Creating a Culture of Connection

This health system newsletter is a summary of Catalyst Learning’s webinar entitled “Creating a Culture of Connection: Proven Strategies for Success.”  To watch the webinar, click here.

The 2022 workplace is being reshaped with a lens toward how the employer-employee relationship is changing.  Workers are questioning their career choices, and employers are asking themselves what is needed to improve retention and how they can better serve the needs of associates.  HR leaders in healthcare are looking at how their people experience community, communication, work appreciation and connection to company values.

One way to more strongly meet employee needs is to create a culture of connection. The BlueBoard organization recently released it’s The State of Workplace Connection Report 2022 and found that employee connection is key to driving critical outcomes in employee happiness, retention, and engagement.

The State of Workplace Connection Report 2022 recognized these as the top ways organizations are working to improve employee connection:

  • Hybrid in-person and online events
  • Formal employee appreciation and recognition
  • Adding tech for better remote communication and collaboration
  • Manager and leadership training
  • Expanding employee learning and development opportunities

How can organizations start creating connections on Day 1? Culture-based Onboarding.

Jacque Burandt, President of Award-Winning Results and former Chief Learning Officer at University Health in San Antonio outlined how a poor onboarding experience can be very costly to employers. According to OC Tanner data, 69% of employees with great onboarding stay 3+ years.  The Gallup organization connects onboarding to safety, citing a study of 200 hospitals in which engaged nurses are the #1 correlation to decreased mortality. 

To connect onboarding to culture, Burandt recommends including the strategic plan and talking about vision and values in active, engaging ways that provide maximum opportunity for interaction.  Involving senior leadership, either in person or virtually is vital.  So are providing an understanding of the patient experience model and recent survey results.  Onboarding also provides opportunities to help new employees connect from day one and establish individual relationships across the enterprise.

To learn more about health system onboarding and creating a great first impression for the Culture of Connection, read more of Burandt’s wisdom in the ATD Talent Development and Training in Healthcare Handbook, Chapter 11, Onboarding.

Increasing connections with nursing and non-clinical team members at East Alabama Health (EAH)

Susan Johnston, VP HR at East Alabama Health, shared her perspective that the Great Resignation goes beyond the employee/employer connection with a poignant story about two experienced nurses who had recently resigned because their “work family” had left her organization.  

Johnston shared 3 strategies that are a focus for retaining employees:

  • Boosting flexibility with multiple staffing models
  • Increasing connections with nursing workforce to understand issues. 
  • Recruiting a strong entry level workforce and upskilling them to fill future needs

To focus on nursing staffing and workload, EAH does daily reviews at the senior level of unit staffing to ensure ratios are met. It created a Nursing Supervisor position during the pandemic to give more support to unit managers and is exploring alternative staffing models to assist with more “hands on deck”.  New roles for LPNs, admission/discharge nurses, interns and medication assistants are either being explored or have been implemented to support the primary nurse role.

The Nursing Advisory Council plays a key role in building connection between leadership and staff nurses to communicate, inform, and build trust; emphasizing transparency and consistency.  Staff serve a two-year term and are compensated for participation.  And charge nurse management training continues to provide an important benefit to nursing staff, ensuring there are trained leaders on the floor.

Like many healthcare systems, EAH is a vital employment anchor in its geographic communities.  Embedded in its culture is a commitment to recruiting strong entry-level workers from the community and upskilling them.  EAH creates career paths through a salary structure that encourages staff to achieve certifications and new skills. School at Work (SAW)® helps with career development and 53% of SAW graduates have been promoted within the organization.  EAH created pipelines for entry-level staff to become nurses, respiratory therapists, and other allied health professions.  EAH’s scholarship program for SAW graduates pays for all community college pre-requisite courses.

To promote a culture of connection, and an environment where employees feel supported and heard, EAH keeps a pulse on changing employee needs and expectations within HR and across senior leadership. It keeps the CFO informed of the cost of turnover, because investment in staff is very small when compared to turnover cost and low engagement. Senior staff helps employees to see internal opportunities which are available to career build and creates two-way communication so staff know they are supported, recognized and heard.


Next Steps

To explore how front-line employee learning, from support positions to charge nurses, can increase your culture of connection, contact Catalyst Learning at 

To learn more about creating a culture of connection, click here for the webinar slides and recording.

To support professionals in your healthcare HR and Learning organization with their own professional development, consider the ATD Talent Development and Training in Healthcare Handbook

Leadership Research Findings: Key Factors for Entry and Mid-Level Employee Development

Every year Catalyst Learning asks its customers, Talent Management and Learning  leaders at health systems across the US, to help us understand front-line employee development priorities.  This focus of this year’s survey was non-clinical employees at the  entry and mid-levels. Not surprisingly, during the Covid/Delta staffing vortex, there are big concerns about staffing and skill shortages in healthcare. 

Highlights of the survey are below.  To learn more about how Catalyst Learning is incorporating this information into development of the Next Generation of School at Work® and ECHO® experiences, contact us at

Why do healthcare DLO leaders invest in entry or mid-skilled non-clinical associates?

Results for the request to select single, most important factor in determining “why you invest” were almost a dead heat between these two reasons:

  • Direct ROI, whether retention, promotion, or both
  • DE&I connections related to employees in entry-level roles.

An altruistic lens towards associate skill investment was not supported as a reason to invest in entry-level and mid-level employees. Concerns related to automation were also low on the scale. 

When quizzed about the types of roles of most interest, developing employees for clinical roles is the overwhelming choice; with Support and IT-related role development of relatively little interest.  Positions both in-demand and seen as attainable with certificate or associate-degree level of education included: Medical/Clinical Lab Technicians, Medical Assistants, CNAs, and Surgical Techs.  When mentioned, support roles most needed were billers, coders, and call center reps.

Given the immediate need for quality workers during the pandemic-induced labor shortage, a focus on RoI and skills is probably not surprising. Filling a talent pipeline for both high need roles and a broader array of jobs is mission critical for our customers right now.

Career Coaching at your health system?

If health systems are willing to get more committed to “growing from within” in this era of high turnover, we next wanted to learn if they have the internal capacity to make this happen.  Overall, the feedback from our panel of L&D Directors and VPs was that they do not have an employee whose full-time job it is to coach low skilled workers for new job roles. Coaching is more likely to be baked into other role descriptions and done informally.  One organization provides programming via the Career Center but doesn’t work 1×1 with employees.  Many of the leaders we received feedback from are School at Work® customers who have internal program facilitators who do 1×1 job coaching as a portion of their role.

