HOUSTON-While cowboys at the Houston Livestock and Rodeo Show wrestled with bucking broncos, corralled cattle, and roped steers, the members of the Health Professions Network (HPN) were wrestling with workforce issues, riding herd on accreditation, and trying to rope in public awareness of the allied health profession. Putting aside their individual agendas, the leaders of health care societies, educational institutions, credentialing bodies and government agencies met here at the Hilton Americas Hotel to collaborate on allied health care initiatives.
The 2004 HPN Spring Meeting, held March 11-14, provided an opportunity for members of the allied health profession to address common issues relevant to the provision of quality health care.
A major concern is the workforce shortage throughout the health care professions and how to attract more people into the field. Assuring the quality of the skills among those entering the field, as well as current practitioners, is another key issue. Attendees addressed credentialing and the accreditation standards of the educational institutions preparing professionals for careers in allied health.
HPN also is working to address the lack of understanding regarding the role allied health professionals play in overall health care. This lack of knowledge about allied health by the public, government and other health care providers aggravates the workforce shortage and affects funding for allied health initiatives.
"Workforce issues are critical because the baby boom generation will begin to turn 65 in 2013, and the demand for health care is going to mushroom for decades," said Daniel Olsen, of the Hennepin County Medical Center in Minneapolis, MN.
He advocated looking "outside the box" and working together to see how quality health care can be delivered in the future.
The American Society of Clinical Laboratory Sciences is planning a lobbying session in Washington, DC, to make the government aware of the problem, said past president Kathleen Hansen.
Workforce shortages are keenly felt by health care administrators who are unable to find enough qualified personnel to adequately fill current positions, said Mary Reitter, executive director of the American Healthcare Radiology Administrators.
As health care continues to evolve, credentialing will be an ongoing challenge, acknowledged Greg Morrison, executive vice president of the American Society of Radiologic Technologists. "We need to be proactive because the various professions will see massive changes in the next few years."
Assuring competency can be difficult because of the growth of certifications and the globalization of health care, said Sharon Goldsmith, director of certification, accreditation and education practice for the Plexus Consulting Group in Washington, DC. With more than 1,000 certification bodies in the United States and a move to outsource some services to foreign countries, it is sometimes difficult to determine the credentials of health care personnel.
Goldsmith is working with the American National Standards Institute (ANSI) and the Department of Labor to help institute new international standards and accrediting guidelines for certification agencies that will cross all fields.
The workforce shortage has increased the demand for foreign health care professionals, said Donna Richardson, JD, RN, director of operations and government affairs for the Commission on Graduates of Foreign Nursing Schools and the International Commission on Health Care Professions. The agency is charged with administering testing in 50 foreign sites. This allows Immigration Services to determine the qualifications of audiologists, speech-language pathologists, physical therapists, occupational therapists, nurses, LPNs, physician assistants and medical laboratory technologists hoping to work in the United States.
"ANSI is going to institute a new international standard of accrediting guidelines for certification agencies that will go across all occupations in health care," reported ANSI program director Roy Swift. "This standard was created because health care is now global; and people are coming into countries saying, 'I am certified to do this.' Countries don't know what the certification is and how it differs from licensure."
As a result, he said, "Terminology needs to be clarified, and certification agencies need to understand the international standards of accreditation as a certifying body. This is real progress because it is the first time the international community has recognized that certification is a major component of workforce development; and it is the way for a government, state or employer to determine whether people have the knowledge, skills and ability to perform in certain occupational specialties."
Another problem area targeted by HPN is how to retain workers while keeping health care affordable, stated Lynn Brooks, vice president of human resources for the American Society of Healthcare and Human Resources Administrators. Just getting people into the system is not enough; health care professionals need to pass on their passion for the work and implement strategies to prevent burn-out.
The government is aware of the problems facing allied health and has already launched some initiatives, reported Katherine Allen, from the Employment and Training Administration in the U. S. Department of Labor. She cited the High-Growth Job Training Initiative.
"Recognition and understanding of the problem are the first step," she said.
The Department of Labor is interested in working with the various health societies on the problems they face and informing the allied health community about available funding for annual workforce re-investment.
