Three case studies show how healthcare organizations improved a critical frontline job
Essential workers have been receiving long overdue recognition for their integral roles to keep our society running. But when we take a closer look at the quality of these jobs, the recognition rings hollow. We call essential workers “heroes,” but the jobs they hold are rarely fit for a hero.
A good job is good for everyone – employers, workers, and communities. Some argue that employers can’t invest in making jobs better during an economic downturn, but business leaders who know the value of frontline workers understand that changing practices to better support them builds a diverse, valued workforce that makes the company stronger during uncertain times.
Spurred by the triple public health, economic, and racial justice crises, the healthcare industry is reckoning with a long history of inequitable practices. The pandemic has presented an opportunity to redesign a more equitable and resilient economy. The National Fund for Workforce Solution’s Job Design Framework and CareerSTAT Guide to Investing in Frontline Healthcare Workers offer vetted best practices to improve jobs.
One of the most basic things employers can do to improve frontline jobs is to listen, recognize, and respect workers. It’s low-cost and high-impact. Empowering workers, especially employees of color, to have a voice in their work has historically been seen as a threat to hierarchal power, rather than a strategy to make businesses more competitive. Building a more equitable workplace requires letting go of old ways of thinking.
Redesigning an In-Demand Job in Dallas
Dallas was facing a regional shortage of patient care technicians (PCT). Over the last couple of years (but before the coronavirus pandemic), three health systems collaborated with Pathways to Work, the National Fund’s workforce collaborative in Dallas, and the Dallas-Fort Worth Hospital Council Foundation to identify strategies to increase interest and satisfaction in this high-demand position.
The first step was to engage current PCTs. People closest to the work see the real problems and frequently have the best ideas on how to solve them. Focus groups revealed common themes: workers felt undervalued in terms of wages, recognition, and support and were eager for more training and mentorship.
Leaders knew they had to move quickly to address these concerns. They prioritized opportunities for “quick wins” but did not dismiss issues that required a longer-term strategy. Each organization developed a strategy that honored the input from PCTs and best met organizational culture and needs.
Recognize and Appreciate Your Workforce
Parkland Hospital and Health System created a monthly public recognition program to specifically acknowledge PCTs for excellent service. Winners of the ROSE Award receive other perks as well, which were identified with input from employees. The opportunity to be recognized for exemplary work boosted employee engagement and morale – key elements of a good job. Both UT Southwestern and Methodist are adapting the ROSE Award to fit their organizations. There is talk of expanding the program regionally.
“I have been working here at Parkland for about six years…and I would have never thought I would have been recognized on such a level. To have been chosen for the ROSE Award and being one of the first to receive this award has been an extreme honor.” Alejandra Gonzales, ROSE Awards Winner July 2018
The First 90 Days – Onboarding is Key
Methodist Health System created a PCT preceptor training program to formalize and standardize training for new staff. This “train the trainer” model was adapted from a training program for nurses and improved onboarding for new PCTs. Participants liked the new eight-hour, one-day paid training program, and leaders noted an increased sense of value, autonomy, and improved teaching skills among participants. PCT turnover dropped from 27% to just 8% during program implementation.
“[The preceptor class] helped me with learning how to teach the job, rather than just to DO the job.” Chris Turman
Provide Structure and Support to Build Skills
UT Southwestern Medical Center developed a PCT residency program (also based on an existing program for nurses) to provide a more structured onboarding process and build competencies for national certification. The medical center created a new position, PCT coordinator, to oversee training opportunities and tasked a clinical educator with curriculum development, instruction, and day-to-day operations. Trainees particularly appreciated the hands-on skills training and simulation scenarios. Managers appreciated the standardization of skills and baseline expectations for PCTs.
One Challenge, Different Solutions
At the National Fund, what constitutes a “good job” is a menu, not a mandate. These three health systems faced a shared challenge around a single job role, but their solutions varied. They leveraged their current workers to identify problems and solutions and started small, adapting existing programs to meet new needs rather than starting from scratch.
As employers, they recognized it was on them to make changes to attract and retain workers in high-demand, high-turnover positions. Wage increases, career pathways, and organizational culture may take more time to address, but there are things they could do quickly to improve jobs and build a stronger and more engaged workforce. For healthcare organizations, that serves their ultimate mission to deliver quality care to patients.
Recognizing the value and dedication of essential workers is long overdue. As they put themselves at greater risk of COVID-19, the frontline workers who keep our healthcare system running – from the front desk to the cafeteria – not only deserve the same public accolades as doctors and nurses, they deserve well-designed jobs and the opportunity to co-create solutions. If we are going to call them heroes, we need to treat them accordingly.
