry, government, 

education and health care organizations 

 Job seekers/student 

 Money  Federal, state and private 

industry 

 Financial Aide Officers  Educators mentors  Legal  Support from legislature 

 Not enough 

sources 

 Competition 

from other priorities 

 Determine 

qualifications of 
Health Care Industry’s Solutions Matrix - Full 

A1-12

Chicago To develop individual and system financial/funding models that promote student enrollment, faculty development and program growth Overall Solution 21

monitored 

 Innovative approaches  Shared accountability at 

each level 

students 

 People defect 

from program 

Issue: Pipeline: Recruitment and Retention Through Increased Partnerships to Increase the Available Labor Pool Solution 5 from Chicago Develop a partnership model between industry, government and education Overall Solution 22

 Identify effective partners 

(right people) 

 Build “sustainability” – 

win-win solutions 

 National, state and local 

level 

 Tailored to the 

occupation and needs 

 A model for working 

together with role clarity, timelines 

 Outcome –based, with 

evaluations 

 Cost effective 

 Industry  Education  Health care institutions  Government  Specific Employers  Each partner 

 Dedicated liaisons from 

each stakeholder 

 Professional, education, 

community and health care organizations 

 Legal associations  Training  Skilled facilitators  Support from leadership 

 Competitive 

markets 

 Differences 

between the partners 

 Socioeconomics  Political, 

geographical differences 

Issue: Pipeline: Recruitment & Retention: Turnover – Changing Culture Solution 6 from Chicago Develop strategies and incentives to move to shared governance and continuous, quality improvement 

 Top management support  Senior management 

champions 

 Clearly defined benefits 

and buy-in at each level 

 Experts trained in quality 

improvement 

 Communication, training 

and strategies to institutionalize 

 Open, honest legitimate 

communication leading to trust 

 Management  Employees  Unions  Community  Various schools 

 Time to meet for 

governance activities 

 Consultants to start quality 

projects up 

 Training of project leaders  Time to do this in a 24/7 

environment 

 Other sites that are doing 

this – St. Mary’s Health System for this 

 Federal funding, 

foundations, state quality awards 

 Staffing level 

requirements 

 Union contracts  FLSA laws 
Health Care Industry’s Solutions Matrix - Full 

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environment Overall Solution 23

 Means to continuously 

measure successful communication to all levels 

 Information systems 

needed to track 

Issue: Pipeline: Recruitment & Retention: Turnover -- Incentives Solution 7 from Chicago Solution: Develop a comprehensive range of employee incentives to remain in the health care field Overall Solution 24

 Include both monetary 

and non-monetary incentives 

 Entire spectrum of 

occupations in health care 

 Top management support 

and creative thinking 

 Communicate incentives 

to all levels of organization 

 Reward managers for 

developing and retaining their staff 

 Management  Employees  Unions  Other health care 

organizations and educational institutions 

 Funding for programs  Creative scheduling  Continuing education  Tuition reimbursement  Pension plans  Sabbatical  Work at home  Housing subsidy  Transit subsidy  Onsite day care  Sharing resources across 

organizations to preserve benefits 

 Across 

organizational issues 

 Traditional 

thinking on employment 

Issue: Pipeline – (A): Recruitment and Retention – Diversity / Nontraditional Labor Pool Solution 8 from Chicago A system wide commitment to provide consistent access, opportunity and support for recruiting and retaining underrepresented culturally diverse populations in the health care workforce Overall Solution 25

 Identification of best 

practices currently being used 

 Educational materials that 

are culturally sensitive 

 Committed employers 

with resources to support workforce diversity 

 On-going programmatic 

focus on the work site 

 Workers  Employers  Educators  Community groups  Governmental agencies 

 Foundations (health care 

related) 

 Diversity trainers  Special interest groups 

(Hispanics in H.R., minority engineers, women in sciences, Black Nurses Association, etc.) 

 Conflicts among 

groups for funding 

 Union 

agreements with employers 

 Political 

expediency 
Health Care Industry’s Solutions Matrix - Full 

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Issue: Pipeline – (B) Recruitment and Retention – Diversity / Non-traditional Labor Pools Solution 9 from Chicago Reduce barriers to entry level jobs and increase retention through financial or in-kind subsidies to targeted populations Overall Solution 26

 Partners to provide 

subsidies 

 Data to assess appropriate 

subsidies 

 Development of posthiring information to 

measure success of a particular subsidy 

 Demographic data 

 State and local agencies  Federal agencies  Trainers from education  Employers  Recruits 

 Social services  Transportation providers  State legislators  Local officials  Community groups  Unions 

 Union 

agreements with employers 

 State and local 

appropriations for funding 

 Political 

experience 

Issue: Pipeline – (C) Recruitment and Retention – Diversity / Non-traditional Labor Pools Solution 10 from Chicago To Improve Retention by Creating Flexible Work Options within health care to Appeal to Non-Conventional Workers Overall Solution 27

 Redefinition of job 

functions to allow flexibility 

 Review prerequisites to 

permit flexible training 

 Flexible scheduling 

 Unions  Employers  Accreditation Associations  Profess-ional Associations  Recruits 

 Workforce  Accrediting Agencies  Professional Associations  Workflow Consultants 

 H.R. Policies  Union 

Agreements 

 Accrediting 

Agency unresponsiveness 

 Scope of 

Practice 

Issue/Challenge: System Capacity Capacity of Workforce-related Organizations Solution 1 from Washington DC 

 Accurate assessment of 

occupational and related educational needs initially and ongoing (assess skill levels of participants). 

 Agreement of 

 Employers  Training Providers  Student/worker  One-stop Career Centers  Community –based 

 Curricula  Tuition  Federal training grants  Loan repayment programs  Foundations 

 Educational 

barrier with teacher credentialing 

 Liability 
Health Care Industry’s Solutions Matrix - Full 

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Partnering with Employers (Hospitals, LTC) and training providers (community colleges, universities, other) on a regional basis. Overall Solution 28

programmatic detail with flexibility on both sides (employer and educational provider. 

 Division of training, 

scheduling. 

 Agreement of who pays 

for what. 

 Ongoing monitoring, 

assessment and evaluation of goals and outcomes. 

 Identification of 

additional support needed to allow the student/worker to attend class – i.e. childcare, transportation, etc. 

 Address prerequisites for 

needed occupation – adult basic education (math, literacy, ESOL) 

organizations 

 WIB  Community 

 State funding  Data resources (HHS, 

DOL) 

 Community involvement 

for meeting students needs, e.g. transportation, childcare, studying needs, mentoring. 

 Student loans 

not available to part-time workers 

 Approval of 

distance learning related to university setting politics of possibly losing students 

Issue: Capacity of Workforce-related Organizations Solution 2 from Washington DC Solution: Training for practicing providers to provide adult learning competence and cultural competence. Training clinicians to teach adults will help more of them become academic and clinical faculty. (Given because many clinicians do not 

 Standard tool set for adult 

learning theory 

 Effective training 

modules for cultural competency (best practices) 

 “Train the trainer” 

method of extending learning 

 Buy-in from stakeholders  Needs assessment of 

educators and students 

 Educators  Employers  Workers  Residents/Patients  WIBs  Diverse ethnic populations 

 Federal funding for 

expansion of current training – Workforce Investment Act funds 

 Foundation and state 

funding for expansion of current training 

 Accurate data supporting 

improved outcomes and educational methods – might help with employer buy-in 

 Potential limits 

in terms of $ and timeframe for education/training. 
Health Care Industry’s Solutions Matrix - Full 

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think they are able to teach adults.) Training in cultural competencies will help clinicians understand the different cultural aspects of their patients/students. Overall Solution 29Issue: Capacity of Workforce-related Organizations Solution 3 from Washington DC Solution: Faculty loan repayment Overall Solution 30

 Funding for graduate 

education 

 Stipends for living 

expenses 

 If online, technology for 

distance learning 

 Duration – Need 

acceleration while maintaining standards of education and practice 

 Special priority for 

diverse populations 

 Employers  Education providers  Faculty members  Students  Diverse populations 

 Foundation, federal or 

state monies 

 State Boards of Nursing  Colleges/Universities 

 State Boards of 

Nursing 

 Requirements 

specific – the Masters of Nursing or other degree in nursing that cannot teach if degree is not as required by the Higher Education Council 

 Too few PhD 

programs to require doctoral faculty for BSN training 

Issue: Capacity of Workforce-related Organizations Solution 4 from Washington DC Solution: Prioritize training and occupations so that budget cuts do not affect key occupation training 

 Assessment of 

occupational needs. 

 Communication of those 

needs to state and educational providers. 

 Buy-in of educational 

providers. 

 Reassess true need of 

degree level to keep costs controlled. 

 Employers  Mayors  Chambers of Commerce  Community colleges  State ONE and Deans and 

Directors 

 Public policymakers  Department of Public Health 

(HHS – HRSA) 

 Community advocates and 

stakeholders 

 Would almost require 

policymaker mandate. 

 Legislation  Accurate data regarding 

projected occupational needs 

 Competitive 

sectoral interests 

 Board of 

Nursing 
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Overall Solution 31Issue: Mid-term Projections Solution 5 from Washington DC Input from Consumers Overall Solution 32

 Consumer ongoing 

feedback on future health care needs. 

 Ongoing by demography 

and race/ethnicity. 

 Consumers and Policymakers  Actual process to have 

consumer input nationwide. 

 Financial and 

technological resources necessary. 

 Privacy 

policies/regulations 

Issue: Midterm Projections Solution 6 from Washington DC Solution: Agreed upon assumptions. In order to have a process the industry and statisticians saw as valid, certain uniform assumptions and results are required. Overall Solution 33

 Standardize data 

collection. 

 Includes employment 

growth and reduction (demand) and replacement needs (supply). 

 Policy-makers  Employers  Training institutions  State and local governments  Suppliers/Manufacturers 

 Ability to share 

projections and develop/share action plans 

 Minimal level of resources 

available in each state. 

 Federal/national 

management and integration. 

 Ongoing funding. 

Issue: Midterm Projections Solution 7 from Washington DC Solution: Database of different occupation and state analyses Overall Solution 34

 Timely  Reliable  Comprehensive  Accessible  State/Regional-based 

national database 

 Ongoing  Sustainable 

 Employers  Prospective employees  Current employees  Policymakers  Training institutions  Health care profession 

suppliers 

 State and local governments 

 Minimal level of resources 

available for each state. 

 Federal or national 

management with systems support. 

 Ongoing funding. 

 Isolation of data 

elements and capabilities 

Issue: Building Partnerships and Healthcare Information 

 Critical Attributes for 

Implementing: 

 Share information among 

all stakeholders. 

 Education system  Licensing board  Coordinating agencies  Health care providers 

 Resources for Planning:  Must be adequately 

funded 

 Adequately staffed 

 Overcoming 

competitiveness of partnerships 

 Competing 

policies and 
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Solution 8 from Washington DC Regional Healthcare Workforce Council Overall Solution 35

 Must have reliable 

workforce data. 

 Everyone’s perspective is 

valued equally and have a sense of ownership. 

 Solutions-oriented  Needs to filter up and 

down from local to regional. 

 Willingness to share and 

help others in partnership. 

 Critical Attributes for 

Implementing: 

 Consortium of 

stakeholders that will be labor pool. 

 Ownership and 

investment – everyone’s role well defined. 

 Communication and trust.  Willingness to share and 

help each other. 

 Unions  WIBs – regional, state, local  Think tanks  Other public agencies  Chambers of Commerce  Area economic development 

agencies 

 Same stakeholders with 

planning 

 Intellectual resources  Repository of best 

practices and successful strategies 

 Resources for 

Implementing: 

 Funding  Demo funding  Funding for management 

of partnership 

 Repository of best 

practices and successful strategies 

priorities of various jurisdictions 

Issue: Occupational Gaps Solution 9 from Washington DC Solution: Develop recruitment and retention strategies Overall Solution 36

 Flexibility  Making professions 

attractive 

 Being grounded in 

workforce trends 

 Good pay/benefits  Support for employees  Supportive work culture  “Grow your own” or 

recruit/train local people who live in area 

 Use multiple strategies  Web sites  Improve staff morale  Employer recognition of 

employee contributions 

 Students are aware of 

 Health care providers  Education systems  Media  Workforce system  Unions  Patients  Foundation  Economic development 

organizations 

 Chambers of Commerce 

 Provide housing subsidies  Advertising funds  Strong communication 

networks between health care providers, educational systems, etc. 

 Staffing resources for 

recruitment 

 Competition  between health  care 

organizations 
Health Care Industry’s Solutions Matrix - Full 

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health careers 



Issue: Occupational Gaps Solution 10 from Washington DC Solution: Expand career lattices within the industry Overall Solution 37

 Flexible minds  Ability of entry-level 

person to go from one job to another. 

 Education and training to 

fill gaps between steps. 

 Understand the career 

ladder and lattice steps to take; make them transparent by mapping them. 

 Accessible training for 

employees. 

 Funding for 

advancements. 

 Support: Support of 

employer; support of employee; child care support. 

 Mentoring and counseling 

and coaching. 

 Tutoring  Cohort of trainees.  Get the core 

competencies in place with training – ESOL, literacy, science 

 Buy-in from management 

(middle and senior) 

 Supervision buy-in on 

training. 

 Education system – 

community colleges, high schools, universities, vocational technical schools. 

 Licensing boards  Credentialing agencies  Health care providers – 

Hospitals, nursing homes, long-term care, acute, chronic, clinics, area agency on aging, community health centers, employees, supervisors, managers, top management 

 Unions  Health care associations  WIBs  Think tanks  Other public agencies, agency 

of community health 

 Funding for training 

programs (individual as an organization) 

 Time  Flexible schedules  Up-front payment of 

tuition 

 Tuition forgiveness  Funding for child care, 

coaching, counseling, mentoring 

 Living stipend, benefits  Equipment – distance 

learning computers, labs (ultimate resource – laptop for each!) 

 Other technical training 

equipment 

 Time of H.R., training 

departments, supervisors, managers 

 Grants (federal, 

foundation) 

 Transportation 

 Licensing and 

credentialing 

 Lack of 

consistent release time policy; lack of ability to release; need for release time at same time! 

 Classroom space  Union 

agreements?? 

 Medicaid/Medic

are reimbursement rates limit; release time; resources for workforce 

 Lack of 

flexibility regarding discipline/job boundaries 

Issue: Occupational Gaps Solution 11 from Washington DC Solution: Distance Learning for Staff 

 Reliable/effective 

technology (e.g. T1 lines) 

 Informed and effective 

trainers and educators 

 Curricula that is effective 

and appropriate 

 Experience with 

computer technology 

 Employers  Employees  Patients  Trainers/educators 

 Technology  Educators  Curricula and materials  Computers at home  Funds  Release time 
Health Care Industry’s Solutions Matrix - Full 

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Overall Solution 38

among learners 

 Support structure for 

technical or other problems 

Issue: Lack of facilities and resources Solution 1 from Salt Lake City Solution: Healthcare – Expand Training Programs – Allied Health Professions Overall Solution 39

 Partnership between 

educational institution and health care provider 

 To supplement current 

curriculum with needed classes such as management skills 

 Life skills training  Cross disciplinary 

education 

 CNAs seen as entry to 

career ladder program (recognize through college credits or advanced placement) 

 Training institution  Healthcare employers  State accreditation and 

licensure boards 

 National accreditation and 

licensure boards 

 Faculty funding  Curriculum development 

for revision 

 Facilities funding  Skills labs – learning 

resource centers 

 Accreditation 

and licensure regulations 

 Allocation of 

resources into allied healthcare programs 

 Recognizing 

mentoring, med tech programs, CNAs college credits 

Issue: Lack of facilities and resources Solution 2 from Salt Lake City Solution: Distance and education learning Overall Solution 40

 E-learning classroom  E-learning staff person  Instructors with 

technology knowledge 

 Partnerships for elearning to provide 

clinical partnerships 

 Hybrid education (mixed 

modalities) 

 Student with baseline 

technology knowledge 

 On-site tutor to assist 

with technology 

 Faculty/Academic institutions  Employers  Technical centers  One Stop Centers  Technical support staff  Community leaders  Libraries  Funding resources  Healthcare providers  Accreditation and licensing 

agencies 

 Equipment  Space  Technical Support  Staff (e-learning) to 

support students 

 Time to develop online 

curriculum 

 Department of Labor  Private funding  Phone companies  Power companies 

 Credibility of 

distance learning 

 Approval by 

each participating state for licensure/accreditation 

 Collective 

bargaining agreements 

 Cost 

effectiveness 

 State 

reimbursement guidelines 
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 Wage and hour 

regulations 

 Company 

internet policies/procedures 

 HIPAA laws 

Issue: Lack of academic and clinical instructors Solution 3 from Salt Lake City Solution: Provide paid time off and flexible work schedules for those that wish to advance their education to teach or want to serve as part-time instructors (both academic and clinical) Overall Solution 41

 Staff to cover  Funding  Students  Instructors  Paid time off  Flexible employers 

 Health care industry  Schools scheduling 

 Staff to cover  Funding  Funding (HC industry)  Tax incentives  Grants  Technology 

 Personnel/polici

es of industry 

Issue: Lack of academic and clinical instructors Solution 4 from Salt Lake City Solution: Subsidize (from industry) BSN and MSN students and professionals to continue their education to become instructors Overall Solution 42

 Increased funding  Recognize need for 

participation by private industry 

 Students who want to 

further their education 

 Industry  Students  Education  Government agencies  Workforce services  Chambers  NIH  DOL  DOE  Sate and local workforce 

boards 

 State boards of Nursing  AHCA  NLN 

 Colleges  Universities  Proprietary schools  Health Care Industry  Scholarships  Grants  Salaries while they are in 

school 

 H1B Grant  Web-based training 

 Individual 

agency policies which prohibit employees from going to school (i.e., benefits, wages) 
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 DOPL  NEA  AACC  LADONNA  Nurses who don’t practice or 

are retires 

 ANA 

Issue: Lack of academic and clinical instructors Solution 5 from Salt Lake City Solution: Increase faculty salaries so they are competitive with clinical practice salaries Overall Solution 43

 Available funding  Private  Institutional  Educational preparation  Pay according to 

educational levels 

 Industry, education, 

government, students 

 Chambers  HAS, NIH, DOL  State and local workforce 

boards 

 Associations  Licensing boards  AACCE 

 Grants, endowments, 

stipends, incentives 

 Qualified applicants  Private foundations 

 State and 

accrediting agency regulations 

 Legislative 

funding 

Issue: Lack of alignment between requirements and curriculum Solution 6 from Salt Lake City Solution: Provide flexible entry points Overall Solution 44

 Some core beginning for 

post-high school preparing 

 Choose a health care path 

but you can move between the ‘silos’ 

 Pathways are visible to 

students 

 Adults (dislocated 

workers) need to find their way to a new career, i.e., steel workers to nursing 

 Acknowledgement of 

prior skills/knowledge 

 Transferable credits or 

advanced placement in programs 

 All year ‘round  Online learning is the 

 Accrediting bodies  Certifying and licensing 

bodies 

 Public consumer of health 

care 

 Health care industry in setting 

the standards 

 Proprietors of the distance 

learning technology 

 Funding for 12 month 

programs – open entry, open exit, self-pacing in program to extent possible 

 More access to lab 

(experience) in nontraditional times/ways 

 Move volume of the core, 

cross-functional courses 

 Accreditation  Standardization 

of competencies across states 
Health Care Industry’s Solutions Matrix - Full 

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model 

 Benchmark points of 

competency 

 Learning modules?  Applying science to 

problem – larger that that 

Issue: Lack of alignment between requirements and curriculum Solution 7 from Salt Lake City Solution: Industryled curriculum development committee Overall Solution 45

 Ability for education to 

respond to industry needs 

 Retrofit to respond to 

technology 

 Initially industry takes 

responsibility for equipment, training, but then moved to earliest education opportunity possible 

