The New Struggles and Strategies for Delivering Healthcare Workforce Training

Hospital CFOs talk about how their organizations are challenged with and maintaining training programs that develop required skills, ensure quality care, and keep workers engaged and loyal.

While case numbers for COVID-19 are declining in many parts of the country, hospitals and healthcare systems continue to be stretched for staff resources and available ICU beds. Most hospitals are anywhere from somewhat to woefully understaffed as they wage this battle. That makes it challenging to focus on such traditional offerings as training and career development programs.

But hospitals can't afford to let training efforts fall behind during even these trying times. It is vital to both the short-term and long-term success of the organization.

Leading healthcare systems recognize that employees must keep their skills up to date to meet industry licensing standards and to provide the best care. Furthermore, the organization's leaders of tomorrow must be developed today, and that requires a commitment from current management to formal training programs.

The current state of training

Maintaining training investments can be especially challenging at smaller hospitals and care centers. That is certainly true for Monadnock Community Hospital. Located in a rural community in South Central New Hampshire, Monadnock Community Hospital serves 13 towns with a combined population of approximately 40,000. It is one of the largest critical access hospitals (CAH) in the country.

While staffing shortages are easily the top concern at Monadnock Community Hospital, training opportunities are a close second, says CFO Richard Scheinblum. "We have limited hands-on training opportunities," he stresses.

Even in good times, the hospital's size works against providing all the training programs it would like. "Sometimes we have to partner and send staff to other hospitals for training and development," Scheinblum acknowledges. But the pandemic has made that process especially difficult.

"I think that we were in crisis mode from March 2020 to the summer of 2021," Scheinblum says. As the pandemic raged, there was little time to focus on anything but treating the rapid increase in patients and perform only essential tasks. Even at the time of the interview for this article, Scheinblum said the hospital has 80 open job requisitions, and 30 staff out due to COVID.

Still, as the first pandemic surge waned in late summer 2021, hospital executives realized they needed to refocus on the strategic practices and priorities of the hospital. Topping the to-do list were programs that would help develop, engage, and motivate existing staff, and help with the recruiting of new employees.

"We started having robust conversations about recruitment and retention of employees, including how we can support people to develop in their careers. Our vice president of human resources has multiple interdisciplinary work groups developing plans," Scheinblum explains.

The challenges of delivering top-level training

The challenges of offering robust training programs are just as real at larger hospitals and healthcare systems, and again, COVID-19 has played a significant role.

At El Camino Health, there have been three significant trends in training over the past two years. El Camino Health includes two nonprofit hospitals: Mountain View Hospital and Los Gatos Hospital, as well as urgent care, multispecialty care, and primary care facilities. Mountain View and Los Gatos, California, have a combined population of 116,000.

"I do believe that in-person training is always better," says Carlos Bohorquez, CFO at El Camino Health. "But given the obvious COVID restrictions to providing a safe environment for everybody, we have had to do it remotely. So having to [train] remotely and ensuring that people have access to the proper tools, that that would be challenge number one."

As with Monadnock Community Hospital, staffing issues have also impacted training initiatives. Hospital employees are working long hours and many days. But the hospital is also dealing with large numbers of employees out at any time due to COVID. That makes it difficult to allow employees to be 'out' for training activities.

The third significant challenge is ensuring that each employee gets the training they need to stay current in their skills, to meet licensing and industry requirements, and to feel valued by the organization. This last point is especially important right now, as hospitals and healthcare centers see large numbers of workers leave the field, Bohorquez notes.

Workers are receptive to digital and remote practices

But there is good news in all of this, Bohorquez says. For one thing, employees in nearly all industries have grown accustomed to communicating and interacting in new ways. The company water cooler has been replaced by digital tools and applications. This aids greatly in the delivery of remote training where able.

Another key area for hospitals to maintain and support is advanced education classes. Scheinblum says staff at Monadnock Community Hospital have specifically asked for additional tuition reimbursement benefits. In response, the hospital's philanthropy staff has raised money specific to nursing education and other disciplines. And the hospital revised its tuition reimbursement policy from the previous one-year waiting period to just 90 days.

"I think the most important thing is to lead a discussion with your C-suite on ideas that folks may have in regard to career development," Scheinblum says. Then, make sure that worthy ideas are funded in the organization's budget, and that it is communicated throughout the organization that those initiatives have top-level support."

The key role of leadership development programs

Maintaining a healthy training program is also key for leadership development within the organization.

"At El Camino, we believe that continuing to develop leaders is vital to the short-term and long-term success of the organization. Despite COVID, we have kept a formal leadership training process in place, and in each area [of the organization] we identify people who we believe are our future leaders."

That process is taking longer than it would have done before the pandemic, Bohorquez acknowledges.

"I talk to my team on a regular basis on the need to provide training to their staff, and the need to get leaders within the organization. We haven't slowed. We've just pivoted to the right structure," Bohorquez says.

"The fact that a lot of training can't be done in person does not preclude anybody from continuing to educate their staff and provide learning opportunities," Bohorquez stresses.

Healthcare organizations can also bring training to the workforce through internal subject matter experts and by soliciting outside experts to present at the organization whenever possible.

"One of the things that I think has had an impact on the entire industry is that a lot of conferences and other educational opportunities have either canceled or gone remote. I think developing that network of peers across the organization and across the industry—to help you see what other organizations are doing—is absolutely important. We are an incredibly great organization, but we can always learn from other organizations across the country, to understand what challenges they have and how they're dealing with them."

The role of the CFO in maintaining investments

"My advice would be to sit down with staff at various levels and ask them what they need to develop in their career," Scheinblum says. "Often, as a CFO, we are driven to just make changes. Taking a step back, asking targeted questions, and soliciting feedback when trying to make an organizational impact is the best approach."

That view is shared by Bohorquez, who also says that the most important contribution a CFO can make is to help the organization remain financially stable so that it can make the investments in staff that it needs and wants.

"At the end of the day, having a stable financial platform will allow us to fund the training needed, allow individuals to participate in conferences, and help us develop young leaders," Bohorquez says. "Everybody in our leadership team agrees that our most important resource is our employees. And right now, more than ever, the workforce is vital to the success of any organization."