Healthcare & Workforce: Consideration

By Alison Benton

Walt Disney reportedly said, “If the vision is clear, the decisions are easy.” Fallout from the recent recession knocked more than a few corporate visions to the ground, but the most resilient industries are dusting themselves off and recreating their visions for the future.The healthcare industry has been busy reinventing itself, not only in response to the recent economy, because certainly their future vision is filled with sustained and increased business, where factors like aging baby boomers, sedentary adults and youth, and a smaller pool of workers to choose from will greatly affect the ability to provide quality care and therefore grow new facilities. Healthcare is not the only business experiencing staffing scarcity factors, as other employers are facing similar skilled worker shortages, but those non-health industries are not likely to have the same universal human and fiscal impact on every other company in the area. Successfully caring for an upsurge in the number of anticipated patients will be closely tied to achieving a balance of quality care and cost effectiveness, resulting in a more tightly monitored bottom-line and increased sensitivity to expansion costs.Site selection, economic and workforce development priority issues intersect in the following three ways:  1) reasons to secure a qualified workforce for healthcare organizations; 2) healthcare is a significant economic development target; and 3) as a major site selection component worthy of careful consideration when non-health industries are contemplating a community presence.

For Want of a Healthcare Workforce
The World Health Organization (WHO) recently reported that “the world will be short of 12.9 million healthcare workers by 2035; today, that figure stands at 7.2 million,” which will have “serious implications for the health of billions of people across all regions of the world” (WHO, 2013).Several key causes were identified, including an aging health workforce with retiring staff or those who leave for better paying jobs without being replaced, while not enough young people are entering the professions or having adequate training. In fact, aging and population growth are projected to account for 81 percent of the change in demand between 2010 and 2020 in the United States (HRSA, 2013).The expanding world population is demonstrating increasing risks of non- communicable diseases, such as cancer, stroke, and heart disease, coupled with the high numbers of health workers who are recruited from internal and international locations that are creating regional imbalances (WHO, 2013).The main recommended actions in the WHO study include: • Increased political and technical leadership to support long-term human resource development efforts. • Collection of reliable data and strengthening human resource for health databases. • Maximizing the role of mid-level and community health workers to make frontline health services more accessible and acceptable. • Retention of health workers in countries where the deficits are most acute and greater balancing of the distribution of health workers geographically. • Providing mechanisms for the voice, rights and responsibilities of health workers in the development and implementation of policies and strategies towards universal health coverage (WHO, 2013).Dr. Marie-Paule Kieny, WHO Assistant Director-General for Health Systems and Innovation said, “We must rethink and improve how we teach, train, deploy and pay health workers so that their impact can widen” (WHO, 2013).More countries have increased their health workforce, progressing toward the basic threshold of 2.3 skilled health professionals per 1,000 people (WHO, 2013), in stark contrast to the top 5 most populous states with the percentage of health professionals per thousand in the United States, such as California 730,270 with 50 percent of health professionals per 1,000 population, Texas with 574,980 at 53 percent, New York 502,209 at 58 percent, Florida 465,460 at 62 percent and Pennsylvania 357,690 at 64 percent THIS COULD BE DONE AS A COMPARISON GRAPH HERE (Bureau of Labor Statistics, 2013). The WHO has noted that it is the future projections that raise the loudest alarms, as the current training rate of new health professionals is falling well below current and projected demand. In the future, the sick will find it even harder to get the essential services they need and preventive services will suffer (WHO, 2013).

Healthcare is an Industry Target
Even though healthcare had been considered somewhat of a support industry in the past by economic development organizations, it has grown to become a significant targeted industry. The site location of major healthcare facilities in regional hubs can be leveraged to create additional opportunities for both health-related support businesses and unrelated businesses looking to move or expand in a community, especially those who recognize the financial importance of quality preventative and acute care for their employees and their families to the effectiveness of their organization.The presence of a hospital will attract other support businesses, which will benefit the state and local sales tax and property tax pools. Even with all of the changes associated with the Affordable Care Act (ACA) and the downturn in the economy, the healthcare industry has right-sized and is now expanding into new models to take advantage of this new mindset and technology.Demand for health services is going to drive the market for higher wages for the best trained and brightest providers, so those workers may naturally migrate to locations where lifestyle and similar or familiar demographics reside. Competing for the best workers will decidedly involve a more comprehensive approach to include standard of living assessments along with fun and effectively managed Young Professionals groups to create a sense of belonging.Many other workforce considerations for healthcare locations include: • A pipeline of workers already trained in the skilled areas needed • An acceptable rate of completion percentage in health-related fields at nearby schools • Forward-thinking communities who recognize the benefits of increasing the number of Physician’s Assistants (PA’s) and Nurse Practitioner’s (NP’s) to lower the pressure to recruit additional medical doctors • Institutions of higher learning (community colleges, trade schools and/or universities) offering to customize training at the employer’s location • Coordinating assistance from the public workforce system for hiring assistance in the initial ramp-up and follow-up, and • Finding those who are bringing together training opportunities to primary-age students to learn computer coding at a young age. These young children are digital natives, and will have multiple opportunities for employment by the time they have graduated from high school, leading to growth field specialty jobs like Health Information Technology (HIT) workers. The shortage in this area alone represents a need for 50,000 more workers, a nearly 50% increase to the current HIT workforce of 108,000 by 2018.Location can determine the opportunities for healthcare industry growth, with factors like where potential workers will be living and if there is affordable housing nearby, available land in an easy-to-navigate site, and the number of suppliers and ancillary services are recruited to co-locate near a larger facility.Creative solutions to difficult issues can be what will separate one location from another. Generating Public/Private Partnerships (PPP) to speak to both sides of the challenge can produce amazing results. For example, Hospital Corporation of America (HCA) partnered with the U.S. Department of Labor to assist airline employees laid-off after the terrorist attacks of 9/11 to be retrained into health workers identified as a shortage in the hospitals in six airline hub cities.  The program was very successful, utilizing the Local Workforce Investment Boards (LWIBs) as a part of the public workforce system through the U.S. Department of Labor to administer the project with the local/regional hospitals, and giving nearly 2,000 people a new career to support their families.

Industries Want Great Healthcare for Their Workers
There is a major site selection factor worthy of careful consideration for non-health industries when they are contemplating an investment in a community that may be overlooked in many site selection processes. It is important to emphasize the healthcare industry cluster as a clear benefit to the company to keep their workforce healthy and ready to work, rather than merely presenting the healthcare facilities as a quality-of-life selling point. The presence of a comprehensive healthcare cluster eases the minds of parents who might otherwise miss more work than necessary with an ill child or other family member, and should be a benefit to raise awareness for fitness and healthy food consumption.A healthy worker is valuable to their employer in more ways than just missing work. A healthy employee is likely to be a goodwill ambassador for the company as well as a representative of the community. Clearly, Walt Disney was a gifted visionary to build an empire around a cartoon mouse, but his advice to obtain the vision first, then the decisions will come more easily continues to be helpful guidance for workforce issues in the healthcare industry.Sources: A universal truth: no health without a workforce. (11 November 2013) World Health Organization (WHO). Retrieved from http://www.who.int/mediacentre/news/ releases/2013/health-workforce-shortage/en/U.S. healthcare workforce shortages: HIT staff. (July 2010) Computer Sciences Corporation, (CSC). Retrieved from http:// www.gru.edu/alliedhealth/documents/CSC_ US_Healthcare_Workforce_Shortages_HIT.pdf