Experiences with Clinical Workforce Vacancies, Recruitment, and - - PowerPoint PPT Presentation
1 Community Health Center Experiences with Clinical Workforce Vacancies, Recruitment, and Retention Findings from the 2015-16 National Health Center Clinical Workforce Survey Caitlin Crowley, MPH National Association of Community Health
1
2
3
4
5
6
FIGURE 1 PERCENT OF HEALTH CENTERS REPORTING A VACANCY FOR SPECIFIC CLINICAL POSITION
100% 90% 80% 70% 60% 50% 40% 30% 20% 10%
ANY CLINICAL VACANCIES FAMILY PHYSICIAN NURSE PRACTITIONER MEDICAL ASSISTANT REGISTERED NURSE LICENSED CLINICAL SOCIAL WORKER DENTIST LICENSED PRACTICAL NURSE/LICENSED VOCATIONAL NURSE INTERNIST PEDIATRICIAN PSYCHIATRIST DENTAL HYGIENIST OTHER LICENSED MENTAL HEALTH AND/OR SUBSTANCE ABUSE STAFF PHYSICIAN ASSISTANT OBESTETRICIAN/GYNECOLOGIST PSYCHOLOGIST NON-LICENSED MENTAL HEALTH AND/OR SUBSTANCE ABUSE STAFF PHARMACIST CERTIFIED NURSE MIDWIFE
95% 69% 50% 48% 41% 38% 37% 31% 23% 19% 18% 16% 16% 16% 13% 9% 8% 0% 7% 6% 6%
VISION SERVICES STAFF
7
FIGURE 2 AVERAGE HEALTH CENTER CLINICAL VACANCY RATES
30% 20% 10%
FAMILY PHYSICIAN LICENSED CLINICAL SOCIAL WORKER ALL CLINICAL VACANCIES NURSE PRACTITIONER PSYCHIATRIST REGISTERED NURSE DENTIST INTERNIST PEDIATRICIAN OTHER LICENSED MENTAL HEALTH AND/OR SUBSTANCE ABUSE STAFF MEDICAL ASSISTANT DENTAL HYGIENIST LICENSED PRACTICAL NURSE/LICENSED VOCATIONAL NURSE OBSTETRICIAN/GYNECOLOGIST PHYSICIAN ASSISTANT PSYCHOLOGIST VISION SERVICES STAFF PHARMACIST NON-LICENSED MENTAL HEALTH AND/OR SUBSTANCE ABUSE STAFF
25% 17% 13% 13% 13% 12% 12% 10% 8% 0% 8% 7% 7% 7% 6% 5% 5% 4% 3% 3% 3%
CERTIFIED NURSE MIDWIFE
8 FIGURE 3 PERCENTAGE OF HEALTH CENTERS RATING SPECIFIC CLINICAL VACANCIES AS VERY DIFFICULT TO FILL
70% 60% 50% 40% 30% 20% 10%
FAMILY PHYSICIAN INTERNIST PSYCHIATRIST DENTIST LICENSED CLINICAL SOCIAL WORKER PEDIATRICIAN OBSTETRICIAN/GYNECOLOGIST REGISTERED NURSE PSYCHOLOGIST OTHER LICENSED MENTAL HEALTH AND/OR SUBSTANCE ABUSE STAFF NURSE PRACTITIONER PHARMACIST DENTAL HYGIENIST PHYSICIAN ASSISTANT LICENSED PRACTICAL NURSES/LICENSED VOCATIONAL NURSE VISION SERVICES STAFF MEDICAL ASSISTANT NON-LICENSED MENTAL HEALTH AND/OR SUBSTANCE ABUSE STAFF CERTIFIED NURSE MIDWIFE
0% 66% 40% 34% 32% 31% 29% 23% 16% 15% 13% 13% 10% 9% 8% 8% 8% 5% 5% 4%
9
FIGURE 4 AVERAGE NUMBER OF MONTHS SPENT RECRUITING FOR SPECIFIC CLINICAL VACANCIES
13 12 11 10 9 8 7 6 5 4 3 2 1
PSYCHIATRIST FAMILY PHYSICIAN INTERNIST OBSTETRICIAN/GYNECOLOGIST PEDIATRICIAN PSYCHOLOGIST DENTIST LICENSED CLINICAL SOCIAL WORKER PHYSICIAN ASSISTANT VISION SERVICES STAFF OTHER LICENSED MENTAL HEALTH AND/OR SUBSTANCE ABUSE STAFF NURSE PRACTITIONER CERTIFIED NURSE MIDWIFE PHARMACIST REGISTERED NURSE DENTAL HYGIENIST NON-LICENSED MENTAL HEALTH AND/OR SUBSTANCE ABUSE STAFF LICENSED PRACTICAL NURSE/LICENSED VOCATIONAL NURSE MEDICAL ASSISTANT
12.7 1 1.4 1 1.2 10.8 8.7 7.7 6.5 5.7 5.2 5.0 5.0 4.9 4.8 4..2 3.8 3.6 3.3 3.2 2.9
10 FIGURE 5
TOP 5 VACANCIES RATED AS HEALTH CENTERS' HIGHEST PRIORITY TO FILL
60% 50%
FAMILY PHYSICIAN BEHAVIORAL HEALTH SPECIALIST DENTIST INTERNIST NURSE PRACTITIONER
40% 30%
Note: 10% inclusive of 5% of respondents selecting a Licensed Clinical Social Worker, 4% selecting Psychiatrist, and 1% selecting Other Licensed Mental Health and/or Substance Abuse Staff. 21% of respondents selected another clinical staff position.
