Symptoms Critical: A Strategic Approach to Pennsylvania's Nursing Workforce Challenge

Planning for a system-wide, organizational change is difficult for even the most robust and well-grounded organization. When a system change plan involves 128 educational programs, hundreds of health care institutions, and multi-dimensional public sector commitment, the road to consensus and planning can be long and complicated. Such a situation calls for the commitment of top leaders, a central vision, and most importantly, an empowering call to action. 

As one of Pennsylvania's largest employers, the health care industry is a critical and driving force of the state's economy. According to the Hospital and Healthsystem Association of Pennsylvania, the hospital sector alone provides $56 billion in direct and secondary contributions to the state's economy and impacts the employment of over 500,000 professionals. Unfortunately, Pennsylvania is faced with severe labor shortages reaching crisis levels in occupations such as nursing, medical imaging, pharmacy, respiratory therapy and direct care. 

Faced with the threat of such health care labor shortages further impacting the vitality of the Commonwealth, Governor Edward G. Rendell created the Pennsylvania Center for Health Careers, a public/private initiative led by a Leadership Council of employers, Commonwealth agencies, industry associations, labor unions, professional associations, and educational institutions. The Center, housed at the Pennsylvania Workforce Investment Board and under the direction of the Leadership Council, is charged to act as an organizational catalyst for developing an action agenda to respond to Pennsylvania's short and long-term health care workforce challenges. 

As one of its first initiatives the Pennsylvania Center for Health Careers, charged THE HILL GROUP to facilitate the development of a strategy to expand the capacity of Pennsylvania's nursing education system. The 128 nursing education programs across the state are reportedly at or near full capacity and are currently unable to admit or graduate any additional nurses. With the nursing shortage anticipated to reach over 10,000 vacancies in the next six years, the goal of expanding this system is ultimately to produce more nursing graduates who will successfully be licensed to practice nursing in Pennsylvania. 

Developing the workforce is a responsibility shared by the public and private sectors. Therefore, it was essential that Pennsylvania's health care industry administrators and nursing educators worked closely to translate this vision into a realistic plan. Throughout the summer of 2004, THE HILL GROUP led a series of Roundtable meetings, for The Pennsylvania Workforce Investment Board which engaged over 143 nursing educators and hospital administrators in regional discussions aimed at drawing out specific recommendations to increase the capacity of the nursing education system in Pennsylvania.

THE HILL GROUP led statewide participants as they examined the issues impacting the nursing education system from all angles. Lively group discussions encouraged new ways of thinking to address these issues and resulted in the creation of hundreds of potential solution recommendations. Challenges such as a the lack of qualified nursing faculty, limitations on clinical education infrastructure, and barriers impacting the attraction and retention of nursing students were the most frequently cited issues of critical need. Considerations were also made to account for the exacerbating challenges contributing to the nursing workforce deficit such as an aging population requiring additional care and an increasing rate of retirement among nurses, both of which will decrease the supply balance of nurses currently in the workforce. 

With the problems clearly diagnosed and a host of potential solutions suggested, the Leadership Council, with the assistance of THE HILL GROUP, was able to create a plan for changing the nursing education system. This fall the Leadership Council of the Pennsylvania Center for Health Careers and the Pennsylvania Workforce Investment Board approved and put forth fifteen recommendations designed to have immediate and long-term impact on the ability of nursing education programs to produce more qualified nurses. The Hill Group congratulates all who contributed to this truly collaborative policy development process and commends Governor Rendell for the vision and initiative to seek such inclusive participation throughout the system change planning process. 

A copy of this recommendation report is available at the Pennsylvania Workforce Investment Board web site - www.paworkforce.state.pa.us.

Alyson Getty Cole specializes in human capital strategy and workforce development initiatives for THE HILL GROUP. For more information about preparing your organization to meet the challenges of your workforce, contact Alyson at 412.722.1111 or via email at acole@hillgroupinc.com.

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