This may change for some systems in the future though. When asked about the future state of career coaching to help lower skilled employees to assume more responsibility, 60% who do not currently have an FTE job coach remarked that they were likely to add one in the future. One respondent said that her system may even add an actual department dedicated to career pathway management. Some survey participants mentioned that a role/program like this would need to show ROI quickly to be considered, but given the need to fill in-demand roles, they are considering it.

Digital Literacy is now an essential skill for entry and mid-level non-clinical associates

It is not a secret that healthcare workplaces are more reliant on technology and that work at every rung of the employment ladder is becoming more digitized. Entry-level non-clinical roles now require the ability to interpret, create, and strategically use digital information. Environmental staff are using apps for communication and task management. Nutrition departments are receiving meal orders via iPads, and production supervisors look at predictive analytics to know how much food to order.

Regarding the level of importance of certain types of digital literacy that are needed by entry and mid-level non-clinical associates, here is how the responses stacked up when asked what was “very important”:

  • 92% – having skills to use computers and other technology tools for hospital-specific program
  • 77%  – having the ability to use digital information/communication technologies to find, evaluate, create, and communicate information
  • 54% having technology skills to use computers and other tech tools at work for widely used 3rd party programs like Word, Outlook, or Excel.

Given this focus on digital literacy, more DLO leaders at U.S. health systems are considering virtual instructor-led L&D learning options than in years past. While the pandemic has forced the growth of virtual delivery, the instructor-led in-person cohort is still the preferred delivery method for entry/mid-level skill development. Not surprisingly, many respondents cited that a hybrid learning model of multiple delivery modalities is preferred.

Hospital First-Level Supervisors: Did COVID-19 Expose Weakness?

First-level supervisors/managers in U.S. health systems have many things demanding their attention each day. And that is during “normal” times! The 2020–21 virus pandemic created more challenges for managers in care delivery organizations, including inadequate capacity, supply shortages, and adjusting workforce capacity to cope with changing needs and patient demand.

Even before the pandemic, many managers were not executing on the right behaviors to lead high performing teams. Did the pandemic show that your managers were not prepared for leading during intense times?

Managers have always mattered in hospitals/systems, but challenges have changed. Management now is about making employees the best at their role, while operating a cohesive team that can adapt during stressful times.

There are widespread reasons why managers are not prepared. One reason may be that management training and development is generally under invested in, especially for first-level supervisors. Also their associates are often just taught to “do their job” and are not invested in themselves. Many frontline health workers for example (nurses, CNAs, environmental, nutrition, administrative, tech positions, patient intake/registration) are not given behavioral skills education, leadership and development training, and don’t see how their own role contributes to the success and vision of the hospital/health system.

So…… how can we help our first-level managers?

Prepare them with emergency scenario information and to be adaptive

Don’t let your managers get caught flat-footed the next time a health crisis happens, be it a mass trauma event, natural disaster, terrorism, etc. Prepare communication chains from the top-down, then teach managers how to communicate and collaborate in a coordinated manner, giving managers autonomy to communicate how they feel is best for the team.

Improve hiring and promoting decisions, then focus on development

Systems need to evaluate and hire managers based on ability to serve the team. Do managers have the communication and people skills to get the most out of the team? Teach managers to hire or promote employees who seek to find operational answers to tough questions, not to answer all these questions themselves. Encourage managers to use skill and experience to develop the team, not to be the most “hands on” working member of it. This could lead to burnout, and will assure managers are not focusing on the right things.

Teach managers to focus on key behaviors of associates, and hold managers accountable

Managers tend to be evaluated by immediate and operational standards, such as were patients rooms cleaned quickly, is food service running effectively, or are patients and their families in the right spots for proper care or services. And at a higher level, hospital administrators look at HCAHPS and performance success indicators/patient scores to indicate how well a hospital is performing. But for evaluating a manager, these operational metrics can give an incomplete picture of management value. Other suggestions could be:

  • Making sure managers have a pulse on their intentional retention rates: Every manager should be able to identify who the performers are they want to keep, who are highest performing who may be lost to promotion, and which employees are not meeting expectations or could be more successful in other departments.
  • Keep managers focused on promotion rates: Managers are the first window into employees’ career pipelines, and/or career ladders for the organization. Managers should be preparing individuals to be promoted, and to take on more responsibilities and to learn more skills. If a manager never loses associates to promotions, they may not be developing their people well. See our related article, Geisinger (PA) Builds Career Pipelines for Individual Contributors.
  • Teach managers how to coach: While employees may understand tasks needed to perform in their daily job, they may struggle with more basic concepts such as time management or communication. A good manager helps frontline employees learn these and other soft skills because it makes the workers more effective in their jobs, and more satisfied with the work they do. See our related article, Frontline Employees: Coaching For Success.

Teach Managers to think about increased productivity and retention of their employees

Healthcare, just like retail, hospitality, and agriculture, struggle with frontline employee turnover and consistent productivity. It is difficult to simultaneously keep employee productivity high and turnover low. But there are a few tactics that can help our managers with productivity and retention:

  • Measure ROI from an organizational level
  • Teach managers to brainstorm moral improvement tactics for their team
  • Teach managers to give praise and better communication techniques
  • Encourage managers to help employees to build a personal development plan

See our related article, Increase Productivity and Retention of Entry-Level Employees.

Now we’re entering a new, brighter reality, with the world getting “back to normal” quickly after COVID-19. That is a really good thing! But when we look back at where we can improve on in the future, especially knowing that other traumatic events will occur, lets ask “were our hospitals managers prepared?” Did the pandemic push managers to the brink, or did it expose that they didn’t have the right skills to lead high performing teams in any environment? In all sectors of the U.S. economy, one thing we learned in the last 15 months is that front-line managers are critical to team success, and that many were not ready for the challenge. This is a risk going forward, so be proactive in how you prepare managers.