 All stakeholders are part 

of the industry specific team 



 Education  Teachers  Administrators  Health Care industry  Practitioners  Administrators  Pharmaceutical  Industry  Equipment  Workforce investment boards, 

one stops 

 Students 

 Time for collaboration, 

curriculum development 

 HC industry must allow 

release time for participation 

 Education 

curriculum change is not quick 

 Licensing board 

need to be more flexible, i.e., multi-state licenses 

Issue: Lack of alignment Solution 8 from Salt Lake City Solution: Academic faculty required to have contact clinical experience Overall Solution 46

 Instructors would have up 

to date knowledge of industry trends 

 Students would be 

prepared to enter workforce day one 

 Partnerships between 

industry, education and science 

 Diffusion, 

communications needs to flow among stakeholders 

 Joint training for the 

academics/clinicians 

 Rotations should allow 

for clinicians/academics to be involved along the way 

 Instructors  Clinical setting for the 

industry 

 Students 

 Shared in-services for 

knowledge exchange 

 Ability to stay ahead of 

the knowledge, clinical practice trends 

 Time for academic 

persona to go to the clinical setting and job shadow 

 Minimum threshold of 

training (people and technological) 

 HIPAA require 

merits limit 

 Students 

exposure 

 State scope of 

practice 

 Not all clinicians 

can teach and not all teachers are clinically able 

Issue: Lack of facilities and 

 Negotiated agreements 

between educational institutions and facilities 

 Colleges  Universities  Health care agencies/providers 

 Academic administrators 

must be in agreement 

 Federal and state funds 

 State laws 

governing licensing and 
Health Care Industry’s Solutions Matrix - Full 

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resources Solution 9 from Salt Lake City Solution: Use of available facilities Overall Solution 47

 Facilities must be 

evaluated for proper equipment 

 Reciprocity across state 

lines 

 Partnerships that would 

facilitate joint use educational programs 

 Funding to create 

community clinical laboratory sites 

 Public school districts  State licensing/credentialing 

entities 

 One Stop Centers  WIB  Governor’s office  State Agencies  Vocational Schools 

 Private funds  Local healthcare council  Trade Association  Federal and state funding 

resources 

certification 

 Collective 

bargaining agreements 

 State boards for 

licensing and certification 

 State practice 

acts 

 Liability issues  OSHA issues  Capacity 

Issue: Lack of facilities and resources Solution 1 from Chicago Solution: Partnership among providers, training and education of public officials to use facilities Overall Solution 48

 Available facilities  Access to current 

technology 

 Sufficient infrastructure 

funding 

 Lab, classroom, 

technology on a continuous basis 

 Hospitals  Clinics  Churches  Schools (k-12-universities)  Chamber of commerce  Economic development 

entities 

 Municipality (local)  State, federal  Students  Community-at-large  Governmental agencies 

 Funds  Furniture  Space consultants  Designers  Architects  Land  Technologies (medical, 

technical) 

 Union 

agreements 

 Sharing of cost  Use of taxpayer 

money 

 OSHA  Policies (state)  Statues  Political party 

Issue: Lack of facilities and resources Solution 2 from Chicago Solution: Clearing house (portal) of resources (space, finding, equipment) Models, exports, programs 

 National database  Coordination among key 

funding sources 

 Visible information  Instructions for how to 

use 

 Education facilities  Accrediting bodies  Industry  Health Resources and Services 

Administration. 

 All government agencies  Foundations  Philanthropic organizations  National, state and local 

workforce systems 

 Technology  Funds to pull it together  Maintenance  “Home” need to select a 

host this solution 

 Communication  Strong links to all 

stakeholders 

 Turf  Confidentiality  Keeping the data 

current 
Health Care Industry’s Solutions Matrix - Full 

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Overall Solution 49Issue: Lack of alignment between requirements and curriculum Solution 3 from Chicago Solution: Curriculum for new models of care Overall Solution 50

 Up to date and forward 

thinking 

 Vision of new models of 

care – including changing technology, job definitions, changing professions, cultural diversity, redesign of workplaces 

 Setting priorities  Understanding of 

changing demographics 

 Understanding of values 

of different generations 

 Same as previous 2  Manufacturers of medical 

equipment and technology 

 Futurists  3rd party payers  Pharmaceutical companies 

 Scenarios, projections, 

forecasts 

 Data! Good 

understanding of current data and how it will change 

 In addition to previous 2 

 Bricks and 

mortar 

 Unknown future  Resistance to 

change 

Issue: Lack of alignment between requirements and curriculum Solution 4 from Chicago Solution: Partnerships between industry and accrediting agencies and certification bodies for a realistic alignment between practice requirements and curricular design and implementation Overall Solution 51

 Shortening of time 

between identification (needs assessment) and implementation 

 Using technology to 

lessen time gap 

 Academic accrediting 

agencies must connect with business and industry 

 Synchronization of 

processes and stakeholders , i.e., certification process and accreditation process not connected and both operate independently of technology 

 Accreditation agencies  Certification agencies  HC industry  Education providers  Department of Education  (same list as #1)  Manufacturers of medical 

equipment and technology 

 Pharmaceutical companies 

 Incentive to bring two 

groups together 

 Convener  Industry associations 

 Disconnect 

between industry standards and what is on certification exams 

 No incentive for 

those two groups to come together 

 No clear leader  Education 

organizations – ‘turf’ 
Health Care Industry’s Solutions Matrix - Full 

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Issue: Lack of alignment between requirements and curriculum Solution 5 from Chicago Solution: HC industry driven curriculum Overall Solution 52

 Common vision among 

the HC industry 

 Convening and 

communication among key stakeholders 

 Identification of core 

competencies and standards of care 

 Reduce 

curriculum/accreditation cycle time 

 Identification of a 

national core curriculum by and across occupations that is tied to accreditation 

 Breakdown barriers 

between education and industry 

 Realignment of resources  Increased exposure to 

world of work for students – build into curriculum 

 Faculty and or curriculum – 

champions at each level 

 Education and training 

providers 

 Accreditation institutions – 

both regional and specialized umbrella 

 HC Associations  Labor Associations  Department of Labor  Department of Education  Department of HHS  Licensing entities  Workforce Boards  JCAHO, etc.  Manufacturers of Medical 

equipment and technology 

 Pharmaceutical companies 

 Identification of 

champions and vision leaders – evangelicals 

 Web-based technology to 

support communication effort 

 Centralized ‘home’- owner  Demonstration models  Funding  Good data and good 

information – historical, current and future 

 Subject matter expertise 

within professions willing to build toward national vision 

 State by state 

structure 

 Institutional 

culture 

 Competing 

accreditation organizations 

 State by state 

licensing issues 

 Turf wars 

between local/ state/national 

 Old technology 

obsolete 

 Turf issues 

within industry 

 Segmentation of 

resources 

 University 

requirements conflicting with professional curriculum 

 Disconnect 

between k-12 education and careers 

Issue: Train practitioners as instructors by partnering with industry Solution 6 from Chicago Solution: Develop an educational program to teach practitioners to be effective clinical instructors Overall Solution 53

 Cooperation of all 

stakeholders (particularly employers) 

 Right type of education 

model (curriculum) 

 Support system – 

scheduling 

 Buy-in at all employee 

levels 

 Cultural change in the 

worth of gaining education 

 Reward mechanism/place 

a value 

 Educational health care 

programs 

 Health care employees  Patients  Payers for health care  Students  General public  Regulatory agencies for 

education and quality health care 

 Industry (health care products, 

IT) 

 Physicians 

 Funding  Forgivable notes  Grants/scholarships  Employers  Willing and qualified staff  Instructors/staff 

development 

 Clinical facilities  Partnership with 

appropriate (GE, Microsoft, etc.) industry to fund fellowships 

 Childcare 

 Union 

agreements 

 Scheduling  Compensation 

while off duty. 
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Issue: Enhance academic instructors’ compensation so it is competitive with practitioners Solution 7 from Chicago Solution: Development of alternative funding mechanisms for education Overall Solution 54

 The will or ability to 

make a cultural change regarding the value placed on the teaching profession 

 Recognition of the value 

of practical work/clinical experience 

 Colleges and universities  State government  Hospitals  Industry Partners 

 Funding  Students/instructors 

 Value placed on 

practical experience 

 Value placed on 

teaching profession 

 State mandates 

for salaries 

 Salary 

compression – possibility 

 Union 

agreements 

Issue: Lack of academic and clinical instructors Solution 8 from Chicago Solution: Distance education Overall Solution 55

 Access to technology – 

technical barriers eliminated 

 Increase the value of 

distance education 

 Updates available quickly 

 Students – self directed  Qualified faculty  Qualified clinical sites  Preceptors  Support of academic 

leadership 

 Accreditation 

 Faculty  Clinical Training sites  IT Support  Competent Preceptors 

 Access to 

technology 

 Faculty  Accreditation of 

distance learning 

Issue: Lack of facilities and resources Solution 9 from Chicago Solution: Donate/lease equipment to stay current Overall Solution 56 

 Current equipment  Suppliers, manufacturers 

 College foundations  Hospitals  School  Faculty/ students  Donors  Financial officers 

 Donors (public, private)  Financial officer  Transportation 

 Transportation  Voltage  Temperature  Acceptance of 

gift policy 

 Training of 

personnel 

 Training on 

donated equipment 

 What are the 

restrictions on donated equipment 
Health Care Industry’s Solutions Matrix - Full 

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Issue/ Challenge: Demographic Shifts and Labor Market Trends The Need for Resources to Remove the “Bottleneck” of Potential Workers into the System Solution 1 from Washington DC Solution: Remove the “Bottleneck” of potential workers into the system by becoming more flexible and creative in identifying and applying resources. Overall Solution 57

 Funding to pay and train 

faculty (nursing professors) 

 Access to clinical sites: 

The need for more “bricks and mortar,” distance learning, and flexibility among employers to allow people time to be trained. 

 A study to determine the 

“real costs” of training a health care professional; i.e. total costs of a program including salaries and equipment 

 Universal professional 

accreditation to allow for increased flexibility for people who relocate or work in multiple jurisdictions 

 Employers  Students  Federal and state legislators  Current Faculty  Insurance Companies  Accrediting bodies (academic, 

professions and industrial) 

 On-site training programs 

with “in-kind” teachers and facilities 

 Resources for nontraditional students – such 

as transportation, child care and insurance. 

 Dollars to build 

infrastructure 

 U.S. Military defense 

contracts. 

 Incentives for private 

sector to contribute 

 Distance Learning 

Improvements 

 Scholarships 

 State Licensing 

Requirements 

The Need for Better Data Analysis, Forecasting, and Dissemination Solution 2 from Washington DC Solution: Establish better data analysis, forecasting, and dissemination by focusing on most appropriate information and increasing processing efficiency. 

 Done at the local levels to 

identify specific needs 

 Identify proper topics for 

collection 

 Better sources (look to 

cases management) 

 Federal should share its 

collected data in a form that will assist the local level. 

 Cross pollination of 

collected data among federal agencies 

 Standardization of what 

data is collected and when 

 Labor market information 

professionals 

 Workforce Professionals 

 Coordination among 

federal agencies 

 Direction  Planning  Evaluation of “the big 

picture” 

 HIPPA 

regulations 

 Difficulty in 

getting government agencies to cooperate 
Health Care Industry’s Solutions Matrix - Full 

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Overall Solution 58

 Collection should be 

“forward thinking” not reflective (more like business market research) 

Skills Development Issue: Public perception Solution 1 from Salt Lake City Solution: To develop programs for branding to enhance the perception of healthcare jobs Overall Solution 59

 Big name endorsement/ 

sponsor 

 Corporate  Individual  Media time donations  TV  Radio  Internet  Magazine  Construct common, 

positive message 

 Co-branding  Unveil media blitz – ongoing 

 Employers  Employees  Community  COL/HHS  Big Names:  Michael Jordan  Bill Cosby  Michael Vic  American IDU  Microsoft 

 COL  HHS  Big Names  Private funding  Health care associations 

Issue: Think outside the bowl Solution 2 from Salt Lake City Solution: To develop an understanding of local or regional constraint points and develop a strategies to relieve that constraint in health care Overall Solution 60 

 Local/regional 

community partnerships 

 Gap analysis  Sharing information and 

resources 

 Co-operative solutions  Building trust  Develop common 

measure of success 

 Create real outcomes for 

all partners 

 CEOs – leaders in health care 

industry 

 Local elected officials  Agency heads  Community college and 

university decision makers 

 Community based 

organizations 

 Workforce development 

leaders (local/regional/state) 

 Funding for planning 

analysis 

 Leaders in industry, 

communities who care make commitment to process/project (all stakeholders) 

 Internal 

organizational barriers? 
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Issue: Increasing available labor pool Solution 3 from Salt Lake City Solution: To modify and improve the health care delivery system by making it more operationally efficient and more patient focused Overall Solution 61

 Leverage technology cost 

reductions 

 Public changes – their 

mindset about how health care is delivered 

 Care givers change their 

mind set about how health care is delivered 

 Identify opportunities to 

eliminate waste in the current delivery system 

 Health care providers  Patients  Insurance companies  Unions  Professional workers  Professional organizations 

(AMA, ANA, etc.) 

 Federal and state governments 

 Research studies for reengineering the health care 

delivery system 

 DOL  Funding  State and federal funding  Industry support for 

service delivery projects 

 Tort reform  State and federal 

laws 

 Union contracts 

Issue: Increasing available labor pool Solution 4 from Salt Lake City Solution: To maximize the available options for access and training opportunities for the emerging transition and current workforce Overall Solution 62

 Standardized prerequisites  Dual/concurrent 

enrollment in courses 

 2+2+2 agreements 

between high school community colleges and universities 

 Increased availability 

online, distance-learning, experiential learning 

 Increased awareness of 

industry certification programs 

 Enhanced school-to-work 

job placement possibilities 

 Increased training and 

employment opportunities for out-ofschool youth 

 Increased outreach 

programs for minority and other populations with barriers 

 Colleges  Universities  Public schools  Private schools  Employers  City and state governments  Health professionals  Skilled workers 

 Department of Labor  State, city governments  Employers  Publicly funded workforce 

development funds leveraged with private sector funds 

 Maximize 

current WIA statues 

 Educational 

standards 

 Job placement 

policies 

 Articulation 

agreements 

Issue: Turnover  Money – public/private 

 Matching funds for 

 Employers  Staff 

 Private funding  Grants- demonstration 
Health Care Industry’s Solutions Matrix - Full 

A1-31

Solution 5 from Salt Lake City Solution: To redesign the health care work environment creating an atmosphere of ongoing professional growth and mutual respect and appreciation Overall Solution 63

additional education 

 Better hours/flex schedule  Improved supervisory 

training 

 Family friendly  Fringe benefits  Opportunity for 

professional development 

 Educate staff on respect  Incentive for senior staff 

 Customers projects – DOL, HHS 

 Community college – 

scholarships 

Issue: Turnover Solution 6 from Salt Lake City Solution: To develop an innovative incentive program to increase retention and support performance excellence Overall Solution 64

 Design a model/template  Criteria for when 

incentives are earned 

 Trading system  Regionalized approach  Additional money  Incentive for 

advancement not just recruitment – loyalty incentive program – stay for pay 

 Employers  Employees  Where a union is involved, 

they play a part 

 Community college 

(training) 

 Public transportation  Facility daycare  Community 

resources/leaders 

Issue: Turnover Solution 7 from Salt Lake City Solution: To develop an innovative program to provide realistic views of all levels of health care professionals Overall Solution 6 

 Design a model  Establish demonstration 

sites 

 Establish communication 

mechanisms 

 speed of certification  e-mails  healthcare association 

buy-in 

 Job shadowing  High school work 

programs/ Internships 

 Technical school teachers  High school teachers/can 

contact the public workforce system 

 Interviews – with current and 

future healthcare workers 

 Labor source 

 Not given 
Health Care Industry’s Solutions Matrix - Full 

A1-32

Issue: Increasing available labor pool Solution 8 from Salt Lake City Solution: To increase the overall wage of entry-level health care workers Overall Solution 66

 Larger labor pool  More stable entry-level 

work force 

 Enhance retention  First choice career 

decisions 

 Increased involvement of 

out-of-school youth 

 Employers  Workers  Unions  Training providers  Professional associations  Local workforce boards  City and country/parish 

governments 

 Insurance companies  Federal government  State governments  Patients and family 

members 

 Employers  Training providers 

 Union 

agreements 

 Existing service 

contracts 

 Insurance 

coverage 

Issue: Increasing available labor pool Solution 9 from Salt Lake City Solution: To leverage youth programs to provide awareness, exploration and training for the emerging workforce in health care careers Overall Solution 67

 Increased enrollment in 

health science and health technology programs in high school 

 Increased job placement 

of high school graduates in health care fields 

 Increased number of 

students enrolled and completing professional./state certificate programs 

 Marketing, brochures, job 

shadows, mentoring, career camps, career days 

 Appropriate hands-on 

activities 

 Capacity building 

instructional techniques for education 

 Employers – health care  Training providers  Public schools  Private schools  Vocational schools  Youth:  A – minority  B – disadvantaged  C – disabled  Existing health care workers 

 National health care skill 

standards 

 DOL demonstration 

projects 

 Employer funded 

activities 

 Redirection of Carl 

Perkins funds 

 Redirection of local and 

state funds 

 Education and technical 

support from health care professionals (AMA, NA, HOSA, etc.) 

 Affiliation 

agreements between business and education 

 Union 

agreements 

 State and federal 

funding policies 

Issue: Diversity/nontraditional labor pools Solution 10 from Salt Lake City Solution: To develop s system to encourage/ that 

 Access to labor pool  Community events  Trusted, meaningful 

community organizations 

 Health care partners 

involved in developing the system 

 Community organizations  Health care employers  One-stop/public workforce 

partners 

 Health care employees  Training providers 

 Funding to develop system  Human resources – 

community based organizations, mentors, etc. 

 Outcome monitoring 

funding 

 Flexibility of 

public workforce dollars 

 Prescriptive 

grant constraints 
Health Care Industry’s Solutions Matrix - Full 

A1-33

encourages community involvement in health care training and workforce systems Overall Solution 68Issue: Diversity/nontraditional labor pools Solution 11 from Salt Lake City Solution: To develop a system that rewards community partnerships / a diverse array of stakeholders Overall Solution 69

 Leveraging resources of a 

variety of stakeholders in the community (i.e., matching funds) 

 All key partners must be 

at the table 

 Must be sustained over 

time (several/many years) 

 Health care employers  Community organizations  Public workforce system  Labor/apprenticeship 

programs 

 Training providers  Community colleges 

 Multi-year funding  Federal and non-federal 

sources 

 Monitoring to ensure that 

outcomes are achieved 

 Internal/organiza

tions barriers 

Issue: Diversity/nontraditional labor pools Solution 12 from Salt Lake City Solution: To achieve basic skills competency and health care prerequisites in nontraditional labor pools Overall Solution 70

 Access to training at 

convenient times/locations for students 

 System flexibility  Reduced training time  Access to training 

supports (i.e., childcare, transportation) 

 Training providers – adult 

education/vocational schools 

 Community organizations  Health care employers  Other technical industry 

employers 

 Workforce system  Local government (economic 

development, school districts, etc.) 

