Cincinnati Children’s Commitment to Diversity & Inclusion through Frontline Employee Career Development

“I believe there’s a whole world of untapped potential buried within me, hoping that I’ll be brave enough to unearth it. I also believe there’s a whole world of untapped potential within you. And it’s hoping, waiting to see if you’re willing to set it free.”

Cincinnati Children’s Hospital and Medical Center (CCHMC) is recognized by U.S. News and World Report as one of the best children’s hospitals in the U.S. It is nationally ranked in 10 pediatric specialties. It is a teaching hospital, medical and surgical, and operates Level 1 pediatric trauma and surgery, within downtown Cincinnati and throughout the southern Ohio region.

While patients are referred from all over the world for CCHMC’s care capabilities, it has a mission to be a vital resource to the health of the local community, focusing on efforts to impact obesity, asthma, preventable injuries and infant mortality. The hospital strategically uses resources and partnerships with local organizations to address health issues that are prevalent in the community.

Commitment to Diversity, Equity & Inclusion. Walking the Talk… at All Levels

Cincinnati Children’s values and regards diversity as an organizational asset, utilizing the strengths and benefits diversity and inclusion bring to patients, families, visitors, employees, volunteers, suppliers and the community. The organization was ranked #40 in Forbes list “America’s Best Employers for Diversity 2020.” This isn’t an accident. The recognition represents intentional progress and alignment with strategic goals, set from the apex of the health system.

Putting this belief and strategy into workforce development practice, CCHMC offers a suite of programs that serve as a catalyst for building pathways for the next generation of diverse healthcare professionals.

  • The “Job Coach program connects employees with appropriate mentors who can help with professional development and help make connections in the Patient Service Division.
  • CCHMC’s William K Schubert Minority Nursing Scholarship seeks to increase the diversity of registered nurses at CCHMC and to assist with economic barriers that prevent some students from pursuing nursing careers.
  • CCHMC offers minority scholarships for medical imaging, to promote the entrance of minorities into the high need field of radiology.
  • Raising minimum wage to $15/hour across the board
  • Career Pathways program which increases the transparency for employees of what education and experience is needed to advance to another role
  • CCHMC augmenting our tuition reimbursement program to also offer a tuition assistance program which makes tuition payments directly to approved educational programs/colleges/universities reducing the burden of employees have to pay for tuition and then wait for reimbursement after completion course

Frontline employees are a significant and diverse part of the total healthcare workforce, yet are often underserved by leadership development and career development programs. CCHMC continues to ensure that the programs they offer are inclusive, intentional, and tailor-made to support this essential group.

CCHMC’s first-ever vice president of Diversity, Inclusion and Community Relations, Bobby Rodriguez, will help continue to change the outcome on these important fronts.

“It’s our responsibility to champion and advocate for diversity, equity and inclusion—within the walls of the medical center and well beyond. My goals are to build a vibrant, culturally sensitive and inclusive environment,” Mr. Rodriguez shares. “Listening and celebrating the differences and similarities of each other will make us a stronger organization.”

Maintaining a Focus on Workforce Development, Despite a Pandemic

One of CCHMC’s goals has been to build career pathways and upward mobility for ethnically diverse entry and mid-level professionals.

For entry level healthcare associates, CCHMC began working with Catalyst Learning in 2010 to implement School At Work® (SAW®), a curriculum and career planning system that promotes upward mobility. SAW® sharpens key behavioral skills to optimize employee performance and puts student associates on a path for career advancement in healthcare. Subjects include Life Management Skills, Communication in the Workplace, Medical Terminology, and Planning For Your Future.

Karen Powers is a Facilitation Consultant at CCHMC, and serves as a SAW® coach. Karen recently commented that “At CCHMC, we want to leverage and lift each other up for success. We need to be able to give our entry-level employees the tools they need to thrive at our organization and see their importance. We want to retain our associates, and show that we value making investments in them.”

Karen tells us that supervisors have reached out to her on multiple occasions to note the changes they’re seeing in their employees. Supervisors have told Karen,

“My SAW® employee is showing up so differently, with increased confidence, interest in responsibility, and is focused on growth and development. They’ve gone from listening to actively participating. SAW is giving a sense of accomplishment that is helping associates reach the next step.”

Danette Fields is a Patient Rep II at CCHMC who graduated from SAW® in 2014. She recently said that SAW® helped her to learn how to interact with co-workers better and to diffuse conflict and difficult situations better. She said it taught her how to keep patients and families in mind as she communicates, and to be accurate and accountable in her work and patient interaction.