“Health Care Management During COVID-19: Insights from Complexity Science,” James W. Begun PhD, H. Joanna Jiang, PhD, NEJM (New England Journal of Medicine) Catalyst, October 9, 2020

“6 Healthcare leaders share the most difficult aspect of their job,” Kelly Gooch, Beckers Hospital Review

“COVID-19 didn’t challenge managers, it exposed them,” Brian Watkins, Chief Learning Officer, May 27, 2021

9 Ways Hospitals can Support Frontline Healthcare Workers, and Create a Winning Culture!

Most healthcare leaders agree that a productive culture is a pillar of hospital success. But there are many organizations with lofty-sounding “corporate missions” that have less-than-stellar work environments for frontline employees. Frontline employees can sometimes be an afterthought in culture development, but they are often the voice and the heart of the hospital to patients and families.

To improve culture, ask yourself – are we supporting our frontline employees’ career and life goals? Is there a sense of belonging and shared commitment among employees about how they serve patient’s needs? Do we have employee programs that are accessible and build support for our organization’s culture?

Here are some nationally recognized hospitals that are super-serious about maintaining a winning Frontline Healthcare Employee culture and some of the steps they have taken:


With focus on patient experience and reduced costs, employers are making a business case for building talent by aligning workforce training and education programs with strategic areas of business impact. Developing talent needs to go further than just a “feel good” public relations objective, so it’s important to measure the success in numbers. Quantitative metrics examples are recruitment costs, reduced turnover, or preventable re-admissions. Qualitative metric examples are new employee competencies in taking care of patients, and improved team climate relationships in a unit.

Yale New Haven Hospital is a 1,541-bed facility that serves the entire state of Connecticut, ranked by U.S. News & World Report as one of the top 50 hospitals in the country in 11 different specialties. YNHH offers a wide range of career development services to its frontline workers; its basic skill development programs include entry-level employee communication effectiveness workshops, conflict management, and effective presentation skills.

With 4,000 trainees annually, these trainings help prepare entry-level hospital employees to meet high quality and safety standards and perform in their roles more effectively.

Read more about Yale New Haven Hospital and their efforts.


When hiring, make an effort to recruit underrepresented members of the local community and demographics that mirror patient populations. This could include a focus on improving lives of local community members facing barriers to employment, or disabilities. Be a part of local workforce boards and other organizations with local outreach.

University Health System, in San Antonio Texas, is an organization committed to equitable talent development. It hires many community members who do not speak fluent English. Their career development programs have expanded to keep pace with the evolving language and literacy needs of their employees, including offering onsite English for non-native speakers.

With their community hires, University Health Systems executes on-the-job learning and career development system through the ECHO (Expanding your Career and Health Opportunity) program, to give mid-level healthcare workers the chance to move into more advanced roles in the organization.

Read more about University Health System and their hiring.


Advancing frontline hospital workers, or “growing your own” will help with obvious staffing and orientation costs. But it will also help maintain organizational knowledge and culture. And now with the economy closer to full employment, a commitment to advancing your own workers instead of looking outside is even more important. Apprenticeships and training opportunities may be a way to turn frontline workers into prime candidates to fill mid-level positions that are open.

At Mercy, the country’s fifth-largest Catholic healthcare system, frontline healthcare employee development is at the core of business strategy. To reach its goals, Mercy operates a Lowest Paid Worker Committee to bring together senior leaders to develop and implement strategies to improve wages and opportunity for frontline workers. Lynn Britton, Mercy’s President and CEO, leads the Lowest Paid Worker Committee. “We invest in the development of frontline workers to help them realize their talents and to support their professional and financial advancement.” Mercy tracks and reports participation in their employee advancement programs yearly, monitoring scholarship programs, tuition advance programs, School at Work® (SAW) graduations, and transportation programs. Mercy measures business impact, citing that 32.5% of School at Work® graduates have advanced into new roles and 9% have enrolled in higher education.

Read more about Mercy and their commitment to advancing frontline workers.


Supportive workforce practices require both qualitative and quantitative data, necessitating the capacity for data collection and analysis. HR should use workforce data to track programs, assess impacts, and analyze future needs. Forecasting tools focus on specific occupational groups, and includes head count, turnover info, recruitment metrics, vacancy rates, employee engagement, and required skills. Using workforce planning and analytics to anticipate future need is especially important when a community is reaching full employment levels.

Norton Healthcare, Louisville KY’s leading healthcare provider, is a healthcare pioneer in integrating workforce investments with business impact. Investing over $11 million a year in staff education and development, Norton’s transformational approach to workforce development integrates with its strategic staffing priorities. Norton monitors future staffing needs, patient data analysis, internal and external partnership impact, and the impact of its investments on bottom line ROI measures. In 2017, Norton Healthcare did an exhaustive study on ways leading  healthcare organizations in the U.S. use frontline investments to improve six key business metrics: Workforce Availability, Employee Competency and Advancement, Employee Engagement, Patient Experience, Community Impact and Quality, and Safety.

Read more about Norton and their analytics.


When a healthcare organization is committed to supporting entry-level hospital staff, they may offer benefits and initiatives designed to ease employee burden, through EAP or HR-direct initiatives.

These could include personal counseling, medical premium assistance, financial coaching, affordable child care, tuition programs, onsite clinics, low-interest loans, transportation subsidies, or employee crisis funds.

UnityPoint Health in Iowa is a leader in providing services to advance frontline employees and help with life events. In fact, UnityPoint’s mission is “Come for a job, stay for a career.” UnityPoint offers a menu of supportive HR options such as tuition assist programs, career coaching,  free transportation, and flexible scheduling.

Read more about UnityPoint and their efforts.


Career exploration, coaching, and mentoring are steps that should be integrated with building talent and advancing frontline workers. Once frontline health workers have developed skills and see opportunity that is available in the organization, have HR or a professional mentor show where they can go to learn more about new positions. Have a commitment to employee coaching, and promoting talent from within.

UC-Davis Health offers career coaching and an array of educational opportunities designed to help employees develop skills and advance careers. UC-Davis Health uses School at Work® as a combination of career exploration and skill coaching, working with employees to define goals and connect them to internal and external services. UC-Davis Health has found this has reduced recruitment and on-boarding costs. UC-Davis Health was also interested in developing Administrative Assistants and has invested in this employee group.

Read more about UC-Davis and their coaching programs.


A great way to support a top-notch frontline employee culture is to invest in programs that promote diversity, foster collaboration, and participation and respect in the organization. Frontline employees are the largest group of workers in most hospitals, so be intentional about achieving more diversity at the apex of the health system.