 Adult education funding  Distance learning access 

points 

 Incumbent 

workers process? 
Health Care Industry’s Solutions Matrix - Full 

A1-34

Issue: Loss of patient care-givers Solution 1 from Chicago Solution: Develop career paths/educational opportunities to retain patient caregivers Overall Solution 71

 Opportunities in work 

environment must be perceived as valuable 

 Employer buy-in  Support of health 

professions 

 Developmental programs 

for incumbent workers 

 Collaboration between 

employers/education 

 Employees  Employers  Educational system and 

faculty 

 Funding to employers  Funding to education 

system 

 Assessment of skill 

demand need 

 Need ‘demand’ data 

 Access to 

funding 

 Existing labor 

contracts 

Issue: Inconsistent recognition of credentials (state) Solution 2 from Chicago Solution: National standards for licensing/credentialing all technical/clinical HC roles Overall Solution 72 

 Establish knowledge, 

skills, and ability requirements for each role 

 Adopted and consensus 

by all stakeholders 

 States comply 

(mandatory) 

 National practitioner 

database (professional discipline/malpractice) 

 Educational systems 

(secondary and postsecondary systems) 

 Professional Association 

credentialing entities 

 Employees  Employers  State governments  Federal governments  Lawyers (?)  Unions  Patients  Regulatory boards 

 Professional (professions, 

organizations and credentialing agencies) expertise willing to commit to development of standards 

 IT resources  Federal funding  Needs champion (DOL?)  Non-professional 

organization (other stakeholder input, ex: facilitated regional forums) 

 Federalism (state 

laws) 

 Professional 

organization turf wars (tithing and between professions) 

 Education 

system 

 Existing labor 

contracts 
Health Care Industry’s Solutions Matrix - Full 

A1-35

Issue: Training is not readily accessible to large group of population Solution 3 from Chicago Solution: Distance learning can dramatically and rapidly expand access Overall Solution 73

 Must be well designed  Easily accessible  Interactive  Educationally sound  Must address  ESL  Computer skills  Math, reading, etc.  Linked to real work 

exposure and career ladder 

 Cultural competency  Employer supports in 

place 

 Trainers  Learners  Employers  Workforce boards  Community leaders 

 Distance learning 

businesses 

 Community collegesprogram design  Employers (chief HR, 

chief learning officer) 

 State Hospital Association  Local foundations and 

business 

 W.I.U. S  Training grants  Research to validate 

distance learning effectiveness 

 Web software  IT experts 

 Distance 

learning centralization, but budgeting decentralized 

 Willingness of 

colleges to accept credits and credentials 

 Distance 

learning image 

Issue: Immigrant workers with health care skills (potential labor pool) not working in the health care field. Solution 4 from Chicago Solution: Develop bridging programs Overall Solution 74

 Assess educational and 

work skills 

 Individual focus of 

program (flexible) 

 Assess 

language/communication skills 

 INS credentialing 

organizations 

 Advocacy groups  Professional organizations  Employers  Co-workers  Educational resources 

(system/employer) 

 Funding for employers  Educators familiar with 

cultural barriers both as program developers and teachers 

 Tool kits  Language programs 

 Lack of internal 

standards 

 Immigration 

laws 

Issue: People are not choosing health professions Solution 5 from Chicago Solution: Incorporate health care in K-12 education 

 Link science and math to 

health 

 School system support  Exposure to real work 

careers and people 

 2-way street between 

healthcare system and school system 

 Creative teaching tools  Partnerships 

 School systems  Healthcare  Organizations  Students  Teachers 

 Counselors  People to design and 

market programs 

 Local financial support  Foundations, associations  hospitals  businesses 

 Channel/satellite 

distribution 

 Role models for 

underrepresented groups 

 Computers, etc.  Financial 

support for kids 
Health Care Industry’s Solutions Matrix - Full 

A1-36

Overall Solution 75 Issue: People are not choosing health professions Solution 6 from Chicago Solution: Develop training to enhance entry-level workers’ basic skills sets Overall Solution 76

 Contextual learning  Pervasive, easy access  Cultural competency  Creating an accepting 

environment 

 Appropriate marketing  Integration of soft skills  Computer literacy 

 State adult ed departments  Community college 

remediation programs 

 Employers  Participants  Immigration rights 

associations 

 Assessments  Workforce boards and one 

stops 

 Existing job training 

programs 

 Funding  Computer access libraries  Churches  Community organizations  Family literacy centers 

 Access to 

funding support 

 No employer tax 

credits for worker education at this level 

Issue: Employers need education on how to provide onthe-job training Solution 7 from Chicago Solution: Standardized template for creating program Overall Solution 77

 Understanding of steps in 

the process 

 Identification of core 

competencies 

 Principles of adult 

education 

 Cultural competence  Ease of Implementation  Positive ROI – retention 

of employees 

 Sharing best practices 

across institutions 

 Academic institutions  Health care employers  Employees  Teachers  In-house training departments 

 Human:  trainers  content experts  instructional designers  child care providers  HR professionals  assessment of outcome  Financial:  ROI  Funding for courses – 

train-the-trainer 

 courseware and materials  Technical:  existing research 

 Employers not 

recognizing the need 

 Financial  Union contracts 
Health Care Industry’s Solutions Matrix - Full 

A1-37

 Web and media designers 

Issue: Targeted/Specialized Skills Solution 8 from Chicago Solution: Encourage seasoned health care workers to move within the systems and explore opportunities Overall Solution 78

 Supportive Employer  Allow flexibility  Not threatened by 

employee exploring 

 See the big picture  Motivated employers  Rewards for exploring 

and advancing 

 Quality system for initial 

exploration that is quick and inexpensive 

 ‘Job info-mercials’ for 

the employee 

 Informational interviews  Time allotment or career 

development beyond initial exploration 

 Cost benefit for the 

hospital –vs.- cost of training/exploration 

 Maintain Benefits, 

seniority, vacation, etc. while training and transferring 

 Employers/Supervisors  Employees  Hospice administrations  Union  Education institution 

 Life long learning tax 

credit 

 College tuition break 

beyond a certain age 

 Involved Departments  Hospital Tuition 

reimbursements 

 Need increased employee 

pool to cover employee who is exploring 

 Computer access and 

training sessions 

 Time constraints of 

employee to get training 

 On-line learning 

 Employment and 

training programs have been cut to nothing 

 Union 

agreements with employees 

 Transferability 

of benefits problems 

Issue: Targeted/Specialized Skills Solution 9 from Chicago Solution: Develop models to share faculty with educational institutions Overall Solution 79

 Increase pools for faculty 

and direct care while also keeping skills current for faculty 

 Promotes life long 

learning 

 Ability to train more 

workers 

 Training curriculum will 

be more up-to-date 

 Educational instruction 

for new faculty will be needed 

 Attention to difference 

 Faculty – current  Educational institutions  Health care workers to work 

part-time shifts when faculty/worker is performing faculty duties 

 Educational trainers for 

faculty training 

 Current faculty  Funding for training and 

to cover shift not covered 

 Computer skills for new 

faculty 

 TIME constraints for the 

employee to get training, etc. 

 Online learning 

 Requirements to 

becoming ‘faculty’ 

 Differences in 

wage and benefits programs between patient care and faculty positions 

 Requirements to 

maintain position in each 

 Who is your 

boss? 
Health Care Industry’s Solutions Matrix - Full 

A1-38

working/learning styles 

 Allow ‘overworked’ 

employee to take a break from manual labor 

 Academia is 

rigid and not conducive to part-time learning – nontraditional learner 

Issue: Targeted/Specialized Skills Solution 10 from Chicago Solution: Map out skill sets and credentials that are transferable Overall Solution 80

 Identify credentials for 

each specialty 

 Identify skills and 

coursework needed for each credential 

 Identify skills and courses 

that are transferable 

 Determine which skills 

are required but not identified as transferable 

 All providers/professions and 

students 

 All credentialing 

bodies/entities 

 All educators and deans of 

educational programs 

 Accrediting agencies and 

standards developers for educational programs 

 Credentialing review agencies 

for foreign workers 

 Government oversight (DOL. 

DOE, DHHS/HRSA) 

 Health care organizations 

 Oversight body – probably 

governmental federal/state/local system 

 Financial (gift in kind 

from hospitals, educators, etc.) support given to oversight body – maybe federally funded or funded by individual professions 

 Need extensive database 

of all health care careers and skills; education requirement needed for each program 

 Ex: ONET (DOL 

NCHSTE 

 Use professional 

organizations as data resources 

 Turf Wars  Educational 

system that does not allow transferable credits 

 Licensing 

requirements for each profession 

 Legal 

implications of oversight body. Can providers do quality work 
Health Care Industry’s Solutions Matrix - Full 

A1-39

Sustainability Issue: Long Term Demographic Changes and Labor Market Trends Washington DC SWAT Team To Develop a StateLevel Workforce System that is Sustainable Across Years and Adaptable to Increases and Decreases in Workforce Challenges. Overall Solution 81

 Requires authority to act 

such as a mandate from the Governor (e.g. MD), certificate of need (e.g. VT). 

 A state center, either 

actual or virtual, which is focused on HC workforce with monitoring, policy advising and related mandates from State. 

 Implements the correct 

scale of all critical attributes such as ‘fit’ to the size of the State, user demographics (e.g. age of population), worker/potential worker pool demographics, resources available, degree of local /regional coordination would be more complex in larger states. 

 The secretariat and 

governance structure requires core funding. 

 Authority or 

legitimization to require of stakeholders the alignment of resources when there are actual or projected variations in workforce needs. 

 Function of coordination 

of support for planning and action on workforce issues is carried out by a 

 Primarily at the State level  Legislative and Executive 

bodies 

 Employers  Community colleges, 

universities and other educational entities who prepare people for HC occupations 

 Public and private workforce 

entities (e.g. workforce boards) 

 HC occupation licensing 

bodies 

 Professional associations  Consumer groups 

 Intersectoral partnerships 

because they can save money (e.g. English-as-asecond language programs; science and math skills; ‘soft skills’ needed for work; resources for workforce lattices such as former military personnel), steps in workforce plans and interventions, time, greater capacity, financial underpinnings, data sharing, definition of State workforce needs 

 Monitoring for finding 

knowledge of transferable ideas from other industries or idea sources 

 A taxonomy of HC 

occupations that is functional for a period of years so statistics and projections are more useful 

 Current list of all State HC 

providers, educators, relevant workforce intermediaries, employee groups aggregated at the local, regional (if needed), state levels 

 States need 

national/federal assistance for links for dissemination of information (e.g. of ideas such as the 

 State/federal/ins

urance funding entities for health care 

 Scope of 

practice regulations 

 Need increased 

flexibility in the use of funds for dealing with adapting to changes in workforce challenges 
Health Care Industry’s Solutions Matrix - Full 

A1-40

coordinator, office for coordination or similar entity. 

 Has measurable outcomes 

that determine system effectiveness and provide a basis for correcting the course of workforce responses through interventions. 

 Competence in the 

diversification of funding resources for workforce pipeline (e.g. State, foundations, ‘sweat equity, employers, employees) targeted to specific needs and outcomes sought. 

 Information system 

capacity adequate for sectoral analysis, projections of workforce requirements, linkages to other workforce sites, research and studies about workforce issues, workforce-related data and informed studies, et cetera.

 Collaboration skills of 

everyone who ‘uses’ or is part of the workforce pipeline. 

 Robust agendas of quality 

of performance, diversity of workforce, distribution of workforce, et cetera.

 Alignment of policy 

direction by key agencies (e.g. Maryland approach) including political policy affecting HC workforce 

marketing concept of Lancaster, PA workforce investment board); “we have jobs but we don’t connect jobs with people who need them”. 
Health Care Industry’s Solutions Matrix - Full 

A1-41

at state, regional and local levels. 

 Seeks communication, 

collaborative opportunities among stakeholders. 

 Maintains information 

linkages with other workforce entities such as DOL, WIB’s, HC employer and employee associations, labor organizations, education associations, consumer associations, et cetera that can inform and enhance the carrying out of the state coordination entity. 

 Skill in serving as one 

catalyst for aligning resources for career ladders/lattices and other recruitment and retention strategies. 

Issue: Sustainability: Infrastructure, Leadership, and Policy Salt Lake City Swat Team Solution: National Model for a Sustainable Workforce in Health Care Overall Solution 82

 Business-friendly – can 

do vs can’t do attitude 

 Ability to Change Policy  Research and models to 

project the needs accurately 

 Must have the authority 

to act; institutionalized 

 “Failure is not an option” 

attitude 

 Quiet deliberation and 

negotiation tactics to “gel” partnerships 

 Use of incentives—

Infrastructure (e.g. fiscal policy - gas tax) for local/state planning. 

 DOL as Lead (broader 

perspective) 

 DHHS  DOJ  DoEd  ANA, AMA (other worker 

associations) 

 Accreditation Organizations  Allied Health  AFL-CIO; SEIU; (labor 

Unions) 

 Insurers  NGA  EDA  Industry-driven (Labor & 

Management) 

 Independent 

Lead/Convening organization that is neutral 

 Fiscal Policy  AACC; other educational 

organizations and entities 

 Demonstration Money  Foundations  Regulatory Boards  Vendors  Minority Voice  BLS 

 Need to define 

the imperative through Legislation that is accountable to the consumer. 

 Possibly take on 

another piece of legislation that speaks to this. 
Health Care Industry’s Solutions Matrix - Full 

A1-42

Incentives must be data driven vs politically driven 

 ROI – value added; cost 

benefit 

 Broad understanding of 

health care from the perspective of those needing care (patientcentered). 

Need For Sustainable Infrastructure, Leadership and Policy Chicago SWAT Team To Identify, Address and Adapt to Local Workforce Supply and Demand Changes Overall Solution 83

 Has the mandate or other 

leverage to engage and convene the appropriate stakeholders to address supply and demand issues. Suggested a local board management structure such as that used by Rush medical center because of its size, complexity yet functional nature. 

 Has community and 

workforce demographic information including projections. Can determine short/mediumterm needs in the context of longer-term workforce projections with decisions based on the same data, common agreement on meaning, done at certain regular dates. Planning tools and data needed. 

 Local workforce systems 

need integration of some sort with education entities to increase or decrease the number and type of HC occupations for the community and to assist with resolving 

 Local entities relevant to HC 

workforce issues.” a community of common interest groups”. 

 Physicians, nurses, allied 

health professionals 

 Labor organizations  Employers  Educational institutions from 

K through post-secondary 

 Community sources of 

potential workers such as religious organizations, YM/YWCA 

 The DOL ETA “Primer” 

when available as it describes the process for the developing and working of a local HC workforce group suggested in this solution 

 Communications specialist 

or media assistance 

 Skill in calculating the 

economic impact of HC workforce to the community ( see Aspen Institute current research on return on investment in HC workforce), in preventing losses to the community, in attracting business to the community, in costing out local, State and Federal decisions such as “add this regulation”. 

 Contacts among 

regulators, accrediting bodies, research sources, media, technology resources (e.g. helping provide care or training to work “smarter”). 

 Key informants for HC 

workforce issues at the local government and 

 Articulation of 

programs so that career ladders can be implemented (e.g. State of Oregon consensus approach by educators) 

 If there are 

Federal or State mandates (e.g. HIPPA, small pox regs, staffing requirements) then there must be adequate public funding to carry out these mandates. 

 State and 

Federal workforce and health care funding. Workforce policies that are intended to support the worker training steps and are too 
Health Care Industry’s Solutions Matrix - Full 

A1-43

capacity issues requiring partnerships. 

 The workforce entity is 

characterized by continuous quality improvement process in its work management. 

 Strong, accurate and 

transparent communications internally and externally when appropriate. .. need for high levels of trust within the group, “sunshine law” on all deliberations, characterized by inclusiveness and accountability. 

 The capacity or authority 

(the group was not sure about the latter) to align workforce resources and to rethink how to best do this. 

 Need to have/create a 

workforce infrastructure that is consistent with career ladders/lattices and must be aligned with State and Federal support (group noted, however, that the levels of government have funding directives that are antithetical to sound workforce development). 

 Core activities for the 

local area HC workforce team: identify local gaps and barriers related to HC workforce; know where money is being spent 

State levels. 

 Diversity groups (e.g. 

disabled workers) 

 Ability to be a support and 

catalyst for developing workforce environments that attract, retain and support patients/residents and employees (e.g. see American Hospital Association commission report; see Eden centers). 

 Creativity and flexibility 

in workforce solutions while assuring high quality of care (e.g. apprenticeship approaches to workforce development, career ladders, Magnet Hospitals recognition). 

often not aligned with current needs (e.g. incumbent worker funding for taking a whole program when the person needs funding for small steps in their career ladder activities). Our group did not know the solution but the fragmentation and lack of alignment of current funding with sustainable and adaptable workforce development at the local level is problematic. 

 Licensure 

reciprocity between States 

 The problem 

with the process required for criminal background checks 
Health Care Industry’s Solutions Matrix - Full 

A1-44

now, how much and its sources both by employers and by workforce pipelines; best practices that are applicable in the local area; set priorities about what issues should be addressed 

 The skill and processes in 

place to overcome “turf battles” (e.g. competition for staff within the local area; competing labor organizations). Serves as an “honest broker” in the community and with levels of government. 

 Ability to do 

multitasking. That is, the group can keep multiple workforce agendas moving ahead even when there is a short-term crisis 
Attachment 2 

Health Care Industry’s 

Solutions Matrix – Condensed 

Health Care Industry’s Solutions Matrix - Condensed 

A2-1

Health Care Industry’s Solutions Matrix - Condensed Overarching Issue/Challenge 

Specific Issue/Challenge Potential Solution 

Recruitment and Retention 

Ensuring the Skills of Entry-Level Workers To develop a competency-based instructional and 

assessment system that covers all Para-professional employees that leads to national standardized certifications and requirements. 

Recruitment and Retention

Ensuring the Skills of Entry-Level Workers The DOL will exercise leadership in identifying the 

needs and finding ways to implement and 

institutionalize skills training for entry-level 

healthcare workers at the national, state, and local level. 

Recruitment and Retention

Employment & Working Conditions To enhance the public image and awareness of 

employment opportunities in the healthcare profession 

Recruitment and Retention

Employment & Working Conditions Continuous problem solving involving all levels to 

improve the working environment in order to increase retention. 

Recruitment and Retention

Employment & Working Conditions Identify successful cultural change initiatives to 

provide “models” to institutions that are struggling with how to improve their working environment. 

Recruitment and Retention

Recognizing that the current supply of workers will not be adequate to meet future health care demands, we need to identify solutions to recruit non-traditional workers (such as, but not limited to: men, older adults, and individuals from culturally and linguistically diverse communities.) 

Design of a national marketing campaign to sell nursing and allied health careers and give information on career entry. 

Recruitment and Retention

Recognizing that the current supply of workers will not be adequate to meet future health care demands, we need to identify solutions to recruit non-traditional workers (such as, but not limited to: men, older adults, and individuals from culturally and linguistically diverse communities.) 

To expose people, beginning in elementary school thru post-secondary. 
Health Care Industry’s Solutions Matrix - Condensed 

A2-2

Overarching Issue/Challenge 

Specific Issue/Challenge Potential Solution 

Recruitment and Retention

Issue: Recognizing that the current supply of workers will not be adequate to meet future health care demands, we need to identify solutions to recruit non-traditional workers (such as, but not limited to: men, older adults, and individuals from culturally and linguistically divers communities.) 

To develop targeted recruitment and retention strategies with community-based organizations (EMS Volunteer services programs, e.g., fire department, area aging agencies) nursing and allied health workers and faith based organizations. ONLY EXAMPLES.

Recruitment and Retention

Incumbent worker training Increased flexibility of educational program provider 

offerings

Recruitment and Retention

Incumbent worker training Create a learning culture that provides time, access, 

and compensation for learning 

Recruitment and Retention

Incumbent worker training Incentives for employee growth, development and 

continuing education 

Recruitment and Retention

Targeted specialized skills areas: How to help retain/orient new hires

Create mentoring opportunities to acculturate new staff to the department or company

Recruitment and Retention

Targeted specialized skills areas: Filling specialty jobs 

Develop system to identify, project and match/map competencies for roles within health care and across industries to identify matches and skill gaps. Create training to bridge the gap. 