Expanding Career Opportunities for Mid-Level Employees

Recognizing that many mid-level associates in roles such as Patient Care Tech, Administrative Assistant, or Health Information Tech also had more upward mobility potential, CCHMC began offering Expanding Your Career and Healthcare Opportunities (ECHO®) to its employees in 2019.

CCHMC SAW and ECHO 2020 Virtual Graduation Celebration

Liz Keith is a Facilitation Consultant at CCHMC, and is also an ECHO® coach. Liz recently commented that “ECHO reaches a different group of employees, those looking for help with career development and professional aspirations at CCHMC.” Liz works with students on resumés, networking and other skills. Liz says, “We love the cohort aspect of it. Learning about other roles from students in the cohort with them. Advancement is of interest. They’re looking for something more and want to remain with Cincinnati Children’s.”

CCHMC has seen career advancements from SAW and ECHO graduates. Students take a customized Career Interest Survey providing them with ideas for career avenues. There have been 8 promotional moves from the last 2 SAW® and ECHO® classes.

Tiffany Puska, a Health Unit Coordinator II at CCHMC is a recent ECHO® graduate. She applied for the programs because she had wanted to further her education, but had been out of school since 2002 so was a little apprehensive at first.  Tiffany said the course on Medical Terminology helped her communicate with both patients and clinical staff better. After her ECHO® graduation, Tiffany felt so confident that created SMART goals to help long-term plan a little better, then applied to college and was accepted! She is now in her 3rd collegiate semester and will attain her Associates Degree in 2022.

Helping Associates Gain Skills, Move to Career Roles with Family-Sustaining Wages

Plans in the coming year call for expanding the network of leaders involved with the program, to help make student-mentor connections and to help participants infuse the workforce with knowledge and skills learned in SAW® and take it back to their respective worksites and teams.

Graduations, always a joyful occasion, were held in a special in-person ceremony prior to the COVID-19 pandemic and have been done virtually in 2020 and 2021. Sandy Puthoff, Rep III – Patient Scheduling Center and SAW® 2021 graduate, summed up the impact when she quoted Joanna Gaines of Fixer Upper,

“I believe there’s a whole world of untapped potential buried within me, hoping that I’ll be brave enough to unearth it. I also believe there’s a whole world of untapped potential within you. And it’s hoping, waiting to see if you’re willing to set it free.”

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Mosaic Life Care Supports its Employee Caregivers with Skill Development and Opportunity

Even in a Tumultuous 2020, Mosaic Life Care Supports its Employee Caregivers with Skill Development and Opportunity

Sees Tremendous Impact on Retention, Internal Advancement

Mosaic Life Care (Mosaic) operates medical centers in St. Joseph and Maryville, MO, and has 60+ clinical facilities offering urgent, specialty, and primary care within Missouri and Nebraska. Mosaic offers a life-care model which combines traditional acute health delivery with a focus on key life elements which affect overall wellness. Mosaic has a commitment to health, well-being and the vitality of the community that it serves.

Being part of the Mayo Clinic Care Network, Mosaic is very focused on high-quality, data-driven, evidence-based medical care. It also takes care of its employees (called caregivers).  In 2020, Forbes magazine ranked Mosaic in the top 15 among 2,500 employers in Missouri for best state employer. Mosaic believes in its mission to serve the community through opportunity, workforce development, and employee career growth. It stresses that whatever employees choose to do in the organization, that each role is important and vital to patient care.

In 2009, seeing that environmental, admin, and nutrition caregivers were sometimes overlooked for leadership development opportunities, Mosaic began looking for ways to increase career growth and opportunity for its frontline entry-level team members. Mosaic also wanted to reduce turnover within these groups. To help with all these issues, the HR education staff found a program offered by Catalyst Learning called School at Work (SAW).

SAW is a comprehensive education and career planning experience that strengthens communication, core education skills, and medical terminology. It also helps entry-level caregivers understand the key role they play in patient care and impact on the HCAHPS rating. SAW helps health systems reduce turnover, increase employee engagement, and prepare employees for the next level of learning.