Main Line Health in metro Philadelphia has been recognized by U.S. News & World Report as one of the top health systems in the country. Main Line organized a Diversity, Respect, & Inclusion Strategy Team to make sure it was developing leaders in the organization who mirror the demographics of metro Philadelphia. This team works to break HR obstacles, tracks entry-level employment patterns, and measures impact of employee advancement strategies like SAW, ECHO, and its internal Career Advisor program.

Read more about Main Line Health and their mission to increase diversity at the top of the apex.


Many C-Suite hospital leaders still view learning and development as cost centers instead of strategic investments. When the strategic apex of any organization looks at low-wage associate investment this way, expectations and leader involvement stay low, leading to little or mixed clarity of how enabling talent fits in with company goals. This is a mistake, because when learning happens throughout the entire organizational chart, all associates start to see themselves as “owners;” and when HCAHPS surveys are taken, you want employees who see themselves as imperative

East Alabama Medical Center (EAMC) has a longstanding tradition of growing their own associates to carry out the organization’s mission of “high quality, compassionate healthcare.” In fact, a V.P. started as an orderly 35 years ago, proof that senior leadership has walked the walk. EAMC is in a small metro market, so hanging onto their best employees is especially important. EAMC invests in skill and education assessments and frontline worker learning programs, building these tactics into the mission. EAMC has built a nationally recognized culture of internal talent growth. Learn more about EAMC.


TriHealth has done the best job of measuring RoI that we’ve seen in 14 years of working in the healthcare workforce development space. The importance of measuring results sounds obvious, but this types of analysis is usually not done. If HR leaders do not show ROI and value, programs can be terminated in later years when budgets get tighter. If you’ve worked to advance turnover/retention rates, days required to fill vacant positions, overtime costs, and Temp agency costs, show it!

TriHealth Inc is Cincinnati’s fifth largest employer, with two acute care hospitals and more than 120 locations. TriHealth was recently recognized by Working Mother magazine as one of the “100 Best Companies for Working Moms,” a designation it has received 9 times. TriHealth uses CareerCare, a web-based career exploration tool for entry-level worker participants, and School at Work® to provide on-site learning opportunities to increase basic literacy, mathematics, and interviewing skills. In 2013, TriHealth did a large 4 year ROI study to show how these investments in entry-level workers had paid off. TriHealth saw huge increases in promotions and employee wage gains, plus savings from turnover costs during the four years of the study. TriHealth also had better job satisfaction scores during that time. Read more about TriHealth.

Building a great culture and support for Frontline Health Employees will not happen overnight, but paying attention to what industry leaders are doing can be a great source of ideas and inspiration! Investing in entry and mid-level nonclinical employees who interact with your patients will pay off, so be sure to measure and communicate results.

With these types of tactics, your hospital could see gains in workforce availability metrics, employee, engagement, improved patient experience, and community impact. Set your organization up for success with a winning and supportive Frontline employee culture!

To see case studies on any of these health systems, please email and we will gladly send you further details. Thank you to the National Fund For Workforce Solutions and its CareerSTAT Frontline Employer Champion program for recognizing these institutions who invest in their entry-level healthcare employees.

Frontline Healthcare Education: Building Learner Confidence & Enabling Advancement

By M. Lynn Fischer, Founder & CEO Catalyst Learning Company

This article is a continuation of the series, “Education and Career Planning for the Front-Line”, focusing on upward mobility for entry and mid-level healthcare associates. Check out the first two pieces: Support Diversity & Inclusion Initiatives by Upskilling the Front Line and Increasing Internal Support for Frontline Education Programs.

When people take advantage of training programs within the Veterans Hospital Administration (VHA), they have countless opportunities to transform their careers, according to Imon Muldrow, Chief of Environmental Management Services at the VA Health System in Pittsburg.  Muldrow is a prime example of amazing career trajectories. Over 12 years, he rocketed from housekeeper to supervisor of 250 associates who play a key role in patient satisfaction and safety. How? He enrolled in training for a fast climb in operations and eventually became a division supervisor.

Our customers are wise in the skill of understanding educational needs and converting those needs to education programs, so I am assuming readers of this series also have that kind of core L&OD knowledge. With that in mind, I’d like to share a few points that are critical to having a robust set of education offerings for front-line workers, particularly those at the entry-level. These are: access to technology; the importance of cohorts on building learner confidence; and knitting the post-secondary pieces together.

Education. Stumbling Blocks and Opportunities Unique to Entry-Level Associates

Access to Technology

Ensuring your learners have access to and comfort level with any technology required for their learning is essential and not to be taken for granted. (Think digital divide.) Having your technology-related bases effectively covered will improve confidence, completion rates, and outcomes.

As I write during the COVID-19 pandemic, the framework for education delivery has been revolutionized. The pandemic has vastly limited the ability for many to meet in traditional classroom settings. It has also extraordinarily accelerated the addition of virtual delivery options.

Given the incredibly rapid pace of change in this area, I won’t try to proscribe specific technology recommendations. My guidance is to research thoroughly your learners’ access to and comfort level with technology-delivered education. It is likely far different than your own. Be realistic about this.

For non-exempt employees, equipment is not the only issue related to “access”.  As mentioned in our last post, the single biggest barrier to providing more education for entry-level employees is the impact of labor cost on the hospital bottom line.  Health systems like Mercy (St. Louis) have crafted policies in which required training (paid) and optional self-development (unpaid) are clearly defined for non-exempt coworkers.  This separation is critical and allows your associates who want to advance themselves to be able to do so on their own time.

Plan, design and budget your proposed education and career planning offerings to remove technology-related barriers of all types. Be creative and collaborative with internal IT leaders or volunteer groups who are often willing to purchase or donate laptops for these employees. Examine your organization’s policies and work with Legal and leadership to alleviate labor cost concerns and increase access to learning for your lower-wage associates.

Building Learner Confidence – Increases Motivation to Succeed – Leads to Upward Mobility

As you attend recognition ceremonies for adult learners at programs like School at Work®, the comment you’ll hear most frequently is something like, “I never would have thought I could have accomplished — insert education, career or life goal — , but now I believe I can”. Makes sense, right? If I’ve had problems in my life experiences that cause me not to believe I have potential, my world view on future options is going to be limited.

Recent research from the Strada Education and Gallup bears out the need to improve low-skilled employee’s confidence in their ability to be successful. “Half of adults in the Public Viewpoint survey say that self-doubt would be a major impediment to their enrolling in postsecondary education, either because they fear they won’t be successful, have been out of school for too long, or a combination of the two. This lack of confidence ranks as the No. 2 challenge to enrollment, above cost (48 percent) and second only to logistics (55 percent).”