Recruitment and Retention

Targeted specialized skills areas: Staff skills necessary to develop into management and supervisory roles 

Develop management certificate program 

Recruitment and Retention

Entry-level worker preparation Provide English as a second language programs to 

develop language skills and meet minimum job requirements 

Recruitment and Retention

Entry-level worker preparation Increase exposure of students to health care 

workforce environment in junior high and high schools 
Health Care Industry’s Solutions Matrix - Condensed 

A2-3

Overarching Issue/Challenge 

Specific Issue/Challenge Potential Solution 

Recruitment and Retention

Entry-level worker preparation Develop and sustain partnerships between local 

educational institutions and the healthcare industry 

Recruitment and Retention

Career Ladder / Lattice Develop career paths to accommodate vertical and 

horizontal moves within the healthcare field 

Recruitment and Retention

Through Development of a Health Corps to Increase the Available Labor Pool

Develop a Health Corps, based on the Peace Corps or Teachers Corps model 

Recruitment and Retention

Pipeline: Recruitment and Retention Through a Media Campaign to Increase Available Labor Pool

Build A Positive and Effective Media Campaign to increase healthcare workers 

Recruitment and Retention

Pipeline: Recruitment and Retention Through Funding to Increase the Available Labor Pool

To develop individual and system financial/funding models that promote student enrollment, faculty development and program growth 

Recruitment and Retention

Pipeline: Recruitment and Retention Through Increased Partnerships to Increase the Available Labor Pool

Develop a partnership model between industry, government and education 

Recruitment and Retention

Pipeline: Recruitment & Retention: Turnover – Changing Culture 

Develop strategies and incentives to move to shared governance and continuous, quality improvement environment 

Recruitment and Retention

Pipeline: Recruitment & Retention: Turnover -- Incentives

Develop a comprehensive range of employee incentives to remain in the healthcare field 
Health Care Industry’s Solutions Matrix - Condensed 

A2-4

Overarching Issue/Challenge 

Specific Issue/Challenge Potential Solution 

Recruitment and Retention

Pipeline – (A): Recruitment and Retention – Diversity / Non-traditional Labor Pool

A system wide commitment to provide consistent access, opportunity and support for recruiting and retaining underrepresented culturally diverse populations in the healthcare workforce 

Recruitment and Retention

Pipeline – (B) Recruitment and Retention – Diversity / Non-traditional Labor Pools 

Reduce barriers to entry level jobs and increase retention through financial or in-kind subsidies to targeted populations 

Recruitment and Retention

Pipeline – (C) Recruitment and Retention – Diversity / Non-traditional Labor Pools

To Improve Retention by Creating Flexible Work Options within healthcare to Appeal to NonConventional Workers 

System Capacity Capacity of Workforce-related Organizations Partnering with Employers (Hospitals, LTC) and 

training providers (community colleges, universities, other) on a regional basis. 

System Capacity Capacity of Workforce-related Organizations Training for practicing providers to provide adult 

learning competence and cultural competence. Training clinicians to teach adults will help more of them become academic and clinical faculty. (Given 

because many clinicians do not think they are able to teach adults.) Training in cultural competencies will help clinicians understand the different cultural aspects of their patients/students.

System Capacity Capacity of Workforce-related Organizations Faculty loan repayment System Capacity Capacity of Workforce-related Organizations Prioritize training and occupations so that budget cuts 

do not affect key occupation training 

System Capacity Midterm Projections Input from Consumers System Capacity Midterm Projections Agreed upon assumptions. In order to have a process 

the industry and statisticians saw as valid, certain uniform assumptions and results are required.
Health Care Industry’s Solutions Matrix - Condensed 

A2-5

Overarching Issue/Challenge 

Specific Issue/Challenge Potential Solution 

System Capacity Midterm Projections Database of different occupation and state analyses System Capacity Building Partnerships and Healthcare Information Regional Healthcare Workforce Council System Capacity Occupational Gaps Develop recruitment and retention strategies System Capacity Occupational Gaps Expand career lattices within the industry System Capacity Occupational Gaps Distance Learning for Staff System Capacity Lack of facilities and resources Healthcare – Expand Training Programs – Allied 

Health Professions 

System Capacity Lack of facilities and resources Distance and education learning System Capacity Lack of academic and clinical instructors Provide paid time off and flexible work schedules for those that wish to advance their education to teach or 

want to serve as part-time instructors (both academic and clinical)

System Capacity Lack of academic and clinical instructors Subsidize (from industry) BSN and MSN students and professionals to continue their education to 

become instructors 

System Capacity Lack of academic and clinical instructors Increase faculty salaries so they are competitive with clinical practice salaries 
Health Care Industry’s Solutions Matrix - Condensed 

A2-6

Overarching Issue/Challenge 

Specific Issue/Challenge Potential Solution 

System Capacity Lack of alignment between requirements and curriculum Provide flexible entry points System Capacity Lack of alignment between requirements and 

curriculum 

Industry-led curriculum development committee 

System Capacity Lack of alignment Academic faculty required to have contact clinical 

experience

System Capacity Lack of facilities and resources Use of available facilities System Capacity Lack of facilities and resources Partnership among providers, training and education 

of public officials to use facilities

System Capacity Lack of facilities and resources Clearing house (portal) of resources (space, finding, 

equipment) Models, exports, programs 

System Capacity Lack of alignment between requirements and 

curriculum

Curriculum for new models of care 

System Capacity Lack of alignment between requirements and 

curriculum 

Partnerships between industry and accrediting agencies and certification bodies for a realistic alignment between practice requirements and curricular design and implementation 
Health Care Industry’s Solutions Matrix - Condensed 

A2-7

Overarching Issue/Challenge 

Specific Issue/Challenge Potential Solution 

System Capacity Lack of alignment between requirements and curriculum HC industry driven curriculum System Capacity Train practitioners as instructors by partnering 

with industry 

Develop an educational program to teach practitioners to be effective clinical instructors 

System Capacity Enhance academic instructors compensation so it is competitive with practitioners Development of alternative funding mechanisms for education System Capacity Lack of academic and clinical instructors Distance education System Capacity Lack of facilities and resources Donate/lease equipment to stay current Demographic Shifts and Labor Market Trends

The Need for Resources to Remove the “Bottleneck” of Potential Workers into the System 

Remove the “Bottleneck” of potential workers into the system by becoming more flexible and creative in identifying and applying resources. 

Demographic Shifts and Labor Market Trends

The Need for Better Data Analysis, Forecasting, and Dissemination 

Establish better data analysis, forecasting, and dissemination by focusing on most appropriate information and increasing processing efficiency. 

Skill Development Public perception To develop programs for branding to enhance the 

perception of healthcare jobs
Health Care Industry’s Solutions Matrix - Condensed 

A2-8

Overarching Issue/Challenge 

Specific Issue/Challenge Potential Solution 

Skill Development Think outside the bowl To develop an understanding of local or regional constraint points and develop a strategies to relieve 

that constraint in healthcare

Skill Development Increasing available labor pool To modify and improve the healthcare delivery system by making it more operationally efficient and 

more patient focused

Skill Development Increasing available labor pool To maximize the available options for access and 

training opportunities for the emerging transition and current workforce

Skill Development Turnover To redesign the healthcare work environment creating an atmosphere of on-going professional growth and 

mutual respect and appreciation

Skill Development Turnover To develop an innovative incentive program to increase retention and support performance 

excellence

Skill Development Turnover To develop an innovative program to provide realistic views of all levels of healthcare professionals Skill Development Increasing available labor pool To increase the overall wage of entry level healthcare workers Skill Development Increasing available labor pool To leverage youth programs to provide awareness, 

exploration and training for the emerging workforce in healthcare careers

Skill Development Diversity/non-traditional labor pools To develop a system that encourages community 

involvement in healthcare training and workforce systems

Skill Development Diversity/non-traditional labor pools To develop a system that rewards community 

partnerships / a diverse array of stakeholders 
Health Care Industry’s Solutions Matrix - Condensed 

A2-9

Overarching Issue/Challenge 

Specific Issue/Challenge Potential Solution 

Skill Development Diversity/non-traditional labor pools To achieve basic skills competency and healthcare prerequisites in non-traditional labor pools Skill Development Loss of patient care-givers Develop career paths/educational opportunities to retain patient care-givers Skill Development Inconsistent recognition of credentials (state) National standards for licensing/credentialing all 

technical/clinical HC roles

Skill Development Training is not readily accessible to large group of population Distance learning can dramatically and rapidly expand access Skill Development Immigrant workers with healthcare skills (potential labor pool) not working in the health 

care field. 

Develop bridging programs 

Skill Development People are not choosing health professions Incorporate healthcare in K-12 education Skill Development People are not choosing health professions Develop training to enhance entry-level workers’ basic skills sets Skill Development Employers need education on how to provide on- the-job training Standardized template for creating program Skill Development Targeted/Specialized Skills Encourage seasoned health care workers to move within the systems and explore opportunities 
Health Care Industry’s Solutions Matrix - Condensed 

A2-10

Overarching Issue/Challenge 

Specific Issue/Challenge Potential Solution 

Skill Development Targeted/Specialized Skills Develop models to share faculty with educational institutions Skill Development Targeted/Specialized Skills Map out skill sets and credentials that are transferable Sustainability Long Term Demographic Changes and Labor 

Market Trends 

To Develop a State-Level Workforce System that is Sustainable Across Years and Adaptable to Increases and Decreases in Workforce Challenges. 

Sustainability Sustainability: Infrastructure, Leadership, and 

Policy

National Model for a Sustainable Workforce in Health Care 

SWAT Teams on Sustainability

Need for Sustainable Infrastructure, Leadership and Policy

To Identify, Address and Adapt to Local Workforce 

Supply and Demand Changes 
Attachment 3 

1001 Solutions Generated at the 

Health Care Industry 

Workforce Development Forums

A3-1

1001 Solutions Generated at the Health Care Industry 

Workforce Development Forums 

Total number of solutions generated at forums: 1001 

The large number of solutions is useful for readers who have a workforce challenge and 

who are seeking a range of ideas for solutions. In this document, a small set of 16 

interesting or unusual solutions has been placed below. These solutions were not 

expanded upon by the Workforce Development Information Forum work groups. 

 Assistive technology/job redesign 

 To redesign jobs to allow older workforce to continue to work (i.e. six months per 

year contracts). Work from home when possible. 

 To create more flexible part-time, work-at-home jobs for individuals with 

children or older workers. 

 To market healthcare career opportunities in sports media, TV, radio, magazines 

normally used by men. 

 Develop career ladders for workers in the health care industry that link 

compensation to new skill development (pay for knowledge) 

 Promote regional collaboration to minimize effect of labor cannibalizing. 

 To improve workplace culture, support incentives to become a magnet hospital. 

 To discourage hospitals/employers from cannibalizing each other’s employees by 

developing city-wide/regional agreements on hiring bonuses/salary, etc. 

 To develop/expand health service corps that exchanges tuition support for work in 

shortage areas. 

 To develop a Health Corp modeled after the Peace Corp. 

 National/state advertising of healthcare jobs sponsored on every major sporting 

event on T.V. 

 Tap into and develop links to distance learning programs to bring educational 

sessions (1 instructor) to teach multiple students over many states. 

 To develop older RNs into instructors – help keep them in healthcare. Reach out 

to retirees to come back to work as instructors; must make it easy or them to be 

licensed instructors (e.g., Georgia model) 

 Stretch faculty further using retired to teach online courses or serve as part-time 

faculty. 

 Licensing requirements reevaluated. 

 National rather than state licensing. 
A3-2

The following is a complete list of the solutions generated at the Workforce Development 

Forums: 

Pipeline: Recruitment and Retention 

Diversity/Non-Traditional Labor Pools 

Washington, DC Solutions

1. National marketing effort to sell the industry and where to go for help (image 

– multi-ethnic) 

2. Identify barriers for entry 

3. Offer immediate employment to older works and train on-the-job 

4. Preparation for different workplace issues 

5. Assistive technology/job redesign 

6. Introduction in elementary/middle schools of healthcare careers 

7. Healthcare clubs – role model, speaker bureaus 

8. Partnering with CBOs and FBOs – develop needs for specific communities 

9. Recruit and test in multiple languages and train – training resources for the 

multi-ethnic/multi-language 

10. Guide for career changers 

Washington, DC “Did You Think of This”

11. Difficulty of immigrants meeting admission standards of community college 

without transcripts 

12. No translation of immigrant skills into U.S. medical occupations (licensing 

board examination) 

13. Cultural competency training needed for supervisors = people leaving jobs if 

they don’t feel respected 

Salt Lake City, UT Solutions

14. Community Outreach 

15. Community Partnerships 

16. Basic Skills 

17. Develop vocational ESL curriculum for health care careers training. 

18. Seek out the alternative Labor Pool. 

19. Develop an immigrant strategy to attract non traditional workers. 

20. Introduce local minority mentorship programs to attract individuals from 

targeted populations. 

21. Recruit workers, especially in home health care, from the families and 

communities of patients. 

22. Promote the hiring of local residents through funding support targeted at 

reducing dependence on foreign labor. 

23. Develop a targeted marketing campaign to large pools of non-traditional 

health care labor pools 

24. Eligible post criminal offenders 

25. Disabled 
A3-3

26. Other types of service workers 

27. Men 

28. International 

29. Engage national, state and local civic groups with regularly scheduled 

presentations, workshops, or linking to a sponsored community health care 

event like a “good eating” event 

30. Provide diverse/non-traditional students with funding supports to enable them 

to gain needed skills. 

31. Provide tax credits to males and other minority groups to enter the health care 

industry 

32. Have inclusiveness training for existing staff 

33. Make the health care profession attractive again to those that left the field. 

34. Develop a media campaign promoting health care as an industry of choice for 

nontraditional health care labor pools 

35. Develop a more diversified educated pool of future healthcare workers and 

increase the availability of programs to youth 

36. Example: Academic Enrichment Math and Language Arts 

37. Mentors/Tutors 

38. Combine existing resources in community to leverage opportunity 

39. Develop and leverage training programs with historically black universities 

and Hispanic populations. 

40. Offer special public transportation from targeted neighborhoods to training 

opportunities. 

41. Work with the industry and community to create “paths” for the older/2nd 

career worker. 

42. Reassess the potential for ex-offenders to participate in certain healthcare 

professions. 

43. Develop an importation strategy of skilled workers for the health care industry 

from the labor force of other countries. 

44. Reach out with multiple partners to minority communities 

45. Develop a support system by which non-traditional students with family 

responsibilities can simultaneously meet family needs and gain skills and 

competencies for health care professions. 

46. Develop partnerships with other service-related industries in order to get them 

to understand the urgency of health care needs and assist in developing 

solutions. 

Chicago, IL Solutions

47. To provide loan forgiveness 

48. To provide child care assistance, support for underrepresented workers in 

healthcare. 

49. To provide county tax rebates for those willing to relocate to serve in 

healthcare fields for up to two years or more. 

50. To establish funds/scholarships targeted to populations. 

51. To provide transportation assistance to healthcare jobs for underrepresented 

groups (e.g. older workers, workers with English as a second language) 
A3-4

52. To provide subsidized prescription drug funding for older workers, second 

career workers. 

53. To subsidize home ownership/housing and offer stipends for students 

including loan forgiveness education. 

54. To remove non-essential physical skill requirements from occupational 

requirements. 

55. To redesign jobs to allow older workforce to continue to work (i.e. six months 

per year contracts). Work from home when possible. 

56. To provide flexible work schedules for non-traditional workers. 

57. To expand scheduling options i.e., 2 - 4 - 6 hour shifts/seasonal 

58. To create more flexible part-time, work-at-home jobs for individuals with 

children or older workers. 

59. To loosen state/fed licensing regulation burdens to encourage retired 

practitioners to do more part-time/volunteer work in healthcare. 

60. To provide role models for diverse student populations. 

61. To develop “back-to-school” programs with practitioners from 

underrepresented populations making presentations/mentoring in inner city or 

rural schools. 

62. To include cultural diversity and sensitivity in healthcare education programs. 

63. To increase cultural competence/cultural sensitivity of all practitioners so that 

potential applicants feel this is a viable option for them. 

64. To use minorities in health care industry as community role models to 

encourage careers in healthcare. 

65. To increase English immersion availability. 

66. To develop recruitment tools in a variety of languages and formats. 

67. To recruit using non-English speaking media outlets. 

68. To provide special education incentive funding for ESL, community college 

students to join healthcare fields. 

69. To bring in healthcare workers that are non-English speakers, to develop 

Spanish speaking teams of healthcare providers to serve Spanish speaking 

clients while also learning English. 

70. To recruit bilingual healthcare providers i.e., doctors, nurses, etc. 

71. To market healthcare career opportunities in sports media, TV, radio, 

magazines normally used by men. 

72. To change image/message to increase males 

73. To attract more men into nursing, change the name to reflect technology and 

management skills needed. 

74. To target lesbian, gay, bi-sexual, transgendered individuals 

75. To identify and attract retired workers back to healthcare 

76. To have community healthcare agencies provide grassroots outreach to their 

local communities. 

77. To expand beyond traditional healthcare occupations to include electronic 

technicians/instrument mechanics, building maintenance, lab techs, 

ambulance drivers, computer techs. 

78. To have employers work with workforce development projects 
A3-5

79. To partner with educational institutions to support programs focusing on these 

groups. 

80. To target new immigrants who are healthcare providers with alternative prep 

strategies to enter U.S. workforce. 

81. To offer non-citizen groups a quicker ticket to citizenship by entering the 

healthcare field. 

82. To recruit workers from overseas by loosening visa requirements and expand 

use of overseas workers in certain fields (information management, reading xrays) by outsourcing to them. 

83. To promote healthcare programs to displaced workers 

84. To re-employ workers from declining manufacturing positions 

85. To work with transitioning Military personnel back into public employment 

(healthcare technical skills) 

86. To partner with Job Service to reach out to displaced workers 

Career Ladders/Retention 

Salt Lake City, UT Solutions

87. Structure training and career ladders to allow for career advancement at a 

more rapid pace. 

88. Develop career ladders for workers in the health care industry that link 

compensation to new skill development (pay for knowledge) 

89. Increase supports needed for people to train and stay in health care jobs. 

90. Develop a process to engage those already in health care to stay in the 

profession. 

91. Provide coursework to aid the academic preparedness of individuals 

demonstrating interest but lacking necessary competencies 

92. Make training available and affordable for low-wage workers, the 

unemployed and entry level incumbent workers. 

93. Increase the number of students allowed in clinical settings or increase wages 

for instructors so the job is more than or as appealing as the hospital setting so 

more instructors could be hired/retain their employment. 

94. Conquer the stigma of males as health care providers by promoting the work 

stability and living wages of the profession. 

95. Provide more career counseling to current workers so they view health care as 

a career and don’t feel they need to leave to have a change. 

96. Provide/help worker access supports to entry level or low-wage workers 

a. Transportation 

b. Child Care 

97. Develop incentive programs for individuals based on seniority 

98. To decrease patient/health care stress, worker ratios, the feeling of being 

unprepared by giving workers opportunities for bonuses, leave, training, child 

care as incentives to stay on board and perform at a higher rate of excellence. 

99. Develop formalized post licensure training with colleges to ensure that 

workers are adequately prepared for job learning curves (continued 

competency). 

100. Promote regional collaboration to minimize effect of labor cannibalizing. 
A3-6

101. Long Term Care – regulation/guidance awareness for families could mean 

higher wages for entry level employees and lower turnover 

102. Improve the lines of communication and reduce disputes between front-line 

worker and management (unions) through the joint creation of community 

visions and strategic work plans. 

103. Develop a compensation plan that produces a living wage for all levels of 

workers. 

104. Develop more flexible delivery of didactic work to meet student demand. 

105. To decrease turnover, assist health profession programs to provide realistic 

views of careers (e.g. require clinical training for all shifts). 

106. Introduce students to basic nursing skills, responsibilities and demands before 

entering a nursing program. 

107. Look at job demands, not money. 

108. Make the work “reality” experienced more in the educational process (RN 

Residency). 

Chicago, IL Solutions

109. To improve workplace culture, support incentives to become a magnet 

hospital. 

110. To develop easily interactive communication links between employee and 

employer, i.e., regular focus groups, teams-shared governance, continue ways 

of improvement. 

111. To create a culture of R-E-S-P-E-C-T 

112. To improve employee satisfaction with leaders/supervisors – highly prepared 

leaders 

113. To develop quick responding process improvement procedures (interactive) so 

that things can change in a timely fashion. 