Micah Robison is a Workforce Development Specialist at Mosaic and also a SAW coach/facilitator.  Ms. Robison believes that sometimes a confidence builder is just what an associate needs. She states that,

“Many of the SAW participants didn’t have the best education background or have not had much opportunity.  But after SAW graduation, I hear things like ‘we can’t believe the change we have seen in her’ and the term ‘go getters’ when managers beam about employee work level. Managers are letting me know when ex-SAW graduates are applying for promotions. As a SAW coach, this gives me pride to know that my students are improving job performance and pursuing more job responsibility.”

Mosaic Life Care School at Work, 2019 Graduates.  15 people are standing clustered together holding flowers and certificates. They are standing in front of three projection screens showing "SAW Guest Speakers" at their graduation ceremony.
Mosaic Life Care School at Work Graduates

A SAW student at Mosaic felt so confident after her graduation that she entered nursing school. Another student working as a 3rd shift housekeeper used SAW to propel her to a job she had dearly wanted and  became an Access Rep. SAW coaches keep hearing about these “light bulb” moments when employee caregivers realize that their role within Mosaic is just beginning, and that there are growth opportunities within the health system.

To leverage SAW and promote career and responsibility expansion, Mosaic partners with local Missouri Western State University. This university offers 3 hours of elective credit for students that complete the 6-month SAW experience. This encourages SAW graduates to get back to school to take advantage of the credit.

Mosaic Life Care School at Work, 2018 Graduates (16 women shown in two rows with the back row standing. There are 10 in the back row and 6 seated in the front row. The group is smiling and are posed toward the camera
Mosaic Life Care School at Work Graduates

One of Mosaic’s SAW graduates who enrolled at MWSU is Aron Battreall. Ms. Battreal had been thinking about going back to school when she heard about the SAW program from a co-caregiver. She enrolled in SAW to get comfortable with assignments and to build confidence. She mentioned that Medical Terminology was particularly beneficial for her role. As a Medical Biller II, the terminology improved Ms Battreal’s efficiency and helped her expand the questions she asks insurance companies. She also has a better understanding of patients’ medical records.

Aron noted that “SAW boosted my confidence enough to go to my management team and express interest in taking on more responsibility. It also gave me confidence to enroll at Missouri Western State University and I will graduate with a BS in Population Health in December 2021.” Ms. Battreall also expressed the impact of the SAW opportunity on her loyalty to Mosaic.

Mosaic Life Care School at Work, 2017 Graduates. 11 people (7 women standing in the back, three women and 1 man sitting in a row in front, the man is on the right). Everyone is smiling and looking into the camera
Mosaic Life Care School at Work Graduates

“By investing in us, it makes my fellow caregivers and I feel appreciated, and I know my classmates and I work harder to be able to give back to the hospital.”

Aron Battreall, Medical Biller II, Mosaic Life Care

Mosaic has offered SAW since 2009 – that is 12 years of commitment to entry-level caregivers!  2020 was a particularly tough year because of COVID, but it did not stop progress. Mosaic offered two classes in March before the nationwide shutdowns.  It resumed class in May started offering hybrid learning models.  Mosaic even continued to have guest speakers from within the hospital present opportunities to the class via Skype. With a combination of outside-the-box thinking, flexibility with staffing issues, some IT support, and with open communication lines, SAW was able to proceed.

Experiences like this, even without a pandemic, aren’t available to entry-level caregivers without strong executive support.  Janelle Lee, Vice President of HR and OD, championed the extension of L&OD to include non-clinical caregivers from its beginning.  She describes Mosaic leadership’s cultural desire to “teach caregivers to fish”, its commitment to community development, and School at Work as “a backbone.” The health system’s goal for skill growth and education also means less employee turnover, and supports Mosaic’s greater goal to improve the community through health and opportunity.

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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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Diversity & Minority Empowerment Strategies for U.S. Health Systems

The Spring and early Summer of 2020 has been turbulent, with regards to how our country’s public and private institutions are progressing and evaluating race in America. In particular our African American community, which has had more trouble in achieving the same economic prosperity that other groups have had. While much recent media attention has gone towards the relationship between African American communities and local police, right now many U.S. organizations are reflecting inward. U.S. health systems are no exception. Health systems and local hospital leadership are analyzing their own priorities and wondering if they are a force for positive change at a local level.

Nearly everyone would agree that rooting positive diversity metrics right into company goals is important. But what can health systems, community hospitals, or clinics do to promote diversity, and spread economic prosperity to under-served, under-valued populations?