For your front-line associates to decide to go back to school to achieve a certificate or degree requires a lot of motivation! At this stage of life, those co-workers likely have family and other responsibilities that go well beyond the college student who enrolls as a single person immediately after high school. They are likely also low-income. In order have the motivation to take on the mega-goal of going back to school, these individuals must be highly confident.

Learner confidence is built by providing a supportive setting that results in program completion. An instructor/facilitator who has educational competence and treats individuals with empathy and respect is paramount. A cohort model in which other employees from similar circumstances learn together and provide moral support, through class challenges and inevitable life ups-and-downs, is also key.

Graphic depicting the progression an entry-level employee makes: first is confidence which leads to motivation. Next a career and life plan is made that is followed by employment and upward mobility.

Ken Bishop of AtlantiCare summeds up the change in confidence by describing students as nervous when one of his School at Work® classes begins. By the end of the program, they are standing in front of their classmates, making presentations and sharing newfound knowledge. “I joke that they’ve grown three inches. It’s because their posture changes. You can see it in how they carry themselves and interact with each other,” Bishop said.

“The program has made me a risk-taker and a goal setter.” said School at Work® Graduate JaQuita Newsome of Palmetto Health. I have been able to learn new ideas, make new friends, meet new people, advance my work skills and job performance, and it has made me push further towards job advancement.

Graduate JaQuita Newsome of Palmetto Health.

Enable Advancement; Knit the Postsecondary Education Pieces Together

Tuition Support. Upward mobility hinges on advanced education. Health systems spend millions supporting the continuing education of their employees. Check on a couple of structural elements to make sure there’s a level playing field for employees seeking their first credential or degree.

  • Ask, does our Tuition Reimbursement policy support community colleges and technical schools? Does it support attainment of credentials that are healthcare specific and roles that are employed within the organization? A “yes” to both of those questions is critical in your efforts to advance low-skilled. Properly credentialed certificate programs can move your colleague from a low-wage role to a family-sustaining wage job in 12-18 months. For those who wish to keep going, they can also be a confidence-building steppingstone to an associate’s or bachelor’s degree.
  • Lobby and Partner for Tuition Advancement. The cost of higher-education can be a barrier for low-income individuals, if they don’t have upfront funds to pay for school, post-program reimbursement may not solve the problem. Jenny Skinner of TriHealth in Cincinnati overcame this challenge by partnering with the System’s foundation. Jenny and her Education team identified, prepared, and mentored entry-level employees who wanted to go to college. The Foundation advanced the funds for tuition. Education then paid the Foundation from the Tuition Reimbursement budget as courses were completed. It is a creative team-solution to help low-wage employees avoid a cash outlay.

Nurture an Active Partnership with your Community & Technical College. Your organization likely already has a vibrant relationship with the local community college. If not, someone in the organization responsible for building the pipeline will want to build one. As the advocate for individuals who are likely not from a college-going background, you can foster their confidence by inviting college staff to speak to your employees, providing them a personal point of contact. Think about taking your group for a campus walk around, to improve their familiarity and comfort level. Get on-line with them and navigate around the college website. Work with them in advance of the taking placement test and if needed provide preparatory classes in Algebra and other subjects. Do whatever you can to make sure your newly motivated associate scores at a level on the placement test that puts them immediately into credit-bearing courses. Work strongly to overcome a placement test outcome that requires they go into remedial math or English classes as these are a total de-motivator and “the graveyard of student success”.

Be an Advocate!

Remember our story about Imon Muldrow?  Imon benefitted early in his VA career from the support of mentors, Elizabeth Jenkins, EEO/Diversity Program Director and Julia Gilmer, Chief of Food and Nutrition.  “Every good organization needs good people who feel like there’s an opportunity to grow, said Jenkins.  Imon had so many skills and abilities that he didn’t realize he had, a diamond in the rough.  The more we polished, the more he shined.”

Elizabeth, our team at Catalyst Learning, and the hundreds of others we have worked with at health systems throughout the US believe there is hidden gold in the often overlooked front-line employees in your organization.  Find it!  Unleash it! Watch them soar!

The lessons the Catalyst Learning team and I have learned about healthcare workforce development over the last 15 years are contained in this article series. (Check out the first two: Support Diversity & Inclusion Initiatives by Upskilling the Front Line and Increasing Internal Support for Frontline Education Programs.)

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Moments of Joy, and Hope, from a Challenging Year

In what has been a year unlike any other, we are reminded of the importance of taking time to celebrate hopeful moments of joy. We’ve seen just how much frontline healthcare workers are putting on the line to provide safe, compassionate care during this pandemic. We have gathered photos from dear customers across the country as the COVID-19 vaccine is administered to Frontline Heroes.

Increasing Internal Support for Frontline Education Programs

By M. Lynn Fischer, Founder & CEO, Catalyst Learning Company

What if you’ve already launched a frontline education program and want to ensure its longevity in your organization for years to come? Likely you’ll face many challenges along the way ranging from budget changes to push-back from departments affected by short staffing. Your ability to anticipate obstacles in the future of your program will help it stand the test of time. Consider the following tips when planning for the new year:

Direct Supervisors and Hiring Managers – Central to Advancing Frontline Associates

The direct supervisors are in many ways the unsung heroes in the whole continuum of front-line employee development. Think about it. They have departments that will “work short” while employees are in training for skills. Your goal may be to get them promoted to work in another part of the organization. And often it is their best people that we’re asking them to develop; knowing they may be leaving that department!

So how to gain a direct supervisors’ support? An example would be to emphasize the near-term gains to the workgroup: a more knowledgeable, motivated, proactive employee with improved communication and initiative. Near-term skill gains can always be identified. You’ll just need to take the additional step to facilitate the connection for a direct supervisor.

Mercy (Missouri, Oklahoma, Arkansas)

Mercy has been very committed to providing learning and development opportunities for its lower paid coworkers, with goals to help compensation. It offers CLiMB, an online library of focused microlearnings for entry-level coworkers. CLiMB focuses on key healthcare work concepts like basic professionalism, communication, productivity, managing stress, and providing exceptional customer service. CLiMB’s 15-minute learning modules enable learners to practice real-world scenarios for learners to improve their performance.