114. To develop a culture of continuous learning by rewarding those who 

participate. 

115. To increase awareness and understanding of and respect for the roles of 

nurses//allied health professionals among physicians and hospital management 

(allied health professions week – Nov 2-8, 2003) 

116. To change culture of M.D.—R.N. dynamic, create innovative med school and 

nursing school partnerships to foster team approach. 

117. To focus management education on coaching career development and other 

areas which support employees. 

118. To increase tuition reimbursement benefit. 

119. To provide incentives for extended stay within a healthcare organization 

beyond wages and hours, such as additional ‘comp’ time or free community 

college classes. 

120. Ability to get time off. 

121. To provide for sabbatical – time out – job rejuvenation. 

122. To reward managers for developing and retaining their staff. 

123. To create more flexible part-time, work-at-home special benefits. 

124. To end the pay/benefit battle between facilities 
A3-7

125. To offer pension programs or other longevity incentives for long term service 

in the industry. 

126. To adopt flexible scheduling, create shared assignments, etc., to promote 

retention. 

127. To provide more attractive total rewards (compensation, benefits, etc.) 

128. To stop the mandatory overtime argument between employees vs. employer. 

129. To provide career ladders for healthcare workers. 

130. To develop career ladders across competing healthcare systems 

131. Utilize tools such as mentoring, career counseling, career ladders, and career 

lattices to provide productive alternatives for exiting the field. 

132. To keep two-thirds R.N’s in the field, streamline ability to get BSN that will 

increase options. 

133. To redesign workload to accommodate the older worker (physical and mental) 

134. To discourage hospitals/employers from cannibalizing each other’s employees 

by developing city-wide/regional agreements on hiring bonuses/salary, etc. 

135. To bridge the gap between long term care and acute care 

136. To realize that turnover will happen no matter what, so build into the 

organization’s plan. 

137. To develop a study that identifies causes of turnover and provides strategies 

for minimizing turnover problems. 

138. To evaluate through a comprehensive national study, causes of turnover with 

attention to local issues, ages, sex, nationality, personal needs, to foster 

models to reduce turnover, step outs and unproductive migration. 

139. To institute “better” orientations for new healthcare providers, to job and 

culture 

140. To implement mentoring programs in each facility with employee buy-in. 

141. To target time of most turnovers (first two years) to nurture people through. 

142. To support mentorships with additional incentives for veteran workers so they 

better accept new employees thereby improving culture. 

Increasing the availability of the labor pool 

Salt Lake City, UT Solutions

143. Youth programs 

144. Living wages 

145. Access to training 

146. Develop increased interest in health careers by providing motivating activities 

to introduce youth to health careers. 

a. Summer camps 

b. A day with health professionals 

c. Dissections 

147. Develop a pipeline of new entry level workers to the health care industry by 

marketing health care careers to middle school and high school students 

148. Develop a formalized process by which high school students can earn college 

credit in the health care field. 

149. Develop a media campaign focused on increasing the reputability and respect 

level for entry level health care jobs 
A3-8

150. Develop a more dedicated work pool to assist health profession organizations 

to improve the image of their profession 

151. Engage community partners to bring increased awareness to various health 

care professions/needs. 

Improving the Work Environment 

152. Improve the quality of the work environment 

a. Better hours 

b. Flexible hours 

c. Improved supervisory training 

153. Work environment to have the industry training more family/work life 

friendly. 

154. Work more with physicians as to their impact on t/o 

155. Foster a working environment that supports long term employment (i.e. work 

hours, fringe benefits, career ladders, etc) 

156. Competitive work place 

157. Provide more opportunities for professional growth and development 

158. Develop programs to constantly reiterate respect and appreciation for staff 

working in health care jobs. Programs at all levels: National, Regional, Local 

and Organizational. 

Chicago, IL Solutions

159. To increase awareness of non-physician/nursing careers (i.e., allied health) in 

K12-PSAs on MTV, Nick, etc., internet banner ads, viral e-mail campaigns, 

etc. 

160. To promote allied health professions to the public to increase the number of 

applicants to ed programs 

161. To recruit all schools, not just public schools. Remember private and 

parochial schools, Remember they frequently have a “mission” philosophy 

162. To develop a positive media image through targeted strategies; i.e. right 

message, right population, right number of contacts 

163. To market the plus side or advantages of a health care career including 

variety, flexibility, transportability, job security, etc. 

164. To lure high school students in healthcare related fields by making the 

different fields more appealing, more sexy 

165. To get healthcare corporate sponsors to donate technical and lab equipment to 

high schools and community colleges so healthcare subjects are more 

appealing to students. 

166. To form partnerships with healthcare corporate providers to develop joint 

training and receiving programs 

167. To increase collaboration between service and education to provide faculty 

and programs. 

168. To improve communications between high school and community colleges for 

better preparation for probable labor pool. 
A3-9

169. To partner with organizations training in future shortage areas to introduce 

healthcare opportunities to them. 

170. To develop effective targeted partnerships, e.g. accelerated BSN requires 

partnering with four year institutions not necessarily with high schools 

171. To finance student tuition (at time of admission) so students can depend on it. 

172. To provide tax incentives for people to move to rural areas. 

173. To develop/expand health service corps that exchanges tuition support for 

work in shortage areas. 

174. To encourage continued state/fed funding to hospitals, Title VII funding 

175. Go to the community service organizations, churches, places where people 

wait (driver’s license or clinics) with recruitment materials. 

176. To encourage new citizens to better understand health care in the US by 

including info with citizenship training. 

177. To recruit former healthcare workers. Provide training and support transition 

back into healthcare. 

178. To work with high school career counselors to increase their awareness of 

health careers. 

179. To support our welfare reform / low income population for success in a 

healthcare career. 

180. To assess ability of non-traditional worker (older workers, part-time workers) 

to supplement labor pool, targeting limited ability workers to areas of limited 

need. And develop career ladders to provide for fallback opportunities. 

181. To use your current labor pool for a grass roots effort (i.e., role modeling, 

education) 

182. To hire students studying in areas with labor shortages for summer intern jobs 

at hospitals, summer camps, (4-12). 

183. To recruit displaced workers 

184. To provide reciprocity for qualified foreign-trained healthcare workers to 

increase available labor pool 

185. To rehabilitate the formerly incarcerated to join the healthcare profession 

(reduces recidivism) 

186. To work creatively with four-year and community colleges to relieve bottlenecks in waiting lists. 

187. To develop on-line training opportunities to attract working people interested 

in changing jobs. 

188. To increase quality of K-12 math/science education—magnet high schools for 

health careers, job shadowing. 

189. To tutor adult students in math, English, and science. 

190. To develop a Health Corp modeled after the Peace Corp. 

191. To manage job listings for healthcare organizations to better generalize their 

info for possible labor pool. 

192. To get employers to actually list healthcare skills needed when writing up job 

orders, not overlooking or minimizing the obvious skills and experience 

levels. 

193. To analyze current processes to reduce reliance on high shortage occupations 
A3-10

194. To establish pools of workers for shared employment across regions, 

employers share costs for employee benefits 

195. To transition our economy from low-skilled manufacturing to “business” 

services, reframe healthcare service into a “business” service model vs. 

caretaking model. 

196. To review and implement a generalist apprentice program for the healthcare 

industry 

197. To provide high school students exposure to healthcare through school-towork programs or healthcare youth apprenticeship 

198. To use job shadowing for persons to explore healthcare careers. 

199. To provide career info and counseling to all existing employees. 

200. To streamline access into healthcare fields, develop entry/access based on 

skills vs. degree achievement. “Career ladder” in the workplace. 

201. To redefine the prerequisites for healthcare jobs so that people are more likely 

to view themselves as likely candidates (cuts time) 

Employment and Working Conditions 

Washington, DC Solutions

(Eliminated in Salt Lake City, UT and Chicago, IL) 

Employment and Working Conditions Defined: 

• Physical Facility 

• Unpleasant Job Attributes 

• Management Issues 

• Increasing Worker Perspectives about Employment Opportunities 

• Job Design 

• Supervisory/Employee Relationships 

• Access to Workplace 

• Support Services 

• Union/Non-Union Relationships 

• Respect for the Job Performed (by the public and private sectors) 

202. Supervisory/management training 

203. All levels involved in decision making 

204. Open communication between all levels 

205. Good new employee orientation – management and department heads 

206. Schedule flexibility 

207. Articulated career path with a fast track to promotion – state-wide 

208. Case management approach to employee support 

209. Competency-based management – clearly define essential functions and 

understanding of the evaluation process 

210. Respect from the top down – team morale building 

211. Workable staffing ratio guidelines 

212. Identification of successful cultural change initiative and national grant 

program 
A3-11

213. Appropriate assignments based on education and training 

214. Continuous problem solving involving all levels 

215. Have fun and let each other know that you care – meet with employees, 

monthly activities, good communication with a positive attitude – TEAM 

216. Work/family balance – accommodating 

217. Regular learning opportunities 

218. Increased reimbursement rates tied to wage and benefit packages, linked to 

retention – key to reward, competitive employment packages 

219. On-the-spot recognition programs 

220. Safety input from frontline workers 

221. Examine “sun-set” rules – licensure, credentialing and certification 

222. Job enrichment – teachers, nurses, and allied health professionals 

223. Federal regulations from pre-employment and continuing education to 

decrease turnover 

224. Clear policies regarding rewards and consequences 

225. Reduce paperwork 

226. Support collaborative and cooperative union relationships 

227. Employee-based training models that integrate healthcare and workforce 

resources 

228. Intelligent use of technology advances, better use of digital technology and 

handheld software solutions 

229. More use of paraprofessionals as peers in training, broad job design 

demonstrations, and innovative patient care models 

230. Partnerships – other recruitment partners (faith, community and charity-based 

organizations) 

231. Military transition/certification 

232. Image campaign (Healthcare Hero) 

233. Apprenticeship 

Washington, DC “Did You Think of This”

234. Pay incentives for supervisors that send employees to education and training 

235. Increasing innovative types of employee benefits vs. just pay > comp time, inkind, etc. 

236. Encourage employers to offer services that are needed by the busy parent of 

today – post office, dry cleaning, etc. 

237. Career ladders that incorporate career counseling/coaching/mentoring 

238. Incorporate incentives – child care, transportation, tuition reimbursement, 

living stipends 

239. Pay increments tied to career ladders 
A3-12

Pipeline: Recruitment and Retention: Ensuring the Skills of Entry-Level 

Workers 

Washington, DC Solutions

(Eliminated in Salt Lake City, UT and Chicago, IL) 

240. Competency-based assessment system – applied research linked to quality 

241. Preceptor/mentor programs 

242. Articulation of skills needed for entry at all levels (uniformity) 

243. National standardized certification/licensure for allied health 

244. Management training for license (nurses) 

245. Virtual E-learning training centers, explore distance learning options 

246. Conduct internal CGNA certification classes 

247. Partner with partners to share skill needs 

248. National leadership on training needs of the healthcare workforce (local and 

state) 

249. DOL resources committed to training staff, credentialing the trainers 

250. Develop cooperative program with institutions – learn while in school 

251. Work incentives linked to training 

252. Partnership with certifying bodies 

253. Better understanding of language problems (assessing abilities, new models of 

language instruction) 

254. Analysis of characteristics of successful worker 

255. Re-entering into practice on-the-job re-entrants 

256. Train on the shift they work 

257. Careful selection process of applicants 

258. Development and delivery of continuing education modules 

259. Industry and education collaboration on needs 

260. Asking workers what they need help with 

261. Articulated reciprocal educational arrangements 

262. Reality-based training for paraprofessionals – e.g. CNAs 

Washington, DC “Did You Think of This”

263. Externships 

264. Career Coaching 

265. Mentoring 

Pipeline: Recruitment and Retention: Dare to Dream 

Employment and Working Conditions 

266. A national “walk in my shoes” day – asking major political/administrative 

leaders to follow a C.N.A. 

267. Nursing services should be reimbursed by billable hours to insurers 

268. National/state advertising of healthcare jobs sponsored on every major 

sporting event on T.V. 
A3-13

269. Creation of new classification of nurse “licensed geriatric nurse” to career 

path certified nursing assistants to L.G.N.s in facilities through a combined 

effort of apprenticeship and community college oversight 

270. National “healthcare for healthcare workers” insurance carve out 

 Non-Traditional Workers 

271. Incumbent employees are trained and given time to mentor new nontraditional employees 

272. Non-traditional workers matched up with non-traditional (cultural/linguistic) 

benefits and providers and pay trans. or relocation for matching 

273. Incentive to attract male nurses (hiring bonus?) 

274. Credit is more available for prior work experience 

Ensuring the Skills of Entry-Level Workers 

275. Kaplan develops, delivers and sells basic skills/language instruction in 

healthcare facilities 

276. ITA funds are available for training at entry-level 

277. National skills standards – tied to virtual ... 

278. One-Stop/job match system based on O*NET 

279. All employees must list jobs with AJB 

280. Head to head with Manpower, Inc. 

System Capacity 

Lack of Alignment between requirements and curriculum 

Salt Lake City, UT Solutions

281. Industry leads curriculum development committees – curriculum review 

committees (corporate funding) Health care academics more accountable. 

Promote the development of a sector initiative between nursing education and 

provider/professional associations to identify weakness in curriculum and 

ways to fill the gaps. 

282. Academic faculty required to have constant clinical experience. Job 

shadowing clinical/academic – so that the curriculum is up to date 

283. Provide flexible entry points – multiple entries and exits to fit industry needs 

better. No need to graduate everyone in April every year. 

284. Develop training the way industry would develop training. 

285. Better screening of textbooks and lab material publishers 

286. Allow additional links to cover allied health training easily so a person can be 

a nurse and also provide other services off that linkage (i.e. physician 

assistant, nurse practitioner, lab tech, radiology, etc). 

287. Money for faculty development 

288. Health care of the future will be high tech – need to incorporate IT into the 

curriculum. 
A3-14

289. Workforce Investment Boards should facilitate taskforces made up of K-12, 

community colleges, universities, economic development corp. and industry 

to bridge the gaps. 

290. Critical thinking skills and preparation for life-long learning need to be 

introduced early in the educational process. 

291. Teach thinking and leadership to nurses and others who may be leading. 

292. Include internships or cooperative experience into programs. 

293. Advisory board terms not to exceed 2 years. 

294. Bring licensing agencies into the discussion, so the time lines and curriculum 

can be refined. 

295. Inservices by clinical facilities to colleges as they move to new technologies. 

296. State accreditation agencies monitor more closely. 

297. Long range goal: Align CNA’s under the nursing umbrella where practice is 

recognized as a basic/entry level for nursing. Thus, CNA training and 

development is always considered in funding and funding programs. 

298. Coordinate recognized competency standards with curriculum mandated 

clinical component (i.e. MRI Certification Program). 

299. Professional days at colleges (Let faculty and students talk with those in the 

field). 

300. Integrate national quality improvement efforts with nursing education to better 

prepare RN’s in continuous quality improvement efforts. 

301. Nursing curriculums need to incorporate concepts of working as teams with 

members of different skill sets. 

302. University based programs need to be encouraged to provide courses that can 

be taken by working nurses and other health workers. 

303. Math, science and reading skills need to be emphasized in K-12 so people are 

prepared to enter health care fields. 

304. Provide greater coordination among K-university curriculum development (in 

math and science). 

Chicago, IL Solutions 

305. Healthcare Industry Driven Curriculum 

a. Competencies 

b. Standard Curriculum 

c. Up-to-Date Curriculum 

306. Partnership between Industry and accrediting agencies for a realistic 

alignment 

307. Curriculum for new models of care. 

308. Develop a regional matrix of aligned programs between training providers 

(HS, community colleges, PA and up) 

309. More state-to-state standardization of requirements. Standardize a nationwide 

credentialing process and standard of care 

310. Mini courses (or CEUs) to meet changes in field 

311. Develop educational programs to deliver practitioners to teach new 

techniques/procedures as they are being developed 
A3-15

312. The future of healthcare requires the development of new models of care and 

the curriculum that supports it. 

313. Regular communication between schools and ‘end user’ as to current and 

projected needs. 

314. HC employer/institution driven curriculum 

315. Need better feedback from employers to understand what grads are not able to 

do 

316. Ongoing collaboration between providers and academic institutions to ensure 

curriculum is changing at same pace as actual practice 

317. To combine input from academics and service personnel on curriculum issues. 

318. Fund demonstration project to ascertain requirements of the professions in the 

workplace in order to develop curricula 

319. Greater ‘voice’ from healthcare industry in designing and reviewing curricula 

320. Include representatives from health care industry in designing/redesigning 

programs. Better alignment between academia and industry. 

321. Engage the department of Education in helping fast track changes in 

legislation to support national standards 

322. Nationally define the competencies (outcomes) for various HC professions. 

Encourage curriculum around competencies 

323. Standardizing curriculum so that instructors can be mobile 

324. Fund demonstration projects to determine entry level, mid-level, and 

advanced practice. 

325. Cored curriculum reduces repetition of core courses across HC occupation 

curriculum ( reduces instructor duplication of effort) 

326. Update curriculum to provide ‘core; than can be inter-changed as technology 

moved field forward 

327. Create certification program to critical care training post ASN or BSN 

328. Address the current curricula which are already full and overburdened. Can’t 

just add new technology. Got to get rid of old curriculum or lengthen 

programs 

329. Judicious use of credentials or certificates as alternative to advance degrees. 

330. Educational programs cover behavioral and regulatory as well as clinical 

requirement so of job. 

331. Bring business, education and accreditation agencies to table for realistic 

alignment. 

Lack of academic and clinical instructors 

Salt Lake City, UT Solutions

332. Increase faculty salaries so they are competitive to clinical practice salaries. 

333. Subsidize (from industry) BSN and MSN students and professionals to 

continue their education to become instructors 

334. Provide paid time off and flexible work schedules for those that decide to 

advance their education to teach or want to serve as part time instructors (both 

academic and clinical) 

335. Workforce investment act funds for 4 year MS degree programs. 

336. Innovative delivery: non traditional modular approach to teach the teachers 
A3-16

337. Utilize experienced CNA’s to teach basic care giving skills such as bed 

making, front-line costumer service, etc. 

338. Provide time off during work week for faculty to work in clinical facilities to 

update/maintain their skills. 

339. Encourage nurse education at earlier stages in the education process (i.e. 

middle school or elementary school levels). 

340. Make job description for like positions more common across facilities so the 

teaching institutions are addressing all required instructional needs. 

341. Articulation agreements between high schools, community colleges and 

universities to avoid overlaps and delays for students. 

342. Link the career ladder to an educational ladder (e.g. CAN, CMA, LPN, RN, 

MSN) that builds on one another and have credit for each level. 

343. Make sure credits earned in lover level classes are transferable to later degrees 

and out of state universities 

344. Require faculty to spend a certain number of hours per year working in the 

field. 

345. Incentives to schools who implement programs like ‘job sharing’ between 

clinicians and faculty 

346. Require teachers to have clinical experience every two years. 

347. Salary subsidies are provided from industry sources to encourage 

professionals to become or remain in faculty positions. 

348. Subsidies are provided for BSN and MSN nursing students to increase the 

pool of faculty for nursing programs. 

349. Health care organizations provide nurses to become adjunct faculty for 

academic programs. Provide release time for nurses while teaching. 

350. Signing bonuses of negotiated wages (moving away from traditional contracts, 

work with local college and nursing unions). 

351. H1B visa money for advanced nursing degrees. 

352. DOL provides training funds to prepare clinical nurses and other allied health 

care workers in classroom teaching skills to improve their skills as teachers. 

353. Call upon retired RN’s to assist in training and mentoring programs. 

354. Subsidies are provided to add clinical instructors for radiology technologists 

to increase the number of students each hospital training site can take at one 

time. 

355. Mentoring and outreach programs for new faculty. 

356. Tap into and develop links to distance learning programs to bring educational 

sessions (1 instructor) to teach multiple students over many states. 

