Florida's Workforce Shortage: Remedy for the Future of Care

00:00:00:07 - 00:00:19:08
Tom Haederle
Welcome to Advancing Health. Florida's high proportion of older health care patients are being cared for by an aging health care workforce as well. Hear what one farsighted caregiver is doing to train younger workers and keep the people needed to meet future health care needs.

00:00:19:10 - 00:00:41:07
Elisa Arespacochaga
Hello, I'm Elisa Arespacochaga, AHA’s group vice president for clinical affairs and workforce. I'm delighted to be joined today by Nikki Daily, chief team resources officer at BayCare Health System in Florida. Today, we're going to be talking about how BayCare has developed partnerships, both inside their organization and with their community, to strengthen and grow their workforce for now and well into the future.

00:00:41:07 - 00:00:46:03
Elisa Arespacochaga
So, Nikki, thanks for joining me. And can you tell me a little bit about your role in BayCare?

00:00:46:10 - 00:01:09:16
Nikki Daily
Sure. Well, I'm very happy to be here. Again, I'm Nikki Daily, I'm our chief team resources officer. We are a large academic health system in west central Florida. I have been with the system 28 years, so this topic is very near and dear to my heart, being that I spent my career and have experienced and benefited from workforce development programs.

00:01:09:21 - 00:01:34:00
Elisa Arespacochaga
That's wonderful. It's always nice to have someone who's been through the programs, but also then helping to give back and develop them. Now we know that the demographic challenges that are coming at us as healthcare, as everyone trying to support the workforce with an aging workforce, increasing number of community members seeking care. How did you were you looking at this for BayCare and for your community?

00:01:34:02 - 00:02:00:27
Nikki Daily
Being in Florida, we're feeling this pinch quite acutely. We have over 1,000 people moving into Florida every single day, and 20% of those people are over the age of 65. At the same time, our workforce is aging. 13% of our team members are over age 60. And we do know that fewer people are coming into the workforce. So really coming up with programs that will allow us to fill those gaps.

00:02:00:27 - 00:02:16:03
Nikki Daily
At the same time, having those team members who are working towards retirement have a plan and a program to hand off that knowledge that they've gained was really important to BayCare as we were formulating our workforce strategy.

00:02:16:05 - 00:02:34:08
Elisa Arespacochaga
I know you looked at building programs both inside BayCare with the team you have, as you mentioned, but then also looking for ways to support your community and keep folks local, but also support those folks who are local to your community in advancing their careers. How did you manage to address both at the same time?

00:02:34:10 - 00:02:59:06
Nikki Daily
It is a partnership and a collaboration from all angles. So building workforce programs that one, meet the business needs and also focus on supporting the communities that we serve was really essential. The first thing that we look at is meeting those team members where they are. So we need to make sure these workforce development programs start at a level where they feel it's attainable and can grow.

00:02:59:08 - 00:03:28:16
Nikki Daily
Understanding the capabilities we have within the organization and having really good relationships with community partners, be it other workforce development programs, colleges, technical programs is essential to making this happen. A really great example is a surgical tech apprenticeship that we are just getting ready to launch. It's been in development for quite some time, but it is closing a gap for surgical texts, which there are a shortage of.

00:03:28:19 - 00:03:50:09
Nikki Daily
Also, it requires partnership with a local technical college, building programs and having preceptors within our organization. And it allows team members to continue to grow and become surgical techs without having to leave the workforce. They can do this on their job. We're really focusing on those programs that meet all the needs together.

00:03:50:12 - 00:04:07:22
Elisa Arespacochaga
I love that, and especially I mean, you can have the greatest surgeons in the world, but if you don't have the O.R. ready, if you don't have those support team members available and ready to join the workforce and continue in growing their own careers, those surgeons aren't going to be able to do what they need to do.