During the pandemic, remote learning and development has become even more crucial for healthcare facilities. Beth Kinsey, a Senior Specialist of Talent Development at Mercy, notes that Mercy is seeing examples of how CLiMB learnings are being applied by frontline coworkers during times of COVID-19. She notes that coworkers are being more intentional about listening, taking instruction better, and diffusing team conflict. CLiMB participation is also gauged by HR as a way to see which entry-level coworkers are most interested in career advancement.

See our related articles, “Mercy Adopts New Technology to Educate & Advance Frontline Workers” and “Mercy Health: Living the Mission through Education of Frontline Coworkers.”

Now let’s consider the impact of the “Hiring Managers” that are in a position to offer a promotional opportunity. If a hiring manager knows an employee as the friendly and efficient person who takes her payment in the cafeteria or cleans her office, she is probably not thinking of that individual as the next candidate for a billing and coding or medical assistant she needs to hire. That’s where you, your internal partners in front-line development (e.g. a career advisor, recruiter, or coach) and, hopefully an organizational belief in “hire for attitude, train for skill” come in.

To change an impression a potential hiring manager has based on the front-line employee’s current role, invite her to attend graduations and other closing ceremonies for your programs. Go to bat for your higher-potential frontline team member by pitching hiring managers on motivation and persistence as valuable traits that merit giving someone a chance in a new role.

Overcoming the Impact of Labor Cost

The single biggest barrier to providing more education for front-level employees is the impact of labor cost on the hospital bottom line. Time in education classes is often categorized as “non-productive time” and carries penalties for direct supervisors who are measured and bonused on labor “productivity”.

Consider this method of compensation: “bonus upon program completion”. If employees clock out for class, there is no productivity impact to the manager and no chance that class time will create an overtime pay situation. By rewarding the employee with a bonus of equivalent amount at conclusion, there is a built-in incentive for completion.

A key element of increasing internal support is translating the needs of the often voiceless and sometimes invisible Essential Workers in our healthcare organizations to key influencers and seats of power. These leaders are busy, usually want to help, and need to quickly understand, “what do you want me to do”? Use the tools outlined here to improve your success with Direct Supervisors, Hiring Managers, and other key executives!

This article is an extension of our October post, “Support Diversity & Inclusion Initiatives by Upskilling the Front Line”, which outlined valuable tools and information needed to implement successful programs for frontline healthcare employees. Catalyst Learning’s front-line employee learning products provide a range of options tailored to different outcomes and budgets. If your target outcome is job advancement, take a look at our School at Work® or ECHO® experiences. If skill building is your focus, consider CLiMB or CAPS.

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Support Diversity & Inclusion Initiatives by Upskilling the Front Line

By M. Lynn Fischer, Founder & CEO Catalyst Learning Company

The American Dream, the belief that anyone, can attain their own version of success and upward mobility through sacrifice and hard work, is alive and well in the Healthcare industry. It is the largest and fastest growing sector in the US economy, has numerous entry points and a myriad of possibilities for promotion and job advancement. Entry-level employees with limited education have a variety of paths by which they can move from low-skill, low wage roles to middle-skill, family sustaining wage positions. This group of essential workers, employed in lower-wage roles, tends to be very ethnically diverse.

“Who touches and impacts the patient? It’s our frontline co-workers. Who has one of the largest impacts on patient experience? Again, it’s the frontline co-workers. When we invest in these co-workers, we enhance the learning and productivity of the organization.”

Sister Claudia Ward, Program Manager Health Leads, Mercy

So you’ve decided that the best way to achieve success through a diversity and inclusion initiative lies with the education and empowerment of your organization’s low-wage front line. Where should you go from here?

Understand How Much Executive Support You Have… and Build from There

Most human beings, and virtually all of those in healthcare, want to “help people”. At its core, that is what front-line development is all about – reaching out your hand to help associates who want to progress in their careers and need help to accomplish that goal.

In our work to advocate for front-line employee development, scare resources sometimes evaporate. Everyone enthusiastically says, “we need to do this”! But the reality is that very few health systems actually implement a system to facilitate long-term development and upward mobility for front-line employees. If nothing is in place, you may want to “start small”, unless you have a C-Suite champion and a good-sized budget.

Atlantic Health (Morristown, New Jersey)

As the only New Jersey-based health care company on the Fortune’s ‘100 Best Companies To Work For®’ List, Atlantic Health System appears alongside some of the country’s best-known and most successful organizations, such as Hilton, Wegmans and American Express.

A program that Brian Gragnolati, President and CEO of Atlantic Health System said he is proud Atlantic Health has instituted is ‘School At Work’ (SAW®):

“We have a lot of staff members who might be in a job that they might desire to progress in. It might be a housekeeper, or it might be dining service or patient transport for an example. They’re in those roles and they can’t progress because perhaps they had a bit of a stumble early on in their lives,” Gragnolati said. “Maybe something happened in their families or they got in a little bit of trouble in high school and didn’t get out of high school and maybe have a GED. Now it’s 10 to 15 years later and feel like they’re stuck.”

New Jersey Herald, “Atlantic Health again one of Top 100 best places to work in U.S.” by Joe Carlson

Gragnolati said everything the health system does for its employees is done so it can “support our staff so human beings can continue to care for human beings in remarkable ways.”

Brian Gragnolati, center, president and CEO of Atlantic Health System, and Nikki Sumpter, center left, senior vice president and chief human resources officer, stand with graduates of the “School at Work” program, which gives employees the opportunity to learn during regular work hours and learn skills needed to explore other career opportunities in health care.

Begin with Your Goal When Designing a Development Program

It sounds so obvious, but I’ve been amazed over the years how many customers proceed with a program because it feels like the right thing to do, prior to having a solid business-related justification. Examples of different types of outcomes you might discuss with your stakeholders could include:

  • identifying and upskilling people for a high-need position
  • increasing the ethnic diversity of people in middle-skill and supervisory positions, or
  • retraining loyal employees whose jobs are in jeopardy due to automation (an increasingly urgent imperative for conscientious employers).

Effective workforce development programs involve a number of different groups within the health system, and typically fall under the umbrella of Talent Acquisition, Talent Management, or Learning & Organizational Development or Effectiveness (L&OD/L&OE). Working closely with these various departments will help you achieve implementing a successful program.

Career Planning & Advising. Essential. Often Missing.

