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Workforce Transformation

In recent years, our nation has seen a dramatic shift in best practices for our health care system. Breakthroughs in research, the way care is delivered, and how we deploy the skills of our workforce have carved out a roadmap to achieve improved outcomes for patients at lower cost. The expansion of coverage and the many payment reforms, pilots, and demonstration projects within the Patient Protection and Affordable Care Act (PPACA) have the potential to catalyze this transformation of our health care delivery system.   PQC’s efforts began in November 2009, when the Partnership for Quality Care (PQC) had the unique opportunity to meet with the Secretary of Health and Human Services (HHS), Kathleen Sebelius, and her staff regarding future post-legislative opportunities. As the Secretary indicated her commitment to work with PQC on a broad vision for improving the quality of healthcare delivery in the U.S., PQC has continued communication with HHS to develop a specific plan on how to work together to achieve better outcomes.   Since the initial meeting in 2009, Marcia Brand, the Deputy Administrator of the Health Resources and Services Administration has delivered a speech at the 2011 PQC Conference entitled, “Changes on the Horizon for the Healthcare Workforce.” The first in-person workgroup meeting was held in April of 2012 in Washington, D.C., and led to the creation of four workgroups on the following subjects:
  1. Coordinating Center for Inter-professional Education and Collaborative Practice  On September 10, 2012, Secretary Sebelius announced that the Health Resources and Services Administration (HRSA) has selected the University of Minnesota to house a new center to focus on Inter-professional Education and Collaborative Practice. PQC Secretary Dennis Rivera will be appointed to the advisory board and to partner with HRSA in piloting training programs and other activities that are consistent with the center’s mission.
  2. Training for Direct Care Workers  PQC and HRSA will identify best practices and model career ladder programs that support the integration of frontline workers in to the care team. In addition to best practices, the group has discussed: core competencies, career laddering, challenges, and barriers. PQC and HRSA will identify curriculum models, crosswalk the content, and build an integrated model that can be widely disseminated. There is a desire to pursue college level credited certificates. PQC and HRSA will partner to assure that care delivery sites are ready to employ these workers, including the availability of incentives (reimbursement methodologies). These training programs will be piloted at PQC member sites.
  3. Integrating Oral Health in to Primary Care  Several PQC member sites will be selected to pilot programs that train both professional and assistive health personnel in the competencies necessary to integrate oral health examinations into primary care. An existing cooperative agreement is under review to address work.
  4. Readiness for Practice  PQC and HHS will identify model programs that enhance the clinical competencies of students enrolled in nursing and other health professional programs, and others that support the transition of new graduates into collaborative practice settings. These training programs will be piloted at some PQC member sites. Dedicated Education Units (DEU) and other models will be included.
  5. Center for Workforce Flexibility  The proposed center for workforce flexibility is based on the idea that health care reform requires that all personnel work to the full extent of their training and scope of practice. A work plan is currently in development, including both an options paper and a timeline. The focus of the proposed center will be nurses and frontline workers. PQC and HRSA will convene a small working group to articulate the mission and activities, in addition to funding and organizational options.