The High-Growth Job Training Initiative works through the "power of e3," referred to employment, economic development and education, Allen said. The initiative provides training programs for jobs that are in high demand at 1,984 career centers and 1,637 affiliates across the country. As one of the fastest growing fields, health care is one of the 12 sectors targeted by the initiative.
To help direct funding according to need, the government needs statistics and projections on the job market. To obtain this information the Health Resources and Services Administration turns to researchers such as Paul Wing, PhD, deputy director of the Center for Workforce Studies at the University of Albany.
More than one in 10 Americans work in the health care field, said Dr. Wing. The health care workforce is predominantly female, lacks diversity, and is aging. Among the factors contributing to shortages are educational system cycles and response lags, a rising demand, an aging population, increased career choices for women, non-competitive wages and benefits, increases in credential requirements, lack of respect, and increased intensity and complexity of services.
Solving the shortage, Dr. Wing said, involves working toward the following:
- an adequate supply of health workers,
- a more effective delivery system,
- better quality of care,
- more cost-effective care,
- increased worker satisfaction,
- information systems that work, and
- a more culturally diverse workforce.
As senior program associate for the American Association of Community Colleges, Carolyn Teich is interested in the projected needs of the allied health professions. One problem she encounters is a lack of faculty to educate the large number of students going through the current programs. This means there is a problem in the pipeline for teachers as well as for students.
However, there is hope for the future through the efforts of groups like the Health Occupation Students of America (HOSA), which makes students aware of the various health careers available.
"We are the pipeline to the health care worker shortage," commented Belinda Mahone, a high school science teacher who is past chair of HOSA. "We affiliate with over 70,000 high school students across the nation interested in health care careers."
The allied health field can benefit from recruiting displaced high-tech workers, said Paula Heggerick, past president of the Society for Vascular Ultrasound. "I get phone calls from highly educated people who cannot find work and are thinking about changing careers."
The Career of the Month feature on the HPN Web site is helpful in showing the variety of jobs available in allied health, she said. While many people are interested in allied health, educational opportunities are limited in some fields by a lack of sufficient clinical sites.
"People say they are too busy, but we have to convince them that clinical sites are important to our students," Heggerick said.
The allied health professions should work to increase knowledge and education, noted Desmond Coverley, MA, an assistant professor in the Division of Allied Health Sciences at Howard University, in Washington, DC, and a member of the National Society of Allied Health.
"For instance, at Howard University we are moving into the tier-one level. Therefore, all facets of the university must be involved in research grant-writing and all the rest," he said. "We need to keep up by involving those in the allied health programs in writing grants and articles and in doing research."
While the university had done a lot of work to develop a doctorate in cystopathology, the program was rejected, he noted. "Many universities are beginning to reject clinical doctorates."
With more insurance carriers requiring accreditation for reimbursement, accreditation is more likely to be the mechanism for quality assurance. The many educators and representatives of licensing bodies at the meeting discussed the challenges faced by the professions today and worked toward consensus-building on accreditation and educational standards.
In addition to workforce shortages and accreditation issues, many attendees cited the problem of gaining recognition for their members.
The National Consortium on Health Sciences and Technology Education is working in conjunction with HOSA to increase awareness of the allied health professions, said past president Don Richards. The organization is expanding its awareness efforts to include middle school students to let them know about potential careers in health care.
"It is amazing how little many students, parents and teachers know about health care professions," said Richards.
Most people only know about health professions that are featured in television shows, and many aren't aware that a vast majority of those fields have entry-level positions that can be entered after only two years of college, he said.
The advocacy committee of the Health Professions Network conducts a number of outreach efforts. An annual mailing of literature on allied health careers goes out to approximately 1,500 educators. In addition, 2,000 copies of a brochure on allied health is distributed at the National Science Teachers Association meeting.
The committee also sends promotional packets for Allied Health Week, which HPN created and sponsors, to provider organizations, accrediting bodies and educators. This year the advisory committee plans to target students in grades K-12 with a special brochure.
Finally, HPN is working to increase allied health representation on national and state health care commissions.
Joyce Ward is on staff at ADVANCE. She can be reached at firstname.lastname@example.org.