Listening to our CHC's
Tuesday, September 23, 2014
Posted by: Joy Ingram
by Lynn Gerlach, Development and Communication Manager
Each year we survey our members, per our agreement with HRSA as well as out of good common sense, to update our perspective on their needs and how we might best serve them. This year’s survey is particularly important because the results will inform our board’s new two-year strategic plan. Seven hundred invitations to participate were sent out, and the survey will close at COB on Tuesday, September 30. If you have failed to respond, this would be a good time to carve out 15 minutes for that purpose. If you were not invited to participate and would like to be invited, contact our Development Office at 206-783-3004, extension 12.
Now, whether you have responded to the survey, would like to, or hope not to be asked, here is a preliminary report that indicates some of the key findings to date. It will be interesting to see whether and how they change with the final input from members over the next week.
Let’s cut right to the chase: Our members are telling us that the biggest health concern, by far, in their communities, is diabetes. In fact, that health issue has, to date, been listed as a key concern almost twice as many times as any other. Next in line is obesity, of course. Then comes hypertension, followed by substance abuse. No surprises here. Addiction and mental illness are currently ranking as the next greatest concerns, followed by access to care, cancer and depression.
What is the biggest challenge your CHC faces?
Specific health concerns aside, what are the biggest challenges our Northwest health centers seem to be facing right now (understanding that results might shift somewhat based on the responses yet to be collected)? We found some interesting one-offs that might find company as more responses are added over the next week. A few samples: caring for our refugee population; union issues; public health – primary care integration; role of the MA; marketing to a small community; HRSA paperwork. (Sometimes you just have to smile.)
But what was the “biggie”? No surprise here: 25% of respondents listed the provider shortage, along with the confounding problems of clinician recruitment and retention, as their CHC’s single biggest challenge. Second (and not a close second) was recruitment and retention of staff in general. So, the next logical question might be this: What is the single most helpful thing we could do to assist you with workforce development? The answers to date have not been as overwhelmingly clear as those above, but assistance with clinician recruitment certainly has won out so far. Some respondents offered helpful descriptors too: “assist in ameaningful way, offer free recruitment services, help us attract providers to the Northwest, and NWRPCA recruit cliniciansdirectly.”
Then we got even more specific: “How would you prefer we help you recruit and develop a high-performing, mission-driven workforce?” Respondents were allowed to check all that apply, so the results were not as clear cut here. “Showcase best practices for retaining high-performing employees” was selected 64% of the time. But 50% of respondents also checked “offer more robust online job posting service for clinical positions” and “provide direct recruitment services.” Also popular were the possibilities of providing training on interdisciplinary approaches to team-based care and a more robust online job posting system for administrative positions. Least popular of the eleven choices, but still selected by 18% of early respondents, was “partner with a sourcing service on your behalf.”
How might we help you through education and training?
In addition to the critical need for workforce recruitment and retention is the development of that workforce through ongoing education and training. So what seem to be the most critical training needs our member CHCs will face in the upcoming year? Once again, we offered no checklist; this was an open-ended question, and respondents were invited to write in any answers they wished. So responses have been all over the board, but a handful of training needs definitely rose to the surface already at this preliminary stage. Here were the top four: ICD-10 training (Sigh! We’ve been offering ICD-10 training through PMG for two years.); training for effective leadership; team-based care training; and electronic health record (EHR) training. Other “hot” training topics were customer service, HIPAA, general management preparation, PCMH, quality improvement, and recruitment and retention skills.
The obvious follow-up question would be: How would you like us to deliver that training? So far, our members are telling us they want Distance Learning. Forty-four percent asked for asynchronous online training, and 40% recommended real-time, live webinars. Surprisingly for an organization known for its outstanding conferences, delivery of training at a conference was the least selected: 14%.
What about the health disparities in your community?
Another thing we really want to understand about our member CHCs is the health disparities they are dealing with in their communities and what they are doing to address them. The group most often mentioned as suffering from health inequities includes those uninsured, followed closely by the homeless population, then those suffering from poverty in general and low-income status. The other health disparity most often cited to date on the survey involves chronic disease management, including hypertension and diabetes.
Now, our survey includes questions about what type of challenges our CHCs face regarding their business models and their efforts toward quality improvement and collaboration. All of those results will be compiled and made available to our board of directors after the survey closes. We have also asked them to identify successful ways they’ve addressed health disparities and a few other key questions, all data to be gathered and reported in upcoming weeks. But I’d like to share just one final set of responses at this time. We posed this question: If NWRPCA could assist you in only these nine ways (and they were listed), how would you rate each in importance to your health center: Very important, important, marginally important, of little or no importance.
Here are the nine methods of assistance, listed in descending order, from most important to least important, based on the preliminary responses:
- Administrative workforce direct recruitment
- Improved positioning for successful community collaboration
- Business model improvement
- Administrative workforce development
- Addressing the social determinants of health
- Quality improvement
- Clinical workforce development
- Achieving health equity among the underserved
- Clinical workforce direct recruitment
Clearly, additional responses would be helpful
Interesting how it all falls out when questions are posed different ways! Although 25% of respondents identified provider shortage as the key issue they are currently facing, and half of respondents listed direct clinician recruitment as the workforce assistance they would most highly prize, when developing the clinical workforce is mixed in with other key CHC needs, it falls quickly to the bottom of the heap. What does that teach us? Probably not much at this point, as the survey is still open and these results are preliminary. We look forward to significantly more responses over the next week. Then we’ll get a better sense of how to move strategically in the best interests of our Northwest federally qualified health centers.