20% 10%
51% 10% 8% 6% 5%
0%
11
12
FIGURE 6 IMPORTANT PROBLEMS FOR RECRUITMENT AND RETENTION
50%
RECRUITMENT RETENTION
40% 30% 20% 10% 43% 39% 25% 20% 20% 21% 9% 5% 8% 13% 4% 4% 2% 3% 0% SALARY THAT
IS COMPETITIVE COMMUNITY AMENITIES AND OTHER HEALTH CENTER LOCATION FACTORS BENEFIT PACKAGE THAT IS COMPETITIVE CANDIDATES’ LANGUAGE PROFICIENCY SKILLS AND/OR CULTURAL COMPETENCY HEALTH CENTER'S CURRENT WORKLOAD AND/OR CALL SCHEDULE HEALTH CENTER FACILITY CONDITION HEALTH INFORMATION TECHNOLOGY CAPACITY
13
FIGURE 7 STAFF HIRED BY HEALTH CENTERS IN THE PAST TWO YEARS
60% 50%
HEALTH PROFESSIONAL WHO TRAINED AT YOUR FQHC HEALTH PROFESSIONAL WHO TRAINED AT ANOTHER FQHC A VETERAN
40%
CURRENT OR FORMER PATIENT FORMER COMMUNITY HEALTHCORPS/AMERICORPS/VISTA VOLUNTEER PEACECORPS VOLUNTEER
30% 20% 10%
Note: 18% report “None of the Above” and 6% report “Do Not Know”. Totals do not equal 100% as repondents were asked to “Check all that apply.”
0%
58% 30% 30% 18% 10% 4%
14
30% 25% 9% 35% 35% 37% 32% 19% 16% 13% 8% 5% 12% 13% 11% FIGURE 8 WHERE HEALTH CENTER STAFF WORK AFTER LEAVING HEALTH CENTER
100% 90% 80%
FREQUENTLY OCCASIONALLY RARELY NEVER I DON’T KNOW
70% 60% 50% 40% 30% 20% 10% 0%
PRIVATE PRIMARY CARE PRACTICE HOSPITAL ANOTHER HEALTH CENTER/FQHC
15
16
FIGURE 9 TOTAL NHSC PARTICIPANTS BY PROVIDER TYPE, AND PERCENTAGE OF PARTICIPANTS AT HEALTH CENTERS
100% 90% 80% 70% 60% 50% 988 225 157 1,617 1,659 972 941 532 171 143 1,127 15 8,547
DENTIST
REGISTERED DENTAL HYGIENIST CERTIFIED NURSE MIDWIFE NURSE PRACTITIONER
PHYSICIANS PHYSICIAN ASSISTANT LICENSED CLINICAL SOCIAL WORKER
HEALTH SERVICE PSYCHOLOGIST
PSYCHIATRIST MARRIAGE AND FAMILY THERAPIST LICENSED PROFESSIONAL COUNSELOR
PSYCHIATRIC NURSE SPECIALIST
TOTAL
40% 30%
Source: NHSC data as of September 30,
Workforce, HRSA, DHHS.
20% 10% 0% 79% 78% 68% 66% 62% 60% 37% 29% 25% 20% 16% 13% 53%
!
Percent at health centers
17
18
FIGURE 10 PERCENT OF HEALTH CENTERS REPORTING KEY BARRIERS TO PARTICIPATING IN RESIDENCY TRAINING PROGRAMS
50% 40% 30% 20% 10% 0% 44% 33% 29% 27% 27% 23% 10% 8% 3% 3%
LACK OF FORMAL RELATIONSHIPS WITH AREA MEDICAL SCHOOLS AND/OR TEACHING HOSPITALS LACK OF SPACE BUDGETARY CONSTRAINTS OR INADEQUATE FUNDING LACK OF KNOWLEDGE IN HOW TO SET UP A HEALTH PROFESSIONS TRAINING PROGRAM COMPLEXITY OF SETTING UP RESIDENCY PROGRAM CONCERN ABOUT LOST PRODUCTIVITY OF HEALTH CENTER’S STAFF DUE TO TEACHING DISTRACTION FROM HEALTH CENTER’S SERVICE MISSION (E.G. PREFER TO FOCUS ON DIRECT CARE) CONTINUITY OF PATIENT CARE IN LIGHT OF RESIDENT TURNOVER PATIENTS’ PERCEPTIONS OF RESIDENTS Note: Includes respondents who indicate they do not participate in residency training programs (N = 151). Totals do not equal 100% as respondents were asked to "Check all that apply." MISALIGNMENT OF UNIVERSITY AND HEALTH CENTER MISSIONS AND/OR APPROACHES TO CARE
19
FIGURE 11
ORGANIZATIONS HOLDING THE ACCREDITATION FOR HEALTH CENTERS' RESIDENCY TRAINING PROGRAMS
80% 70% 60%
HOSPITAL/MEDICAL SCHOOL HEALTH CENTER OTHER CONSORTIA
50% 40%
Note: Includes respondents who indicate they participate in a residency training program (N = 348). Totals do not equal 100% as respondents were asked to "Check all that apply."
30% 20% 10% 0% 78% 22% 7% 2%
20
21
22