357. Have partners in the community provide scholarships and start-up funding for 

higher educational programs (e.g. providers, workforce services, universities, 

foundations). 

358. Remotely educate from where instructors are (i.e. online schooling, web based 

schooling). 

359. Request support/assistance/create affiliations with technical and professional 

society leadership members. 

360. Increase faculty pay to the level of MSN floor nurses 

361. Competitive salaries to faculty. 
A3-17

362. Increase salaries to make them equal to clinical practice. 

363. Provide grant money to instructors to enhance or retool their skill sets 

364. Provide supportive families, spouses, cars that don’t break down, kids who 

take care of themselves, and endless monetary resources as well as quick 

minds and plenty of sleep (and housekeepers). 

365. Shorten the time period for articulation from BSN to MSN in order to increase 

teaching ranks. 

366. Change the teaching modality to allow increased numbers of students for 

clinical rotations. 

367. Increase the number of people with advanced degrees in non nursing health 

professions. 

368. Create a “loaned executive” program to local community colleges. This 

program would be funded by a corporation. 

369. Develop instructor training for Master Science in nursing and in doctoral 

program to train in instruction. 

370. Shared faculty among programs (nursing – radiology). 

371. Faculty chairs are endowed by industry philanthropic sources 

372. Greater funding to schools to reimburse for health care training (federal funds 

to help state payments for instance). 

373. Bring masters level training to the rural areas to train educators that will likely 

stay in the rural community. 

Chicago, IL Solutions

374. To develop older RNs into instructors – help keep them in healthcare. Reach 

out to retirees to come back to work as instructors; must make it easy or them 

to be licensed instructors (e.g., Georgia model) 

375. Provide incentives for health care professionals who want to be clinical 

instructors 

376. ‘Un-couple’ content and increase the use of technology to ‘teach’ those areas 

that can be taught that way, i.e., online, computer assisted. Use live 

interaction for those areas that require it. 

377. Better use of technology that can augment face-to-face instructors(e.g. 

distance learning, simulation programs) 

378. Train practitioners as instructors by partnering with industry – top 

379. Enhance academic instructors. Compensations so it is competitive with 

practitioners 

380. Distance education 

381. Demonstrate cost savings to health systems that participate in clinical 

education 

382. Increase investment in training for target industry sectors (HC) from federal 

sources such as FIA 

383. Develop models promoting non-traditional pathways for someone to become 

an educator in there field of expertise. (a way so they can keep their current 

job in educations) 

384. Provide funds for instructors from staff of HC institutions (adjunct professors) 
A3-18

385. Attracting more into joint appointment roles. Allowing currently practicing 

professionals an opportunity to share their knowledge and experience and 

diminish burn-out. 

386. Incentive: share funding for clinical instructors with health system 

387. To offer incentives for faculty who sign up for clinical assignments 

388. Development compensation programs to encourage clinical staff to become 

academic and/or clinical instructors 

389. Industry partners add to education salaries, e.g., endow charities to attract and 

retain faculty at industry salary 

390. Partner with local entities (chamber of commerce, city office, etc) in a plan to 

share costs 

391. Training/education/apprenticeships/approaches to the conversion from 

practitioner to faculty 

392. Provide training opportunities for heath care professional who want to become 

educators 

393. Provide skill/education development of HC personnel to increase number of 

staff with instructor credentials 

394. Fund academic faculty positions 

395. Increase funding at state and federal levels 

396. More grants for allied health professionals to obtain advance degrees to teach. 

397. Create more opportunities for educators to obtain higher degrees (scholarships 

stipends, etc.) 

398. To provide resources to engage current front-line employees (technologist, 

nurses, others) to be able to obtain thee education to become faculty 

399. Clear practitioner to faculty competencies 

400. To offer incentives for training, i.e., scholarships, relocation benefits, tenure 

opportunity 

401. To enhance faculty/teachers salaries to be competitive with the practitioners 

salaries 

402. To increase salaries of clinical instructors and academic faculty 

403. Increase salaries of instructors in educations institutions to reduce disparities 

with HC industry 

404. Increase pay for instructors to be more equitable with practicing professional 

405. Link increase compensation and instruction, especially for practitioners 

406. To reward healthcare site clinicians for instruction and mentorship with 

students 

407. Adjunct faculty salaries increase to recruit/retain quality education 

408. Pay differential costs to health OCC instructors 

409. Improve the pay to instructors 

410. Must provide education and training for clinical instructors. Many ‘teach’ 

without having basic understanding of how to teach. They are technicians 

who teach the students in the hospital and clinics. 

411. To provide resources to guide academia (both clinical and academic) thru job 

security issues ( in light of multiple programs closing since managed care) 

412. Train and use practitioners as clinical instructors and as appropriate academic 

instructors 
A3-19

413. Need educational programs to train clinical instructors on how to teach in the 

clinical setting 

414. Develop mechanism to promote clinical instructors to academic faculty – will 

need advanced degree based on the entry-level preparation for field 

415. Offer incentives for training to become faculty – general 

416. Enhance salaries for academic institutions to match practitioners 

417. Train and use practitioners at institutions with partnership of industry 

418. Non-traditional education pathways to develop instructors (keep and retain 

employment) 

419. Encourage practitioners to become clinical faculty through incentives to the 

faculty and individual 

420. Fund academic positions 

421. Fund higher education of faculty 

422. Use external $$ to support instructors costs (WIA, state funds) 

423. Partnership between education and industry so that educators can stay current 

with new trends in industry 

424. No Poaching 

425. To enhance faculty mentorship programs, i.e., experienced faculty specifically 

assigned to newer faculty or graduate students to encourage academic 

participation. 

426. Regionalize programs: strategic determination of location of HC courses in 

region (e.g. Radiological Technologist program in northern MN) and reduce 

duplication of efforts. Instructors 

427. Provide more instruction outside of traditional times and methods and seek to 

recruit instructors who find these times more compatible with their schedules 

428. Engage in strategies that result in legislative solutions. Plug strategies for 

funding and increasing focus on critical skill shortages through 

reauthorization of Higher Ed Act; directed use of Perkins state/local funding 

streams. 

429. Promote articulation among AS to RS to MS and on (not only for employees 

but will smooth transfer for educators) 

430. Need to create ability to educate/train faculty members in non-traditional 

settings or areas without access to education institutions 

431. Resurrect diploma program 

432. Use industry professionals as guest speakers to classroom teaching to let 

students know of current trends 

433. Address the stigma of education 

434. Tied to generation, differences of student pool 

435. Lack of funding 

436. Decrease in job security if program closes 

437. Why would I want to leave my stable job for this hassle? 

438. Retention of student in coursework 

439. More mileage out of each instructor 

440. Mentors for new hires to increase retention 

441. Articulate programs between training providers and share instructors 
A3-20

442. Identify potential instructors from providers and have them certified or placed 

in a position to be certified 

443. Partner with local health providers in developing pool of instructors 

444. Involve education and industry partners for ‘loans’ or joint appointments 

445. More communication between providers and academic institutions about how 

partnerships and resource sharing could alleviate problems 

446. More support for the clinical/site side of the practicum experience. Clinical 

site may be a great place to identify potential faculty. 

447. Sharing agreements of scarce faculty – alternative acceptance of coursework 

448. Align degrees needed to teach with experience infield. Need accrediting 

organizations at table. 

449. Address the fact that many professions have engaged in credential creep 

(mandating that educators have one level higher in education). 

450. Educate and direct students on opportunities for academic and clinical 

incentives 

451. To utilize more teaching assistant programs (grad students) in healthcare to 

assist instructors in the classroom and in the field. 

452. Develop programmatic pipeline to grow local instructors. K-12 and higher 

453. Need to develop faculty skills in using technology, e.g. Web-based learning, 

to deliver education to students in distant sites. 

454. Development of ‘faculty supports’ to make a double role more viable. 

455. Use of mentors and online mentoring systems to take some load off 

instructors. 

456. Offer programs to educate the current workforce staff about the potential of 

becoming an educator with continually support once someone takes this 

program thru career centers. 

457. To increase high school student counseling re: nursing instructor careers 

including onsite visits to meet college faculty 

458. Promote/create a network promoting these clinical and academic positions. 

Most technologists are not aware of such opportunities or when they do find 

such they don’t know where to find resources. 

459. To offer flexible, short term teaching or clinical assignments for older faculty 

or those with children who require a less structured work routine. 

460. Intense recruitment campaign with incentive thru staffing agencies with 

access to potential pool of instructor candidates 

461. Promote education and academia as a viable career pathway 

462. Marketing to change of career folks 

Lack of facilities and resources 

Salt Lake City, UT Solutions

463. Use of available facilities (i.e. k-12 buildings, hospitals, long term care, 

colleges, one-stop centers, etc) during non traditional school hours. 

a. Distance education and learning 

b. Internet (online courses) 

c. Telehealth 

d. Mobile labs 
A3-21

e. Take course to students 

464. Expand training (community colleges) programs – funding needed 

465. Larger community college districts with multiple sites are combining facilities 

to build one large facility to decrease costs. 

466. Use K-12 schools as extensions of adult teaching facilities 

467. Dollars to fund/incentivize schools to offer non traditional approaches (night 

programs, etc). 

468. Cooperate across the educational boundaries for facilities. Make multi-user 

lab facilities that different schools can use. Use facilities in after hour, 

nontraditional ways. 

469. Hospitals provide clinical teaching laboratories and classroom space for 

nursing programs. 

470. Shared resources (e.g. hospital labs and college classrooms not being used on 

nights and weekends). 

471. Clinical sites offering on-site training during alternative hours/shifts. 

472. Develop programs at night and weekends for incumbent workers utilizing 

high school labs, hospitals as clinical labs, under utilized space and distance 

learning in academic institutions. 

473. Partner with all kinds of health care industry 

a. Manufacturers of equipment 

b. Community health agencies 

c. Alumni 

d. Etc. 

474. Establish common teaching facilities among competing hospitals for high 

shortage jobs (i.e. patient care tech) that are flexible to identified needs in the 

community. 

475. Have more hospitals become training hospitals. 

476. Subsidize transportation and child care so that people can get to classes and 

have child care during class hours. 

477. Provide dollars (matching or full) for capital equipment. 

478. Mobile labs – travel to rural communities (sponsored by colleges and 

industry). 

479. Develop self supporting (and not state funded) programs. 

480. Provide funding to expand community college programs. 

481. Partnering with cities, community colleges, industry and workforce 

investment boards to build training facilities in rural areas. 

482. Use technology to increase productivity and quality of instruction 

483. Involve private sector business (facilities) to cosponsor programs in exchange 

for employment opportunities – preceptorship/internship/apprenticeship 

Chicago, IL Solutions

484. Partnerships among providers, training and education and public officials to 

use facilities 

485. Clearing house of resources 

486. Space 

487. Funding 
A3-22

488. Equipment 

489. Donate/Lease Equipment to stay current 

490. Provide resources (FTE, $) for clinical sites to upgrade teaching strategies 

(film teaching files and cases, manual exams with photo copy examples vs. 

online with actual films) 

491. Partner with industry to provide technology to educators (software, product 

models, technology, display hardware and software as well as informational 

knowledge of new technology 

492. Address the rapid changes in medicine and additions in technology; molecular 

imaging, gene TX, new peptides, monoclonal antibodies, fusion imaging. 

493. Distance learning 

494. Use of online and simulated models when appropriate (not to replace sitebased training, but to stretch that resource) 

495. Effective use of e-learning 

496. Use of technology to produce virtual hospitals – enhance experiential learning 

if no site available 

497. Take advantage of distance education and put the students where clinical sites 

are located – rural, e.g. 

498. Use of distance education when appropriate (no clinical) 

499. To offer tax incentive to corporation that sponsor and contribute to academic 

programs or student support. 

500. Review and develop a plan to address gap between didactic completion of 

some allied health programs and long wait times to get into clinical programs. 

RT – up to 2-3 year wait with 2 year AS programs at local vocational 

technology programs 

501. Clearing house 

502. Better communication between providers and academic institutions about 

availability of space, equipment, computer labs, etc. 

503. Provide centralized clearing house for grants (HRSA and other Fed, 

Foundation and industry) lists. 

504. Community inventories of facilities and resources with rewards for sharing 

and collaboration 

505. Develop a comprehensive ‘portal’ of resources ($, for healthcare education 

and training (not by agency, grantor, etc. one place to identify various 

resources) 

506. Regional collaboration for use of scarce facilities 

507. Regionalism 

508. Partner with hospitals and other clinical sites to provide supplemental funding 

of educational programs 

509. Provide incentives to college universities to maintain develop education 

programs 

510. Develop industry/government partnerships to help share cost of programs 

511. Partner with industry for providing clinical experiences from industry folks (to 

teach pharmacology and other specialties 

512. Eliminate duplicate pf curriculum development. Should develop across 

educational institutions (Wisconsin, ‘Regionalism’) 
A3-23

513. Industry making their facility available to education for students 

514. Partner with municipalities, schools and providers on developing facilities 

(use of bonds, medical districts, sharing space) 

515. Provide incentives for health care industry to provide clinical sites 

516. Look to non-traditional partners for space (churches, restaurants, hotels) 

517. Partnership between education and industry to use facilities 

518. Use healthcare facilities for instruction (particularly off-peak 

519. Participation with healthcare facilities and community colleges for in-site 

classes 

520. Lease vs. buying equipment in order to stay current with industry updates 

521. Reach out to suppliers (equipment, pharmaceuticals) for donated resources 

522. Partnership between education, industry and manufacturers donating used 

equipment to education. 

523. Donate/loaned state of the art equipment form equipment 

suppliers/manufacturers 

524. Encourage industry to partner by providing resources – equipment, supplies, 

etc. 

525. Loans of cutting edge technology experts 

526. Government grants for facilities, equipment, planning for high growth field 

527. Provide education on grant writing to the program directors 

528. To intensify philanthropy efforts focused on healthcare scholarships or 

student placement – college age foundations 

529. Increase funding and see money to start up new programs and increase clinical 

affiliate sites 

530. Student retention strategies 

531. Budget funds for equipment and supplies for labs and maintenance service 

contracts 

532. Develop incentives for schools who offer health career programs 

533. Provide incentives for rural health facilities to participate in supporting 

clinical education 

534. Develop ways for schools to share resources (facility, equipment, labs, etc.) 

Capacity of Workforce Organizations 

Washington, DC Solutions

(Eliminated in Salt Lake City, UT and Chicago, IL) 

535. Partner with those that know how to design curriculum quickly and use 

available community resources, ed/training providers with hospitals; use 

hospitals as teaching facilities; on-site training and education for employees; 

develop proprietary nursing programs in hospitals or long-term care facilities 

with training providers or community colleges. 

536. Increase University programs to get practitioners to study teaching. (adult 

learning concepts); Cultural competency training and teaching education 

(adult learning theory) for clinical staff so they can go from providing care to 

teaching how to provide care. 

537. Faculty loan repayments – allow teachers or clinical staff to learn how to 

teach and pay their loans, and pay their loans if they teach. 
A3-24

538. Prioritize training to protect training classes from state budget cuts in areas of 

high demand, i.e. community college nursing programs. 

539. Stretch faculty further using retired to teach online courses or serve as parttime faculty. 

540. Integrate public school financing with workforce planning so schools are 

teaching the needed skills/knowledge for tomorrow. 

541. Incentives for health care providers to release credentialed staff to teach health 

care development programs. 

542. Demonstration projects for improving system capacity that can be replicated, 

exempt from WIA outcomes. 

543. Articulation agreements between universities, community colleges, workforce 

system, employers to update curriculum and employ graduates. 

544. Faculty from other healthcare disciplines to teach basic healthcare skills – 

expand faculty and share. 

545. Focus on specialties – training providers train in own specialties and have a 

continuum partnership, i.e. 1 training provider = math, English, ESL; 1 

training provider = employability skills; 1 training provider = healthcare 

skills; 1 training provider = credentialed programs. 

546. Experimental pilot for paying preceptors to teach and provide clinical 

experience for students. 

547. Interim strategy for more PhD programs, but in the meantime to partner with 

other potential faculty and training people; requirements for teaching in BSN 

programs. 

548. Rejected students – placement strategy so they are not discouraged and still go 

into healthcare. 

549. Decrease recidivism in nursing with mentoring programs; offer modular 

curriculum so you could not wait 1 year before re-entry.. 

550. More money for providers that serve as educators.. 

551. Expand healthcare training advisory committees to represent all sectors and 

stakeholders. 

552. Money for core knowledge, math, science, ESL, literacy.. 

553. Modular curriculum that can be distributed and customized; just-in-time 

training; HS-AS-MSN. 

554. Faculty shortage in community colleges: releasing nurses from clinical work 

to go in as faculty or clinical faculty. 

555. LTC, community college and technical college image is lower than 

universities – attract faculty by bettering the image and increase income 

(salary and incentives). 

Midterm Projections 

Washington, DC Solutions

(Eliminated in Salt Lake City, UT and Chicago, IL) 

556. Database of different occupations with like descriptions: real-time, numbers, 

wages (JHU/ABELL); Funding. 

557. Agreed assumptions to base projections on: demographics, qualitative 

indicators.. 
A3-25

558. Input by stakeholders, HHS, etc.; Communication with educators for 

budget/policy decisions. 

559. Increased funding of LEHC database; social security info, etc.; community 

profile of available workforce with what occupations/skills living in proximity 

to available jobs, education/training. 

560. Expand ES202 data; real-time surveys of employers; basis for selecting survey 

sample: hiring? contracting? in what occupations? wages? trends? vacancies? 

turnover?. 

561. State-wide analysis of employment setting. 

562. Clearinghouse of new procedures or changing practices/procedures (noninvasive surgery, radiology special procedures); Keep education/training 

current with technological advancement. 

Addressing Occupational Gaps and Geographic/Market Distribution 

Washington, DC Solutions

(Eliminated in Salt Lake City, UT and Chicago, IL) 

563. Expand career lattices. 

564. Partnership building: getting basic info on resources, jobs, etc. 

565. Recruitment and retention strategies to assist and market distribution issues: 

Tuition reimbursement. 

566. Distance education. 

567. Improve understanding of different occupations by workforce development 

system: Identify workforce needs; tighter partnerships. 

568. Certificate programs: Tiered certifications with articulation between 

occupations. 

569. Quality of work life: EE involvement; organizational decision making; team 

problem solving; cultural transformation; implement recommendations of 

American Hospital Assn “In Our Hands” report; Assns develop uniform exit 

interview; certificate of initial mastering. 

570. Increase diversity of the pipeline. 

571. Supervisor training: gather and disseminate curriculum/share. 

572. Reward supervisors who train their staffs. 

573. Bringing education to the worksite. 

574. Loan forgiveness for employees or new hires in return for number of years 

worked in an institution. 

575. Career mobility: Clinical preceptorships; distance learning; leverage 

resources. 

576. Education loan repayment 

577. Who to invest in: keeping trained people; help with childcare for people who 

stay in community. 

578. Understanding breadth of healthcare core curriculum: math, English, science 

and career exploration. 

579. Case management: more training for interdisciplinary case management. 

580. Rural issues: distance learning; better recruiting of young people; more 

support of young people; family support; transportation and in-home 

computer support. 
A3-26

581. Increase capacity for in-home care: appropriately trained, paid; incorporate 

tech-trained workers. 

582. Knowledge and image of long-term care: Info/educational campaign regarding 

long-term care. 

583. Targeted partnerships for rural areas; health parks with multiple companies: 

long-term/short-term, case management, etc., everyone close by with multiple 

career opportunities. 

584. Career counseling; marketing and advertising; multiple approaches/flexibility 

of staffing. 

585. Military transitioning: get licensing before they leave. 

586. Shortage of case management professionals: Recruit clinicians who have left 

the field; look off-shore to other English-speaking countries. 