00:04:07:24 - 00:04:34:10
Elisa Arespacochaga
Absolutely. So I know you have built a series of approaches because of course, there's no one workforce approach. One is your surgical tech program. But can you tell me a little bit about the work you've done to work with your current team members and say, those in maybe entry level positions that might want to grow into something else, and how you've adapted all of the resources you offer to those needs.

00:04:34:18 - 00:04:58:24
Nikki Daily
Absolutely. So we've worked really hard to develop career pathways, and those are really roadmaps that show our team members each step that they need to take to get to what their dream job may be. And we've done this in both clinical and non-clinical fields. Something like food and environmental services, which are a very common entry level job in our organization,

00:04:58:24 - 00:05:21:25
Nikki Daily
we provided career pathways that show what knowledge and skills they need to grow to other roles. We even noticed through that work that we had a gap with helping people get a high school diploma. They can get that first level job without a diploma, but if they wanted to grow, they needed a high school diploma. So we just introduced a high school diploma program where we've graduated 31 team members.

00:05:21:27 - 00:05:50:01
Nikki Daily
We also have within nursing, for example, different pathways because every person's journey is different. Some may start as a patient care tech and go right into nursing school. And they can. We have earn as you learn programs which help support training. Also understanding not everybody can leave the workplace to get their education. So it supports that. We also have pathways where some people might want to be a practical nurse first.

00:05:50:01 - 00:06:00:14
Nikki Daily
So we have partnerships with technical colleges and we have that journey as well. And then it takes them into internships and ultimately becoming a registered nurse.

00:06:00:20 - 00:06:27:13
Elisa Arespacochaga
I love that you've got these pathways, and then you're supporting your team members in helping them work through what's the right path for me, what are the options and how can I continue to do the job that I'm doing but also move forward? Can you tell me a little bit about  - it doesn't sound like there is a typical trajectory - but what would a trajectory look like for one of your trainees, and how they can then start to look at that portfolio of options available to them?

00:06:27:16 - 00:06:45:16
Nikki Daily
There isn't any one path, but typically we look at what that entry level role might be. Sometimes we get phone calls from people through our recruiters who are looking to get into healthcare, and we would pry. So if they ultimately want to be a nurse, they haven't had any experience or exposure, we might make them a nurse helper.

00:06:45:16 - 00:07:10:14
Nikki Daily
So that puts them on a patient care unit. They get to watch and observe what the team, the care team is doing and how they do their work. So from that nurse helper job, some might decide to go into a patient care tech. Others through that may have gotten exposure to other positions like imaging, radiology techs, respiratory therapists and decide to take those journeys as well.

00:07:10:14 - 00:07:36:13
Nikki Daily
So from there, that's where those career pathways are really important, because it would show them if that person decided they wanted to be a radiology tech. We have technologist assistants that they could take that nurse help or the skills that they learned there, and then move over and become a technologist assistant while they prepare for imaging or radiology school or what their next step might be.

00:07:36:20 - 00:07:56:14
Elisa Arespacochaga
I love that that you really are looking for ways to stack those credentials and just add to their knowledge base, and not have to go back and start at the beginning for the next level of schooling. Can you add a little bit of color on the non-clinical pathways? Because I think we have a lot of folks are looking for what are those clinical pathways

00:07:56:14 - 00:08:06:13
Elisa Arespacochaga
and certainly we need every clinician we can get. But what are some of the roles where I don't think most people think are in hospitals that you've been working on?

00:08:06:15 - 00:08:34:25
Nikki Daily
Yes. It takes every type of role to contribute to making our health care system successful. A lot of people want to work in healthcare but not be a clinician. So we do have pathways in areas like registration. So it really is important, I think, as people are looking at a career in healthcare or a hospital system, they have transferable skills like customer service, computer skills, organization skills.

00:08:34:25 - 00:09:12:21
Nikki Daily
So we see a lot of people come in to registration positions or billing positions, and from there they start to gain that knowledge and that experience. We can have pathways that show them how they can, if they really love that work, how they can grow those skills, expand them and move into leadership, or if they are looking to grow those skills and move into another area, things like registration and the skills that you learn there can transfer into medical offices, in a medical office rep position and other forward facing roles that we have.

