As the Affordable Care Act, America's aging population, and a host of other factors transform the healthcare landscape, providers across the healthcare industry must answer a critical question: "How can they manage cost effectively while also maintaining employee engagement, creating quality outcomes, and improving their patients' satisfaction?"
While the question has multiple answers, many healthcare leaders are missing an obvious solution: they can reduce their administrative costs and error rates by investing in the skills and education of their frontline workers. Serving as patient care assistants, housekeepers, and dietary aids, many frontline employees interact with the patient more than any other caregiver and, therefore, have a significant impact on patients' perceptions of their health care experience.
By investing in the skills and education of these workers, healthcare providers such as Genesis HealthCare and Homebridge have reaped favorable business impacts throughout their organizations including reduced turnover, fewer accidents, and a more engaged workforce. Representing dramatically different organizations, both Genesis HealthCare and Homebridge provide an excellent example of how other healthcare organizations can reduce their costs and improve their quality of care by investing in the training and development of the their frontline workers.
As one of nation's largest skilled nursing and rehabilitation therapy providers, Genesis HealthCare serves as a prime example on how strategic workforce investment can transform a provider's culture and business model. In 1999, Genesis HealthCare in Maryland was facing a severe shortage of trained certified nursing assistants (CNAs) and was spending $3,500,000 per year on staffing agencies to provide travelers and temporary labor in order to meet their high staffing demands. Fully aware that this was not only costly to the organization but also was reducing the consistency and quality of care, Genesis began to develop its own labor pool by establishing a Staffing Services program. With a culture focused on "Growing its Own," Genesis HealthCare in Maryland built a culture of personal development and growth and created an in-house Certified Nursing Assistant training program that provides standardized curriculum, on-site evaluation, and on-the-job training to thousands of its employees. Genesis started its new CNA/GNA Training Program in 1999 and has since graduated 4,367 CNAs over the past 16 years. By having a stable supply of CNAs, Genesis in Maryland reduced its reliance on CNA staffing agencies by 98% and in comparison, spent only $67,229 for CNA staffing agencies in 2013.
Complementing its positive business impact, Genesis's focus on internal development has transformed its organizational culture. Genesis HealthCare CEO George Hager believes that Genesis HealthCare's employees are the vital link between Genesis and its patients and residents. He says, "Our training program is part of the Genesis HealthCare culture to 'Grow Our Own.' Our employees are the service we provide, the product we deliver. They are our most valuable assets, because they know our health care setting, our patients, and our residents."
Genesis's decade of data seems to demonstrate that health care systems can do well by doing good. By creating the programs and footing the bill for workforce training, they have catalyzed their own significant business impact while also dramatically benefitting their community and employees. While Genesis's investment represents a tactful response to growing market pressures within the healthcare industry, are they the outlier? With more than 95,000 employees nationwide and locations across multiple states, Genesis HealthCare's scope and economies of scale are much larger than other institutions, but does this mean that only large organizations can make an investment in long-term training programs?
While such questions are valid, smaller organizations such as Homebridge in San Francisco have also created, implemented, and benefited from long-term skills investment. An organization of less than 600 employees, Homebridge annually provides home care to more than 1,800 elderly persons and people with disabilities in San Francisco and San Mateo County. While a much smaller organization, Homebridge has given frontline worker advancement the same level of attention as Genesis and has seen similar results. Of its 545 employees, 87 percent are frontline caregivers working directly with patients in home care settings. Due to the many challenges associated with home care work, turnover is extremely high with the national turnover rate averaging 61 percent. Finding and keeping good caregivers is a major industry challenge but with Homebridge's up-front investment in training and on-the-job supports, it prepares its employees to manage difficult circumstances. This preparation has keep Homebridge's turnover rate at 60% of the national average. With a 37% turnover rate and more stable pool of caregivers, Homebridge is not constantly rebuilding its workforce and is instead able to focus on the key business goals of increasing patient satisfaction and developing new methods to accommodate the region's growing elderly population.
To prepare its workers for a changing work environment, Homebridge created its Training Academy for Personal Caregivers and Assistants (TAPCA), a program that provides competency-based training curriculum designed for adult workers. As students progress through the program, each of the necessary skills is tested with standardized assessments ensuring the mastery of each competency. Highlighting the value of hands on learning, Homebridge's training facility includes a simulation apartment where caregivers can practice with beds, wheelchairs, and bathroom facilities. This training helps employees understand the challenges associated with home care as well as the opportunity to develop comfort and confidence in providing home care.
To complement the development of its own 475 caregivers, Homebridge has also made sizable investments in its community workforce. A premier training provider for entry-level caregivers in California, Homebridge has trained nearly 2,000 community caregivers since 2010 creating its own valuable pipeline of trained caregivers while also assisting non-employees find employment within the health care industry. Despite its small size, deep and constant employee development is critical to Homebridge's continued success. Throughout its history, Homebridge has invested heavily in workforce training for its entry-level home caregivers because it believes that training is essential to delivering high-quality care for consumers, enhances safety and job satisfaction for caregivers.
Genesis HealthCare and Homebridge have also received national recognition for their leadership in frontline worker investment and have both been recognized as 2015 Frontline Health Care Worker Champions by CareerSTAT. An initiative of the National Fund for Workforce Solution, CareerSTAT represents a network of hundreds of healthcare providers across the country. CareerSTAT recognizes the top organizations developing their frontline workforce and tracks the business impact from investment. CareerSTAT tracks the newest and most innovative workforce investments being made in the health care market and uses the information to promote greater investment in frontline workers.
Representing health care providers both big and small throughout the country, Genesis HealthCare and Homebridge have both responded to the rapidly changing health care market with the same solution: strategic and thoughtful investment in frontline employees. By improving the competency and flexibility of their workers, they have become more accommodating to employees and patients while also improving their efficiency and success.