I have long been astounded by the huge dollars spent on external recruiting of new employees and the paltry sum spent on developing internal staff. Return on Investment will be demonstrated over a period of years as the percentage of “internal hires” grows. Once a career is successfully planned, the advancements can be game changing. The lives of the front-liners get a boost and their families also benefit. Helping an employee identify a middle-skilled position that is a “good fit” and attain it, can jump wages by 45-50%.

Help Associates Define Options

“If you don’t know where you are going, any road can take you there.”

The classic 4-step career planning process includes: self-exploration; job research; exploration of job options; and taking action. For front-line workers at the entry-level, this way of thinking will likely all be new and require structured support. Those who are already employed in certificate-level positions may be more autonomous once you get the right tools in their hands.

Encourage the leader of your Talent Acquisition group to dedicate at least one person to career advising. Important skills for the internal developer are nurturing talent and facilitating connections within the organization, making the position different than a typical recruiter.

You’ll want a focused area in the organizations website where employees who are able to operate autonomously can learn what tools are available to them and be provided with contact points for related activities such as job shadowing and tuition support.

Something to consider is adding a supplemental program, such as CareerCare®, that allows employees to do guided self-reflection, a career interest assessment, and learn about high-need jobs within your organization. Employees will then be able to approach HR with a well-qualified idea of what will work for them that the hospital has need for.

Think about developing a class where the goal outcomes are a completed Career & Learning Plan, confidence in the future, and motivation to act on the plan. Access to an advisor or mentor will also be essential for your entry-level employees to successfully complete a career plan.

A key element of this work is translating the needs of the often voiceless and sometimes invisible hardworking people in our country to the seats of power. Seats of power that are busy, want to help, and need to quickly understand, “what do you want me to do”? Using the tools outlined here, be ready with your answer to that question!

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Emory Healthcare & Catalyst Learning – 15 Years of Frontline Workforce Advocacy

School at Work (SAW®), a career development system for entry-level healthcare employees, has proven to develop viable paths for career progression and shown significant changes in day-to-day performance in frontline employees at Emory Healthcare, according to Anne Nelson, Vice President of Organizational Effectiveness and Talent Management. Nelson goes on to tell us that participants’ supervisors have said that

these graduates are more willing to take initiative and speak up, now that they feel like they have a voice.

Emory Healthcare, a leader in innovation, has a celebrated history of stellar accolades ranging from positive patient satisfaction scores to its advocacy for the frontline non-clinical workforce. Emory Healthcare is the only National Cancer Institute Designated Cancer Center in Georgia and the only health system in Georgia with three Magnet-designated hospitals. Nationally ranked for quality among the top ten percent of academic medical centers in the U.S according to Press Ganey[1]Emory Healthcare continues to set the standard for all aspects of care in Georgia time and time again.

Recently recognized as a 2019 CareerSTAT Frontline Healthcare Worker Emerging Champion[2], Emory Healthcare uses SAW® to provide frontline workers with a stepping-stone into certificate or degree programs. SAW® is a comprehensive program that strengthens communication, grammar, reading, and writing skills as well as providing a well-developed career plan within the organization. A typical SAW student has a high school diploma or GED and works in Dietary, Environmental Services, Housekeeping, as a Nurse Aide or in an entry-level office position. Using adult learning principles with a Blended Learning Model, SAW® has produced completion rates considered best practice in adult-learning.

Debra Longo, Corporate Director of Organizational Development and Learning Services at Emory says, “we long to find the right formulas, processes, and approaches to retain our frontline workers. There’s such a competition in the market for so many positions that we need that are critical to the business of healthcare.

SAW® gives us a chance, to engage some of our frontline workers in learning and in the mission of the Healthcare System.”

Sandra Barber, Emory’s Training Specialist and SAW Coach of 7 years, says “From a Coach’s perspective, you get to see folks who come in as frontline workers who have some very low confidence around their potential and their abilities in the skill development area. Barber goes on to say, “Once they complete SAW®, the associate feels more connected to the organization. When they’re back at work, they have a better sense of their ‘Why?’. You realize that your role is much larger than you and that your intent as well as your impact matters. They feel like they have a future in the organization.”

When setting their new five-year OE plan, Nelson wants to continue to outline expectations, provide resources and training, and measure the outcomes associated with programs.  “We look at our progression – the number of people who graduate from SAW® that then go into our Emerging Leaders program and our New Leader Foundation program.”

With SAW® as a contributing factor, Nelson states, “We have seen career progression, advancement into leadership roles, and leaders recognizing significant changes in performance for those who have completed SAW. I want to make sure that it’s hardwired into internal career progression at Emory Healthcare.”

Nelson also speaks to the efforts she made to facilitate the connection between the executive team and the SAW® students. “For our first graduation, we invited the executive team including the Chief Executive Officer, at the time John Fox. John was so incredibly moved by the stories of our graduates thanking the executives for giving them a second chance.” She has spoken at all sixteen School at Work® graduations held at Emory Healthcare and continues to make sure that the program gets recognition from the executive team. President and CEO Jonathan S. Levin, MD, FACR says, ”Emory Healthcare’s vision is to provide the best place to work, learn, and grow by creating an inspiring work environment for our frontline workers and teams that allow them to contribute to their highest level.”[3] With more than 200 School at Work® graduates over the past 15 years, Emory continues to push their drive for excellence stretching from every corner of its hospital system. In 2020, despite the challenges placed on them as a result of COVID-19, 28 Emory employees graduated from SAW® in April. This group worked together to create a plan that they stuck to, ensuring they finished their class on time.

Catalyst Learning Company (CLC), creator of School at Work, was founded to increase access to education for low-wage workers; adults who have been left behind and aspire to “do better”. CLC provides high quality skill and career development programs to healthcare organizations across the U.S. These programs target the frontline associates of the organization – from entry-level individuals to first-level supervisory nurses. Catalyst Learning is honored to serve 600+ acute care hospital customers, including Emory Healthcare. Many of Catalyst Learning’s customers are nationally recognized for their efforts in providing education and opportunity for healthcare frontline workers, including nine who have been recognized by CareerSTAT as Healthcare Workforce Champions.  Learn the “9 Ways Hospitals can Support Frontline Healthcare Workers, and Create a Winning Culture!”


[1] Magnet Recognition.” About Emory Healthcare. Accessed 08 August 2019.

[2] Christenbury, Janet. “Emory Healthcare recognized as emerging champion for School at Work program for frontline health care employees.” Emory News Center. 19 July 2019. Accessed 08 August 2019.