00:09:12:23 - 00:09:34:06
Elisa Arespacochaga
Let's talk a little bit about how you involved your team and those departments that you worked with in building these programs, and especially attacking the culture that that may not be so open sometimes, but really creating a welcoming community to new roles, new team members, to training people. How did you accomplish that?

00:09:34:08 - 00:09:58:10
Nikki Daily
So first and foremost, our culture is so important to us. We are recognized as a top workplace. We are very passionate about having the right people who want to work here. We want to first ensure we get the right people. We really do work together. We have engaged our leaders. We have educators within our department and educators in the community, as well as program graduates.

00:09:58:10 - 00:10:23:13
Nikki Daily
We want to hear back from people who have been through the program to understand what works, what doesn't work, what we may need to do to evolve and change as we're putting together the programs that we need. Sometimes you have to publicize the work we're doing. A great example that Maria is our amazing manager of workforce development, who is really the person behind a lot of these programs. She said

00:10:23:14 - 00:10:55:24
Nikki Daily
digging into the data, we saw dosimetrists, which is a job where we don't have that many of them, but over half of them are preparing for retirement. Well, we weren't aware of that. You know, she and the leader have connected. They're having conversations about what we can do to now put a focus on ensuring we have a pipeline to either grow people into that or partner with colleges and universities where we can do internships and bring people, introduce them to our organization so we can ensure that we fill those gaps.

00:10:55:24 - 00:11:00:15
Nikki Daily
So really, it's that constant partnership and collaboration.

00:11:00:18 - 00:11:16:14
Elisa Arespacochaga
That's awesome. So what advice do you have to those who are listening about how to both build internally, but then reach to your communities to encourage people to apply into the system and show them that these pathways exist?

00:11:16:16 - 00:11:40:18
Nikki Daily
Absolutely. My advice is to start looking at the job board, to go to career fairs. So BayCare has career fairs where we invite people from the community to come in. There are recruiters present. There are leaders present over different areas so they can have conversations and learn about those roles. And don't make assumptions that you have to come in already knowing what to do.

00:11:40:19 - 00:12:00:03
Nikki Daily
That's what these programs are for. We want people to not come to BayCare for a job, but to understand they really can grow into their full career. So understand what your skills are and what you're good at, and some transferable skills you may have. Start to apply for roles that you qualify for, but then understand once you get in the system,

00:12:00:03 - 00:12:06:03
Nikki Daily
we have so many programs to help you grow and support you to move into your dream job.

00:12:06:10 - 00:12:12:27
Elisa Arespacochaga
I love that. Anything I didn't ask about your programs that you want to make sure to share for our listeners.

00:12:13:04 - 00:12:35:20
Nikki Daily
It's something we're very, very proud of. It is a continuous effort and journey. We look at the data every single quarter. We're always looking at developing and evolving our workforce strategy. And it really is a partnership and a desire from all levels. It can't be run just by team resources. We need that buy-in a partnership from the departments.

00:12:35:20 - 00:12:46:25
Nikki Daily
We need to have great relationships with our community partners to ensure that we're having these people trained and have the opportunities to grow into these really important, critical health care careers.

00:12:46:26 - 00:13:04:24
Elisa Arespacochaga
Well, Nikki, thank you so much for sharing the work that you are clearly very passionate about and all of the amazing work at BayCare that you've done to grow and keep and really encourage your team members to live up to their fullest potential in healthcare. I really love that we have such a strong community at your organization.

00:13:05:00 - 00:13:07:18
Nikki Daily
Thank you so much. I appreciate you having me.

00:13:07:20 - 00:13:16:14
Tom Haederle
Thanks for listening to Advancing Health. Please subscribe and rate us five stars on Apple Podcasts, Spotify, or wherever you get your podcasts.