587. Rural workers moving to larger areas: Form public-private partnerships. 

588. Long-term care workers moving to hospitals: Look at retention in each 

occupation and see a move from one occupation to another as a “win” if 

retention exceeds the average; on-site training; improve conditions; 

incentives. 

589. Shortages on regional level: Funding for partnerships; assess, partner, 

implement. 

590. Apprenticeship training: work while you learn; distance learning with rural 

recruiting. 

591. Working with declining industries: better partnerships – local/regional career 

counseling. 

592. Making perceived poor jobs into good jobs: Look to call center model. 

593. Strengthen National Health Service Corps, or similar. 

System Capacity -- Did you think of this? 

594. Innovation in Flexible work schedules and Training Schedules 

595. Dr. Hours – Redesign of MD’s 

596. Adequate and Competent Workforce 

597. Core courses for Allied Heath 

598. Torte Reform 

599. National Standards for Training so Credentials Transfer Across Boarders 

600. Ban of Acronyms 

601. Adequate Specialties of MD 

602. Standardized curriculum teaching MDs now to treat patients 

603. Improved Rural HC – Telemedicine 

604. Zero Errors 

605. Diversify Workforce 

a. Providers 

b. Educators 

c. Partner w/WIB 

606. Image and Perception 

607. Seamless Career Pathways 

608. Respect and Team Building at All Levels – Cultural 

609. Cultural Change 
A3-27

610. All Partners Need to Play 

611. Embracing Technology 

612. Elementary Students Know Numerous HC Careers 

System Capacity -- Dare to Dream 

613. National skill standards for all occupations. 

614. Long-term care and geriatrics will be held in same esteem as acute care(i.e. 

funding, image) 

615. Career ladders for every health care discipline, with needed training, 

employment data. 

616. State-by-state annual top 50 best health care places to work (benchmarking). 

617. Free child care, health care benefits for those who are learning. 

618. All Elementary/JHS/HS have a “healthcare careers program. 

619. Facilitate the transfer skills/credentials of foreign workers/military for their 

U.S. licenses. 

620. Group to project, anticipate systemic workforce needs: employers, community 

colleges, universities, workforce system partners. 

621. Continuous lifelong learning for public policy decisions will be based by part, 

on LL (?). 

622. Full funding for ESL. 

623. Continuum of lifelong learning: flexible to move throughout industry and 

resources to support. 

624. Health Education Council in regions/counties (regional centers). 

625. Living stipends. 

626. Core national curriculum: Cuts across disciplines; customizable/adaptable to 

local needs; recognized knowledge; transfer of credits. 

627. Other/broader cross-training for allied health occupations. 

628. Licensing requirements reevaluated. 

629. National rather than state licensing. 

630. Full scholarships based on need for all/most occupations. 

631. Accurate database on state/regional HR planning. 

632. Full release time paid for employees to go to training that employers do not 

pay for. 

633. Just in Time training as the needs occur 

634. Virtual labs in health care settings 

635. 10:1 Turnover 

636. Career Counselors (with industry) 

637. Academic Programs at every level for working people (alternative schedules – 

universities). 

638. Employers interested in quality of education vs. numbers 

639. Money 

640. Good affordable child care 

641. Use school child care programs 

642. School readiness programs (industry) 

643. Elderly parent care 
A3-28

644. More flexibility of WIA funds to increase capacity (example: higher paid ed 

people to be reskilled). 

645. Transportation subsidies 

646. Compensation and benefit structures for the retired 

647. Determine ideal skill sets for nurses what other skills can be delegated 

(convert voice to print) 

648. Model in 5 years and determine skill sets 

649. Future planning and assessments 

650. New vision for future of health care work force (“the look” of the criteria and 

aptitudes) 

651. Health care system based on quality not reimbursement 

652. Paperless technology (M.D. adopt). ....for physician orders, charting, etc. 

653. Academically prepared faculty 

654. Reevaluate the environment 

655. Retrain incumbent workers for tech. 

656. Subsidies so people can go to school and work fewer hours. 

657. Loan and grant program – simplified 

658. Loan forgiveness programs – allied health 

659. Take on drug companies and allow importation of drugs. 

660. Utopia would consist of accurate role delineation studies for all professions. 

These studies would delineate the knowledge components; competencies and 

attitudes necessary for success in each profession/occupation. All Educational 

and credentialing requirements would be designed to ensure attainment of 

these competencies, knowledge and attitudes. 

661. Enact a National Licensing System base on professional certification and 

educational requirement sot that providers are nationally “approved” and 

states add specific regulations so that providers could look nationwide where 

needs are seen. 

662. National funding annually guaranteed to Allied Health Promotion Education. 

663. The culture of AC system – demonstrate to workers at all levels that they are 

valuable. 

a. All organization investing in developing HC workers with community. 

b. Investing in community education system based on ability/interest: 

economic barriers non-existent. 

664. Education system that includes promotion/graduation/certification based on 

competency. 

665. Healthcare accessibility for all. 

666. Create a competency and measured proficiency system. Doesn’t matter where 

learning occurred (other state, other country, self-taught). Live in global 

economy and must accept global talent. Americans are biased and our 

educational system isn’t superior to many countries. 

667. Competency-based systems coupled with asynchronous (i.e. a program that 

can be taken at any time as contrasted with synchronous programs that require 

program be taken at the same time) or tutored learning (self-taught). In this 

competency-based system there would be no penalty for attempting to acquire 
A3-29

a different skill multiple times. Records would compound as skill level 

increased. 

668. College would have a feeder system from high schools that have early health 

care exploration and basic healthcare classes and scholarship/tuition assistance 

for those students. 

669. The education systems K-12 should have a national set of value and standards 

(competence) that support entry into all work settings. 

670. Funding for healthcare (either federal support or reimbursement) recognizes 

the importance of continued development of the healthcare workforce and the 

subsequent effect on quality of care. Then contract for payment that includes 

not just cost of care but investment in workforce. 

671. All health professions would start out with the same core courses all taken 

together – socialization in career tracks would come only at the end – e.g., 

doctors, nurses therapists, technicians, everyone – would learn about how to 

communicate with patients together. Benefits: cost effective, promotes 

interdisciplinary respect and understanding. 

672. That there would be a system to bring together the values, needs and vision of 

the core constituents in health care: 

a. Consumers 

b. Employers 

c. Educators 

d. Employers 

673. Require mandatory civil service post high school for all in health care, 

education or military. Service would expose young adults to careers and role 

models in caring professions before they enter post secondary school 

education. 

674. Provide federal incentive awards to colleges and universities who are willing 

to bring the classroom to the student. 

Skills Development 

Incumbent Worker Training 

Salt Lake City, UT Solutions

675. In partnership with local education, identify skills needed and develop online 

programs which can be offered on-site. 

676. Offer basic skills and common general education courses at the worksite on 

several shifts (ESL, computer keyboarding, medical terminology, English and 

math). Combine with information blitz on job opportunities/career 

information and career counseling to help workers decide what they are 

interested in and know how to get there. Partner with colleges (possible 

distance learning). 

677. Community colleges can offer courses on worksite for units (college credit) 

678. Employer provides opportunities to take classes to increase skills in a way that 

can be done while keeping up with current workload. 
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679. Create a learning culture that provides time, access and compensation for 

learning 

680. Provide incentives to continue education (after a BSN earns the same as a 2 

year RN). Also, need to incentivize nurses to get advanced degrees to have 

availability to teach and relieve faculty shortage. 

681. Explore attractive funding or reimbursement options, grants, tuition, 

reimbursement, higher salaries, cooperation with industry, loan forgiveness, 

etc. 

682. Expose middle school and high school students to health care professions that 

aren’t as visible. 

683. Provide incentives for current employees to increase skills and remain in 

health care industry 

684. Incentives need to be offered to encourage current employees to receive 

additional training for specialized areas 

685. Provide multiple exit points and career support for workers who aspire but are 

unsuccessful to save their employment with in the health care field. 

686. Enhance the educational programs that teach LVN to RN. 

687. Health care needs to provide a welcoming and supportive of staff system to 

retain and promote from within (grow our own). 

688. Provide inservice training for current low level skill workers. Workshops 

should include a step by step process of carious options for gaining/increasing 

new skills needed for the next level. 

689. Provide “job fair” for current employees 

690. Education requirements that can be stepping stones to other opportunities. 

691. Provide access to other positions within organization (e.g. career ladder). 

Learning is presented as a benefit to employment 

692. Support nurse reentry in your community to capture those not practicing in the 

field. 

693. Provide a model and available classes/training for workers to easily access 

that identifies needed steps to come back into the field after having left to 

raise children, etc. 

694. Create a position within health care systems and hospitals that provides career 

growth/development opportunities and knowledge within the organization and 

crossing including all job areas/professions. 

695. Communicate training opportunities: flyers with timecards, websites, 

brownbag lunches, staff meetings, -- *over communicate*. 

696. Define potential career tracks for current workers and publicize and provide 

opportunities on-site for educational training 

697. Work with agencies, facilities to offer opportunities and solutions to address 

curriculum/certification/ registry barriers to incumbent workers across states, 

certification bodies/boards, schools such as challenge exams and nontraditional equivalencies. 

698. Job shadowing within organization 

699. Encourage exploration of other fields within healthcare by providing 

internship or shadow opportunities 
A3-31

700. Establish precise articulation/certification among seemingly unrelated areas 

such as military, apprenticeship, private sector and public sector to define 

career lattice and curricular pathways to career advancement. 

701. Create educational and training partnerships that impact incumbent worker 

702. Develop partnerships with other regional health care provider in collaboration 

with educational institutions develop programs to meet needs of local in house 

workers – more cost effective with more partners. 

703. Forge multi-employer academic – labor partnerships to offer 

specialized/tailored programs to meet particular training needs. Involve 

employers in refining prioritizing competencies to train to. 

704. Flexible scheduling of courses with training, accommodation of work 

schedules, use of alternative delivery methods. 

705. As possible, help workers attend training on aid time or with salary or benefits 

supplement. 

706. Provide competency based training for the skilled work and on-the-job 

training for higher education credit. 

707. Provide funding options for entry level worker preparation. 

708. “Case Manage” employees while they go through school – link them to 

resources (child care, financial aid, how to work with managers to adjust work 

schedule). 

709. Provide child care for non-traditional ours, allowing employees to go to 

school or training 

710. Develop a systematic plan of staff development that addresses current 

needs/changes of industry 

711. Create work-based study groups for those wanting to advance their training. 

712. Take the training to the student – possibly during paid work hours. 

713. Increase flexibility of when courses are offered (evening/weekend/distance). 

Tailor to the adult worker. 

714. Use part time health care workers to help teach on the off shifts. 

Chicago, IL Solutions

715. Online distance learning systems for common courses (medical terminology) 

and work to get these transferred to community colleges 

716. Portability and consistency of training in core skills 

717. Identity management and HR skills and competencies and train middle 

management 

718. Org. skills, financial management skills 

719. Create review boards to recognize other states skills/standards licensure 

720. Programs for foreign-trained professional to get through exams, etc. 

721. Mentorships 

722. More higher-degree/level positions in Healthcare 

723. Flexibility in certifications 

724. Federal tax credits for on-clock training 

725. Compile career ladders best practices clearinghouse. (BRG) 

726. Create individual employee development plans 

727. Provide training that maintains skills and job satisfaction 
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728. Work with CBO to teach technical language skills 

729. Bring school to the students/workers 

730. Make being nursing education/teaching more attractive 

a. Portability 

b. State of the state 

c. Within the profession 

d. Latticing across jobs 

731. Core skill sets to move within healthcare 

732. Related career development areas 

a. Management 

b. Financial management 

c. Leadership 

d. HR systems 

e. Mentorship 

f. Apprenticeship 

g. Shadowing 

733. Take advantage of incumbent worker training dollars available through WIA, 

through states. Make the case for need and job opportunities. Stress new 

skills needed. 

734. Provide tax credits employers who provide skill development for this group, 

such as they receive for college education 

735. Provide federal tax credits to employers whoa re willing to allow release time 

to workers to attend training. Tax credits for each hour of release time paid. 

736. Nurture existing workers – formal skills review of workers with regularly 

scheduled repetitive training which focuses on maintenance of necessary skills 

and not just training regarding new technology. 

737. Object – increase job satisfaction - decrease adverse incidents 

738. Partnerships with school and cultural groups to teach workers clinical foreign 

language terms to increase communication skills with changing demographics 

of patient and provider population 

739. Can development of skills for success for all healthcare workers. This should 

be beyond orientation-more like continued development. It would be nice to 

refine a notion that learning is life long in the workforce include: 

a. organization skills 

b. financial management 

c. healthcare issues 

d. personal finance 

740. Identify and credential management skills/competencies for 

supervisors/managers – AHA’s commission report (LTC managers are 

certified now) 

741. Team management training – not just one group – works toward culture 

change. Core competencies: 

a. financial 

b. communication 

c. management 

d. modeling 
A3-33

742. Can separate out care skills and create certificates – so that any HP could 

build upon acquired skill sets. 

743. Structure on the job training based out of brooder skill sets. For instance; jobs 

requiring medical terminology use the same preparation. That way the 

employee may meet a requirement for a future job. 

744. Develop a national distance learning system to deliver courses needed by 

large groups, e.g. ABE, Med Term, Physiology and Anatomy – same as entrylevel, make it easy to implement. 

745. Spearhead effort to make classes like Med Terminology transferable to 

CC’s/for credit (now requires state-by-state approval). 

746. Provide part-time for skills upgrade. Use studies showing impact on bottom 

line. Incorporate into performance. Supervisors as career coach 

747. Encourage development of career moves through review of goal setting at 6 

month – 1 year review. 

748. Develop clearly defined career ladder with continuing education credits that 

allow incumbent workers the ability to earn advanced certification without 

quitting their job and going back to school full or part-time – be more flexible 

in the timeline to complete training. 

749. Identify interest in field – allow shadows on work time in individual 

assessment, career counseling. 

750. Include mentor responsibilities in job descriptions and evaluations. Rate 

performance by mentor and person mentored. 

751. Building career ladders for entry-level. Compile ‘best practices’ clearing 

house and share/promote e.g., how to set up job sharing, job shadowing, 

mentoring. Building an RIO for I.W. Training investment. 

752. Portability of educational credits across health professions. Encourage 

recognition of credits for basic course work across professions 

753. Provide scholarship reimbursement money to hospitals or medical facilities 

who are will to hire entry-level workers and agree to hire them at other levels 

when complete training. 

754. Develop a career path that lead back to education and values HC faculty. 

a. Make it attractive. 

b. Portability of credentials 

755. Develop career paths and educational programs that lead to other health care 

opportunities 

756. Look for ways of locating, attracting and encouraging immigrants who have 

health skills/living in US and not currently working in health care to be able to 

take jobs in healthcare industry 

757. Develop educational programs within health care. Skilled provider who wants 

to advance must go to education or management – What about advanced 

degrees in health care that teach these skills? 

758. Identify immigrant who are credentialed in their native country and under 

employed in the US. – Develop programs to meet their specific needs and fast 

track them. Must be able to define skill requirements and develop exams or 

proficiency test to demonstrate skills so foreign workers can be accepted and 

certified into our health care professions. 
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759. Lots of trained HC non-US citizen workers live here. Let’s work with 

community organizations, AC organizations, and immigration organizations 

to develop core trainings to fast these folks through licensing/certification – 

provide child care. 

760. Nationalize professions laws – experience nurses from CA (20+ years) could 

not get license in Illinois because her clinical practice had used (non-faculty) 

preceptors rather than facility supervision - OR – create review boards that 

would allow potential candidates to perception for licensing within another 

state as long as their skills were deemed to be effective and safe. 

761. Portability of credentials 

a. Encourage simple reciprocity for licensing HC workers who move in the 

US. 

b. Encourage uniformity of licensing requirements for health profession. 

Use professional societies for guidelines. 

762. Reform state legislation and regulations to unify state differences - 

consistency across states based on a national standard 

Entry Level Worker Preparation 

Salt Lake City, UT Solutions

763. Develop basic health care management courses/for all certification programs. 

Employees interested in pursuing supervisory and management positions in 

partnership with local academic institutions and health care administrations 

764. Incorporate general courses on health care delivery systems, reimbursement, 

medical care, etc., to which all health care professions regardless of discipline 

attend together, to break down cultural differences in health care professions. 

765. Provide strong articulation between 2 and 4 year academic institutions to 

create more effective career ladders. 

766. Develop partnerships between local education institutions of higher education 

(2 and 4 year) and health care institutions to develop customized and 

educational solutions for that local, regional entry-level worker skill 

development. 

767. Create coalitions between industry and education to share the burden of 

training and remediation if needed. 

768. Enhance 2 + 2 programs high schools and community colleges – (begin 

teaching needed basic skills in high schools) – health academies at the high 

school. 

769. Outside of the box solutions for assistance with planning career changes with 

concern for familial responsibilities. 

770. Expose elementary school students to applied science through partnerships 

with hospitals and health care providers utilizing field trips, speaker bureau, 

demonstrations, and science career days. Include applied basic science in 

curricula. 

771. Develop partnerships between local health care institutions and secondary 

schools to mentor high school students and encourage them to enter the health 

care workforce. 
A3-35

772. Increase exposure to health care workforce environments in jr. high, high 

school through school and private sector partnerships. 

773. Create a health care “Big Brother/big Sister” program at the jr. high /high 

school level with focus on profession/worker relationship – not as much 

emphasis on personal development. 

774. Introduce/utilize ESL training to expose potential students to health care. 

a. Include basic math, skills in English needed to continue on with education. 

775. Provide “ESL” training to ethic populations/low level entry. 

776. Access to programs that meet/fill deficiencies (help to prepare them to meet 

minimum entry requirements) 

a. E.g. GED preparation 

777. Language skills 

778. ESL training for students in every school or training facility. 

779. Promote hospitals and other health care facilities for community service 

programs for local high school students. 

780. Promote hospital/back room visits for aspiring health care workers and others 

who work outside of traditional health care fields i.e. environmental techs, 

maintenance techs, medical equipment techs, ambulance drivers, etc. 

781. Offer job-shadow opportunities to incumbent workers and high school 

students, displaced workers, community, to help them learn about health care 

and the many opportunities available. 

782. Evaluate and quantify academic skills necessary for success in these fields to 

be matched to effective/proven tools for recommendation of these skills. 

783. Tutoring services for students needing help in basic reading/math and health 

courses. 

784. Create training models that focus on skills training rather than purely 

academic. More competency based training to focus on individual students 

needs. 

785. Change academic curricula to eliminate unnecessary courses that are not 

relevant to the skills and knowledge needed for a specific profession/career. 

Focus coursework on direct applications that are needed with less general 

requirements. 

786. Evaluate non-academic personality traits for effective participants in health 

care fields then compare these traits to aspiring students/workers in these 

fields. 

787. Provide short-term specific courses at the college level where students can 

explore career options in health – earn a college unit and proceed with 

additional courses (increase their awareness and interest in health). 

788. Offer vocational training in high school: CNA, pharmacy clerk. Teach 

medical terminology in context of health car. Give health care workers 

opportunity to teach. 

789. Presence of support systems to enhance self-esteem/confidence in ability to 

acquire and practice skills. 

790. Educate public about career opportunities through ladders, shadowing, and 

mentoring programs with local health care providers, medical schools, 

academic institutions and community leadership development programs. 
A3-36

791. “One Stop” shopping for health care careers. 

792. Acknowledge different learning styles of workers – provide options if at all 

possible (e.g. print, self study, web etc.). 

793. Create “mentor” program for those entering professions; for those in lower 

level, provide work/school programs for exposure to health care environment. 

794. Go beyond skill development and provide orientation to culture and assure 

worker of ability to impact that culture. 

795. Identify interested high school students and provide paid internships and 

scholarships for additional education 

796. Develop internship programs at local health care institutions for high school 

students. Could be summer paid internships with meaningful work – not just 

filling. 

797. Curriculum and cross curriculum issues are often barriers for entry level 

workers. 