Communicate Initiatives and Measure Results

Health systems and community hospitals, should identify hiring or advancement goals and craft messages to your various audiences. Make sure your current associates and your community know about diversity hiring and advancement goals. People vary in how they understand messages, so think through communication plans and how to reach intended audiences. Newsletters and communications to staff through mid-line managers can be a successful tool. Social media and community organizations can also help spread messages to the community. If you’re trying to hire more from the surrounding community, a recruitment tent at a public event may be a vital communication tool rivaling recruiting solely online.

It is also imperative to measure the results of diversity initiatives. Increased representation of identified minority groups and improved employee survey scores should be captured. Diverse employee retention metrics, advancements, training metrics, or public recognition are other tactics which can be communicated, measured, adjusted/reviewed, and celebrated.

Hire Based on Communities the Health System/Hospital Serves

When hiring, recruit underrepresented members of the local community, and demographics that mirror patient populations. 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. UHS hires many community members who do not speak fluent English. Available career development programs have been expanded to keep pace with the evolving language and literacy needs of employees, including offering onsite English for Speakers of Other Languages (ESOL).

By hiring within their community, University Health Systems executes on-the-job learning and career development system through the ECHO® (Expanding your Career and Health Opportunity) program. ECHO® gives mid-level healthcare workers the chance to move into more advanced roles in the organization. Read more about University Health System and their hiring practices.

Create “Blueprints” for Success for Minority Candidates

Diversity at the mid-line management or Director-level is often discussed as a barometer of an organization’s diverse employee leadership practices. When employees are in an entry-level or mid-level role, it may be difficult for them to envision what a higher leadership role would look like; especially if the people currently in those roles don’t look like them. To overcome this lack of representation, identify high-performing employees to be the blueprint for what advancement could look like.

If “upskilling” is needed to bridge the gap, show what learning tools are available, whether internal or through certifications and community colleges. Develop a mentorship program aimed at promoting and advancing diverse populations. Career exploration conversations, coaching, and mentoring are steps that could help with advancement of diverse or underserved employee populations.

Put Learning Tools in Places Easy to Access

When building the talent pipeline of the lower-level employees, it’s important to find the top-performers in that group to earmark for development or future advancement. Building the talent pipeline in an organization generally means learning tools are needed.

With the recent virus pandemic, amid furloughs and layoffs, job training or soft-skill development have unfortunately been put to the side by many systems. But as many workers are now being tasked with more responsibility to fill in gaps, and hiring hopefully ramps back up, learning opportunities are going to become more important than ever.

One such offering that can support job training or soft-skill development is CLiMB™. CLiMB™ is an online library of microlearning modules, that is completely contextualized for healthcare front-line associates. Lessons and activities use real-world scenarios from healthcare-specific settings and focus on the job positions of the targeted learner. Scenarios were created based on input from customers and subject matter experts and show how behaviors can be applied immediately on the job. CLiMB™ has 5 themes: Good Work and Good Relationships, Effective Job Communication, Caring for Yourself and Others, Exceptional Patient Experience, and Building a Healthcare Career.

Obtain Support from Senior Leadership

For initiatives of diversity inclusion, hiring, or advancement to be successful, the organization’s Senior Leadership needs to buy-in. Senior Management should understand the business case for inclusion techniques and see direct links to the organization’s strategic goals. Hold Senior Management accountable for supporting actual diversity applications to the workforce. Creating a stand-alone diversity committee or ‘senior champion’ for inclusion are among best practices.

A model health system in championing diversity hiring, retention, and advancement is Main Line Health in Philadelphia. Main Line Health’s ‘senior champion’ is CEO Jack Lynch, who is outspoken and intentional about achieving more diversity at the apex of the system. Lynch believes in investing in programs that promote diversity, foster collaboration, participation, and respect in the organization, while reducing turnover costs. Main Line Health’s Diversity, Respect & Inclusion Strategy team has been in place for 7 years now. This team is tasked with developing leaders within the organization who mirror its patient population, as well as the demographics of Philadelphia. With many Baby Boomers nearing retirement age, leadership development was crucial to build a base of engaged workers for the future.

Main Line Health partnered with Catalyst Learning to implement “School At Work” (SAW®) and “Expanding Your Career and Healthcare Opportunities” (ECHO®), programs that aid in the career development goals of entry and mid-level healthcare employees. Main Line Health’s goal is to champion building a pipeline for a more inclusive leadership team. Read More about Main Line Health.