[3] CareerSTAT Frontline Healthcare Worker Emerging Champion Emory Healthcare; Education as a Priority for the Frontline Workforce.” National Fund for Workforce Solutions. Accessed 08 August 2019.

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Mercy Adopts New Technology to Educate & Advance Frontline Coworkers

Mercy serves millions of patients each year, with a health network that comprises more than 40 acute-care hospitals and nearly 900 physician and outpatient facilities across Missouri, Oklahoma, Kansas, and Arkansas. Mercy is the country’s seventh-largest Catholic healthcare system and employs more than 40,000 people.

Mercy’s mission statement is to deliver patients a transformative health experience. But Mercy has another calling of service, one to its coworkers. In addition to outstanding leadership development, Mercy is deeply committed to advancing and educating the ministry’s frontline workers.

Mercy aims to improve compensation for low-skilled co-workers. Through its Social Determinants of Human Dignity Committee, senior leadership builds opportunity and career development tracks for these lower paid coworkers. Mercy offers tuition advancements, apprenticeship programs, internships, plus supportive HR policies like medical premium assistance and affordable childcare. Removing barriers to career advancement for lower paid coworkers is part of Mercy’s ministry.

Building on workforce development efforts that originally began in 2004, Mercy and Catalyst Learning collaborated to provide a new microlearning solution for developing employees.

CLiMB is an online library of focused microlearnings for entry-level coworkers who are working in a healthcare setting. It focuses on key work concepts like basic professionalism, communication, productivity, managing stress, and providing exceptional customer service.

All of CLiMB’s 10 to 15-minute learning modules enable learners to practice real-world scenarios in order to improve their performance on-the-job. During the recent virus pandemic, remote learning and development has become even more crucial for all healthcare facilities.

Talent Development Sees the Positive Impact of CLiMB

Beth Kinsey, a Senior Specialist of Talent Development at Mercy, commented that much of the feedback from CLiMB was that it helped co-workers process information.

“Learners are asking clarifying questions with their leaders,” Kinsey says, “They’re repeating information back to leaders and seem more engaged when tasks are being explained.”

Effective listening and preparation for tasks is part of the module “Listen for Accuracy.” This module teaches learners to avoid distraction when speaking with leaders, to clarify what is being said, and to take accountability for what information was processed by asking clarifying questions.

Soraya Humphries, another Senior Specialist of Talent Development at Mercy, commented that CLiMB really opens up accessibility of L&D to so many more of Mercy’s lower-paid coworkers because it is all online. “All departments within the health system, clinical and non-clinical, have been accessing CLiMB,” says Humphries. There have been 469 individual learners and 2,146 total modules completed.

Examples of how MicroLearning is Being Applied by the Front-Line During COVID-19

One CLiMB participant in the Emergency Department at Mercy was going through a COVID-19 outbreak preparedness training this Spring. She suggested to HR that the CLiMB module “Speak to be Understood” should be included in the package of that training, because giving concise instruction is so important during crisis situations.

Another CLiMB worker-learner commented that she is now more intentional about listening before contemplating her responses. She has learned to paraphrase instructions that are being given back to her manager and is asking more clarifying questions to help comprehension.

Another course participant gave similar feedback, commenting that she now stops working on any activity and fully focuses on what her manager/nurse is explaining in order to not be (or seem) distracted.

A mid-level manager commented that she uses the ‘4 Best Practices for Speaking Effectively’ to get lots of needed information out to entry-level coworkers on her busy evening shift.

One supervisor said that he uses the CLiMB module “Engage with Customers” to help motivate his staff to improve customer service. He references this module at huddles and in 1:1’s, and strives to model these behaviors as he interacts with his staff. This module helps coworkers to communicate with customers in a way that positively impacts their experience.

Finally, another supervisor said that he uses CLiMB to help diffuse occasional team conflict. He said that CLiMB gives good guidance on handling difficult situations, and it assists his team to better communicate during stressful moments.

The 3-step strategy of responding thoughtfully, avoiding blame, and focusing on the future resonated with his team, and they revisit this conflict diffusion strategy when needed.

Through Scalable Applications Come Opportunities for Career Advancement

CLiMB offers Mercy the opportunity to scale-up the quantity of co-workers who can be served with development opportunities and can be used by many learners at a time that is convenient for them. Coworkers can access CLiMB microlearnings independently, with their leader, or in a learning lab at a hospital for example.

To market the availability of CLiMB to its frontline workers, Mercy uses open enrollment and internal communications like health system newsletters. Education leaders at Mercy are seeing that most courses are taken because of self-motivation from coworkers, not because of any management mandates or deadlines.

Besides just offering this as a soft-skills training opportunity, it also lets Mercy see which coworkers are most interested in career advancement. If HR sees that a coworker is completing every one of the modules, that can foster a conversation, and generally the coworker then informs managers of a desire to advance or take on more responsibility.

CLiMB offers the opportunity for HR and management to track course participation, and quarterly goals are set for each department. Course completions, how many times a course is accessed, unique page views, and what departments are completing the most courses are all tracked. Mercy even keeps a “Top Ten” list of engaged departments for fun. Manager’s subjective feedback is monitored as well.

One mid-level manager for example cited that she had team members who were looking for skill development and advancement opportunities. This manager discussed the need to her senior leadership, and was made aware of all the resources CLiMB offered. One of the modules included was even a “Your Healthcare Career: Set Yourself Up for Career Success” module. This manager was excited to be able to take all this learning and development opportunity back to her team.

Looking to the Future of Talent Development in the Front-Line Workforce

A future goal of Mercy is to use CLiMB’s available Coaching Guides for better 1×1 teaching opportunities, and to integrate CLiMB into its upcoming Career Development Academy. This academy will be an intentionally designed learning burst opportunity, and the most crucial leadership capabilities will be taught to high potential candidates. CLiMB should integrate perfectly since it proves how short, targeted, scenario-based learnings can have a big impact on employees and their performance.

It is likely that Mercy will always be at the forefront of frontline employee education. Mercy understands that it isn’t just about an altruistic outreach to its employees, it’s also about preparing the frontline co-workers who touch and impact the patient. Career development within a healthcare setting requires a variety of tools to fit the unique needs of employees, including work schedules, family situations, and education or advancement goals.

Mercy is recognized by Fortune 100 and CareerSTAT for achievements in advancing entry-level employees. Catalyst Learning is honored to be a contributor in this system’s employee engagement success.

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