Chicago, IL Solutions

Entry Level Worker Preparation – definition (from Chicago) 

• Employability 

• Desire to Work 

• Personal Skills 

• Soft Skills 

• Patience (to advance) 

• Career Interest (early on) 

• Gateway Prep (ESL refresher) 

- English occupational 

- Basic Literacy 

• Criminal Screens/Prior Backgrounds

798. Work with temp agencies to broker training, etc. 

799. Identify needs and implement skill remediation programs (on work time) 

800. Structured orientation program/ongoing process 

801. Early career exposure/school to career/exploration/job shadowing (should 

begin in middle school) Also include learning about skill requirements 

802. Hospital – adopt a school with a healthcare track—Industry – sponsorship, 

scholarships 

803. Broad track for healthcare careers: 

a. Soft skills 

b. Core skills/allied health 

c. Science and math 

804. Market allied health careers for K-12 

805. Online learning 

a. Employer provides computers 

b. Computer literacy training 

806. General employability/work readiness skills for HS level 

807. Learn to earn – short successful HS work experience 
A3-37

808. Train employers on how to train workers (learning techniques/styles) 

809. Expose to male career professionals (military) 

810. Promote use of English skills in social context (for non-native speakers) 

a. Rewards/incentives 

b. Motivations 

811. Engage workforce intermediaries (immigration, CBOs) 

812. Effective communication skills 

813. Work with foreign trained nurses to move them up here 

814. Create supportive work environment and culture 

a. Flexible work schedules 

b. Childcare 

c. Beyond wages 

815. Community service piece for pre-college (MS/HS) that serves as introduction 

to industry 

816. Use healthcare examples into all general curriculums in K-12 

817. Improve diversity in workforce (older workers, A-A, Hispanic) thru outreach 

recruitment 

818. Programs for employers to gauge risk of high-risk employers (parking lot) 

819. 21st century basic skills credential, for employability (HS graduate level) 

820. National distance learning system for basic literacy (at 1-stops, libraries, etc.) 

821. Curriculum for new immigrations in their native language re, American work 

culture and expectations. 

822. Work readiness - closet tattoo removal, dental, etc. 

823. Provide seminars to employers on how to train entry level workers on the job. 

Explain the different type of learning styles. Help employers to understand 

the essential steps in their work process so they remember to teach it. Check 

for understanding. Take your time and do it right. Could be online training – 

Internet based. 

824. The instant gratification generation presents a challenge for training (on the 

job) in entry level positions. One possibility is to vary training techniques. 

Not relying on only one method. 

825. Train and encourage health care careers in the poor/unemployed. Teach basic 

skills through community programs to fill workforce shortages from the pool 

of unemployed or underemployed – develop a basic healthcare course at 

community level and recruit to underserved areas. 

826. Work with temp agencies to broker training and screening resources. 

Research available tax credit incentives for win-win situation. 

827. Supportive work environment 

828. Respect (internal and external) 

a. Dollars/Budget 

b. Childcare 

c. Schedule flexibility 

829. Volunteerism – work with getting youth/young adults into HC setting. 

a. Exposure to work environment 

b. Community service piece 

c. May be able to be a starter for skills development, career choice 
A3-38

d. Utilize internships (paid or unpaid) to introduce new workers to the field. 

Street core values/competencies needed in designing fob and evaluation 

instruments. 

830. Teach patient interaction thru high school programs. 

831. Teach healthcare skills in elementary and high school – simple skills such as 

taking a temperature/feeling a pulse, using a stethoscope, studying and x-ray 

machine, etc., can be taught at an early age and would develop interest in a 

future health care worker 

832. To increase English language skills – create social clubs in 

neighborhoods/schools/churches where English is required to be spoken. 

Have some sort of incentive for participation 

a. Games requiring language skills attractive prizes 

b. Outings to first run movies 

833. Emphasizing to non-English speaking children the importance of English 

language in the workplace. Practice English with other non-English speaking 

children outside the classroom. Build in rewards or incentives for those who 

practice English outside the classroom. Language skills are essential in the 

workplace. 

834. Work with local immigration offices to reach out to hospitals/HS settings. 

Communities provide programs in HC training language proficiency, cultural 

pieces, etc. (timeliness, dress, accountability). Not just language but 

communicates effectively. 

835. Diversity as a business imperative. Identify role models in the Hispanic and 

African American community. Older workers – retirees from public sector. 

836. Assist people with personal appearance 

a. Set up ‘loan closets’ where people can get business cloths for interviews 

b. Tattoo removal programs 

c. Appearance/.grooming workshops (partner with cosmetology programs) 

d. Dental work 

837. Develop a 21st century ‘basic skills’ credential. GED has negative 

connotation, but something like this, that has a positive, motivational ‘brand’. 

838. Poll employers to see what skills are missing across professions and use the 

data in training programs. Teach a basic set of skills to all healthcare 

professions. If each profession was taught basic communication/ethics 

issues/professionalism/ basic management in a uniform consistent way – skills 

would be expected at entry. 

839. Generic preparation tract for students interested in healthcare careers that 

includes science math and communicators (written and verbal) on the high 

school level. I suggest to keep this broad the average high school student 

can’t definitively c omit to an exact job/career. 

840. Emphasize employability skills at the middle/high school levels. 

Accountability/employability skills such as attendance, desire to succeed, and 

English/grammar skills. 

841. Develop curriculum in K-12 that teaches workplace skills. It should be a 

required class each year building on previous years learning. Curriculum 

should include: following and taking directions, following rules, working in 
A3-39

teams, being on time, understanding how what you do affects others, being 

responsible, etc. Bring in employers to high school classes to explain their 

expectations and why they hire people, why thy fire and who gets promoted. 

842. To increase desire to work – work with high schools to introduce students to 

short, successful work experiences for compensation. Ideal of these are health 

related. 

843. To attract more men, provide exposure to male role models – military techs, 

pharmacy technicians, nurses, radiologists, etc. Early on decisions are made 

about careers. Basic job skills. 

844. Provide education to employers on the to provide on the job training 

845. Target youth. Non-traditional groups and other workers who would have an 

interest in HC by providing orientation programs that are put together to 

generate interest. 

846. Utilize distance learning tools by using a wide variety of venues including the 

workforce system. Educational system and business to deliver ESL; basis 

computer skills, math, reading, etc. 

847. Utilize distance learning and provide mentorship/shadowing experiences at 

local community. 

848. National distance learning system that offers regular courses in classes 

commonly needed by very large groups of people, e.g., reading, math, basic 

computer, ESL. Classes could be offered in various venues, e.g. employers 

sites and one stops. They would be packaged for easy implementation in an 

effort tot maximize and accelerate access. 

849. Employers to provide computers to assist workers to advance skills – provide 

computer training. 

850. Partner with adult education resources to enhance reading and math, grammar 

and communications, etc. Skills specific to industry (e.g., in Michigan 

Partnership for Adult Learning). Workforce development and education. 

851. Offer exploration time for interested potential workers such as healthcare 

sponsored explorer clubs for teens and adults. This should give a more 

realistic view of career options in healthcare. 

852. Health careers should be introduced in middle school. Make sure students 

know what is required. 

a. National Consortium for Health Science and Tech Education 

b. Chicago workforce Board/CPS/Tribune Program 

853. Work with DOE Local Board of Education to encourage opportunities in K12. Local industry could partner with schools to support students: science 

programs, computer training, higher education tuition reimbursement, 

volunteer/intern/extern opportunities for pay. 

854. Develop interest in allied health at K-12 level. There are professions other 

than medicine and nursing that most people know nothing about. Inform the 

public about the 100 other health care professions so that interest, and 

therefore education begins early and is complete by entry level time. 

855. To increase employability work with grade schools and high schools to 

introduce science and math content in an interesting way so that students view 

health careers as an attractive option and they will have the background to 
A3-40

gain entry into programs. Hospitals could adopt local schools and provide 

some of the content. 

856. Real work practices in employability traits prior to work life e.g. work/study 

HS by feed back. Also career specific information early on. 

857. Early training or orientation while in HS career orientation; exposure to 

industry thru field trips and/or emphasizing to educators/counselors of skills 

necessary for maintaining a job, exposure to career ladders, assessments of 

basic literacy/English occupational and assistance for development of English 

skills, education/information giving at early states at schools and advising of 

criminal screens with regard to careers. 

858. Orientation programs that are 6-8 weeks duration which emphasize the 

organizations function and culture. Orientation programs that truly review 

entry level skill competencies and identify skill deficiency and remediation. 

Process for formal feedback by entry level workers and use of buddy system. 

859. Assessment of skills at the time of hiring and periodic re-evaluations to access 

improvement. Training in deficient areas during work time. Increase salary 

commensurate with improved skill base. Remediation jobs for those with 

criminal backgrounds. Check to limit patient care. Workers with dependent 

children don’t have time to go to school after work – too many other 

responsibilities on the weekend (or their time off). Provide training during 

work time (day care not an issue) with homework. Provide computer access 

to workers with training in how to use them. Reward employers for their 

ability to display patience (counter-culture). 

860. Work with successful WIA projects that have developed ‘soft skills’ models 

for entry level workers. See assessment and training tools found effective 

‘YO’ model. 

Targeted Specialized Skills Areas 

Salt Lake City, UT Solutions

861. Develop mentor programs at all levels in career ladder 

862. Develop a “Leadership Academy” for those moving into management 

positions 

863. Develop basic health care management courses/certificate programs for all 

employees regardless of profession, interested in pursuing management 

positions in partnership with academic institutions and health care 

administrations. 

864. Provide supervisory training opportunities (e.g. communication skills, conflict 

resolution skills). 

865. Bring together managers, educators, recruiters, workforce planners to identify 

other groups that may already have skills in another setting – offer training to 

bridge the gap. 

866. Review job skills and training to see what professions’ skills may overlap so 

can utilize skills – especially in rural areas. (i.e. EMT to pharmacy tech) and 

relieve shortage areas 

867. Devise career lattices for multiple entry and exit points for all increases in 

specialization 
A3-41

868. Provide information to current workers on specialized areas, the requirements, 

how to fulfill those requirements. 

869. Information readily available in health care settings about specialties, 

advantages, education, etc. 

870. Target lower entry levels and high school students of opportunities in 

specialty areas so they can be working toward that goal from the start. 

871. Addressing certification creep could greatly diminish problems caused by 

explosion of new, unique specialized skill areas. 

872. Quantify precise academic and kinetic skills necessary to perform these tasks 

and then develop methods to evaluate and remediate if appropriate. 

873. Provide aptitude testing or surveys to assess current staff for specific areas. 

874. Identify specialty skill areas that could be addressed by part-time or shared 

employers to pull “stop outs” back into the workforce. 

875. Expose 3rd and 4th year nursing students to specialized areas of nursing 

(CCA, ICU, Emergency care). 

876. Provide on-going computer training that can benefit all employees and 

enhance productivity in all areas of operation. 

877. Employers who make it easy for workers to become trained in specialty areas 

such as giving them time and pay for receiving additional training. 

878. Health organizations need to identify current and future needs to begin to 

advertise and recruit staff. 

Chicago, IL Solutions

879. Work culture tools 

880. Subspecialties within professions 

881. Preparation for management 

882. Certifications/continuing education 

883. Career exposure to related skill areas and career progressions 

884. Transition of less demanding role (later career progressions) 

885. Both academic and industry provided solutions 

886. Partner with educational institutions to deliver on-site training 

887. Early ID of interest and mentoring 

888. Rotate employees into new specialized areas 

889. Employee reimbursement for certifications 

890. Partner with professional organizations on design of curriculum 

891. Provide assistance for special needs workers 

892. Older workers/incentives 

893. Incentives to nurses for going into specialties 

a. Tax 

b. Early retirement 

894. Create skills transferability roadmap from one specialty to another 

895. Use virtual learning combined with local clinical experience 

896. Create a clearinghouse of best practices (BRG/DOL) 

897. Transitioning out workers. Train incoming workers. 

898. Develop model to share facility responsibilities and floor responsibilities 

a. Incentives 
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b. Flexibility 

899. Work with schools of nursing to encourage graduate nurses to seek 

employment in specialties with shortages. 

900. Incentives to offer specialty courses/electives 

901. Increased exposure in these area 

902. Professions should accept credentials or education from other professions to 

minimize time to entry-level 

903. Early identification of persons who feel drawn to/interested in specialized 

area. Development through mentoring and place in training for the 

specialized career area of inters through internships. 

904. Employers utilize rotation of employees to new areas after 2 years of service 

for 3 month periods to enhance skills used. Produce interest in specialized 

areas. 

905. Partnering with educational programs to instruct workers in subspecialties – 

using the proposed federal funds provided to institutions to allow workers to 

return to school. 

906. Partner with academic programs to offer training for skills/certifications. 

907. Employers sponsor review courses and reimburse cost of certification for 

those who successfully complete certification. 

908. Bring together health care specifics and management skills to design 

curriculum (SHRM and other groups) 

909. Development of incentives to encourage nurses to go in to specialties with 

shortages (OR, critical care, ER, etc.) 

a. Monetary 

b. Early retirement benefits 

c. Tax incentives 

910. Employees provide dollars and other incentives upon completion of new skills 

911. Utilize virtual learning opportunities to learn skills, develop fellowship (3 

month rotation) to gain practical experience for new skills. 

912. Create a clearinghouse for best practices in building career ladders. Market it! 

913. Early identification of need for transition into a less physically demanding job 

into a one that would nurture less experienced/newer staff. Veteran employee 

would be able to train and mentor in specialized area. 

914. Network between professions. Nationally or state or within institution to 

know what each other does 

915. Use HPN 

916. Use Allied Health Prof Week. 

917. Map out skill sets and credentials that are transferable 

918. Provide avenues that encourage the seasoned HC worker to be able to move 

within the system and explore opportunities 

919. Develop models to share faculty 

920. Funding assist to help skilled older workforce transition to faculty position 

with a worker to teacher transition program. 

921. Provide incentives (grants) for incorporation of assistive devices in 

specialized work area to assist healthcare workers to stay active. 
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922. Develop job sharing program for older workers transitioning and newer 

entrants to field 

923. Develop clearly defined grids or database that depicts the transferability of 

skills and course work t\from one specialty area to another and outline the 

skills or course deficiencies that must be obtained to move to another health 

care specialty. 

924. Work with employers (or employee culture) to see that their skills are 

transferable and to consider new areas in healthcare. 

925. Develop models to share faculty/direct care responsibilities. Including 

incentives components, flexible scheduling, etc. 

Skills Development -- Dare to Dream 

926. Health care employers sharing resources and not competing 

927. Collaborate rather than compete within health care industry "stop eating our 

own”. Eliminate the caste system. 

928. K-12 strategy in place - mentor, encourage to come into the field, profession, 

evaluation 

929. Seamless strategy from high school to college. Transferable skills to go from 

one profession to another. 

930. Required core curriculum for all health care professions to include courses on 

general health care...would promote dialogue and collaboration among 

disciplines 

931. Transferability of classes 

932. Status of health care occupations other than Dr\s. Many have left field. 

933. Legalities of private/public partnerships don't impede programs. 

934. WIBS - some are easy to work with, others aren't. Need a system that is more 

consistent and responsive to employers. 

Sustainability: Building sustainable partnerships, addressing demographic 

shifts and labor market trends

Washington, DC Solutions

935. Identify relevant champions/stakeholders 

936. Define and redefine occupational skills in health care 

937. Use community service/character awareness (trends in high school) 

938. Establish partnerships with associations and organizations like HOSA (health 

occupation student association) 

939. Public sector funding to leverage private sector dollars 

940. Articulation of vision, mission, and goals 

941. Earmark workforce dollars to increased demand in health care occupations 

942. ID resources available to partnerships 

943. Payment system aligned with health occupations 

944. Require periodic reports and assessments on workforce collaborations 

945. Central core of workers larger core of associates 

946. Highlight exclusive and inclusive self-interest 

947. Foster interdisciplinary research among agencies 
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948. Educate the workforce system about health care system and visa-versa 

949. Legitimization and sanctions in place to support planning, etc. 

950. Change image of health care workers 

951. Change culture of interaction 

952. Use DOL to facilitate shared employment across sectors 

953. Connect Unemployment Insurance and other social programs to vocational 

needs 

954. Establish regional coalitions 

955. Establish peer-to-peer and face-to-face meetings with human resources and 

case managers 

956. Require a collaborative process between public and private workforce system 

and health care system (policy) 

957. Establish industry /education partnerships 

958. DOL to lead by example 

959. Public models that are working (best practices) 

960. Ongoing partnerships to assess accreditation 

961. Establish minimum competencies for all jobs – pushing credential down 

instead of up 

962. Understand that solutions that work are locally led and driven 

963. Address long-term care financing so as not to enforce low wage jobs 

964. Highlight education 

965. Establish sheltered workshops where appropriate – OJT 

966. Use one-stop system as broker 

967. Strategic match making 

968. Common technology – different focus 

969. Coalesce certifiers, technology, and service providers 

970. Structure funding to support collaboration 

971. Life-long learning 

972. Need vs. budget decisions 

973. Incumbent worker training as important as worker training 

974. Change of work environment (culture) 

975. ID and quantify non-academic issues required to sustain and persist 

976. Demonstration projects 

977. Local planning for workforce priorities 

978. Raise employer awareness of supplementing care-giving 

979. Parent body/initiator 

980. Close gap in education/marketplace divide 

981. Provide incentives and acknowledge contributions of others 

982. Better career counseling for college bound students 

983. Alignment of immigration policy 

984. Balance the grant percentages over the health care continuum 

985. Better school/work connection (science and math/K-12 occupational 

information) 

986. Insert career ladders and formal articulation agreements 

987. Results – Outcomes 

988. Assimilation of immigrants into the health care occupational pool 
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989. Charter partnerships and clear memoranda of understanding 

990. Engage the public school system with health care industry and for-profit 

industry sectors 

991. Use DOL to establish reciprocity among accreditors 

992. Systems point of view rather than programs point of view 

993. Partner with entertainment industry to address cultural and generational 

differences 

994. Charter partnerships with clear MOUs 

995. Adaptability to the changes in the industry, i.e. the need to redefine 

occupations 

996. Using the one-stop system as a broker 

Sustainability Did You Think of This? 

997. Build ESOL/literacy structures to build a qualified pipeline 

998. Distance learning for pipeline for rural jobs 

999. Target a high school or junior high school to partner with a hospital or LTC 

facility – In other words, the business mentors the students throughout their 

education 

1000. Refocus on bringing back individuals with health care training 

1001. Federal incentives to provide interstate licensing reciprocity 

Sustainability: Leadership, Policy & Infrastructure 

Salt Lake City, UT Solutions (Further notes are documented on the Matrix- Solution #82.) 

When we went over the “issues” to drill into for our group they wanted to “tweak” the 

projections focus that we listed – the group felt that the workforce projections that are 

needed for the industry should include workplace changes that impact skill needs & 

service delivery models & expectations of the new entrants into HC professions. 

 

Will this be a National HC council? A National HC alliance? 

Composition of the National Alliance or Council: 

The smaller lead group will be comprised of some federal agencies such as DOL, DHHS, 

DOE, insurers (private and public) Labor Unions, a governor, providers, consumer 

organizations. Aspen Institute, the Advisory Board, Higher Ed or Community college 

representation. 

There will be focused sub-committees in conjunction with smaller council/alliance. 

This Alliance/Council will be charged with working through a neutral lead organization 

that will convene the group – to establish a common ground for the work of the group; 

achieve consensus; guide research and dissemination of findings and key information; 
A3-46

leading innovation through demonstration projects; broker solutions to barriers (i.e. 

policy and leading the quiet deliberations to gel, strengthen and maintain relationships). 

Policy recommendation from the “national council” must be reflected in federal agency 

plans – therefore legislation to convene this “national council” may be needed 

The council must be empowered to make change happen and not just make 

recommendations. 

Mission Statement: 

“To articulate the imperative and craft an on-going response for a national model that will 

reach national consensus on the urgency & critical areas of the health care workforce.”