Additionally, OhioHealth is working to prepare physicians and other providers in this model of care through a partnership with Ohio University's Heritage College of Osteopathic Medicine. In 2014, the first group of 50 medical students began courses at the college's Dublin extension campus. The partnership expanded clinical, residency, and fellowship opportunities in central Ohio and through the OhioHealth system.
"They are a medical school whose history has been to support primary care, so we've worked very closely with them," Vanderhoff says. "Simultaneously, as we've worked to grow and expand the medical school class, we've worked with them to also develop training of some of
their advanced practice providers, very specifically, their physician assistant school."
The two organizations are also exploring similar work with the school's nurse practitioner program.
"The pipeline is a very important part that we have invested in. I think there's no question that we're going to need more physicians than we have been historically producing, but I would agree with the assessment that the solution involves developing care providers across multiple disciplines," he says.
OhioHealth hopes its commitment to team-based care will appeal to the providers who have trained in this collaborative care model.
"As we're going down the patient-centered medical home and the CPC+ journey, [we want to] hardwire that experience for our physicians through their residency training directly into our practices," Thornhill says. "If I'm finishing as a resident, and I know how it works in my residency program, I know if I go to another practice in OhioHealth, it will feel like that. It will have the same resources available."
Grow your own
Healthcare leaders at Fairview Health Services, a nonprofit health system with 11 hospitals and 56 primary care clinics in Minneapolis, recognize that investment in the clinician pipeline is essential to meeting the organization's needs.
"My point of view is there is both a skills shortage and a people shortage. What we're having to do to fill critical shortages—what we have to do to pipeline people in—it's a different game now," says Laura Beeth, system vice president of talent acquisition at Fairview. "We have to really balance our short-term recruitment with looking at incentives and sourcing, but we have to augment that with pipelines of really thought-out career pathways and academics."
At Fairview, this means prioritizing training for positions such as medical assistants, surgical techs, psychiatric associates, and nurses. The organization is doing this through registered apprentice programs, dual training, career pathways, local hiring strategies, and internship programs.
In 2015 and 2016, Fairview received two awards totaling $1,225,000 for apprenticeships grants from the U.S. Department of Labor to support 245 nurses and other healthcare workers to advance their careers, including moving from an ADN to a BSN.
To be recognized as a registered apprentice program by the DOL, programs must meet certain criteria such as 2,000 hours of on-the-job training, a progressive wage scale, and a specific number of hours of safety and training in addition to an academic credential.
"It can't just be they're learning something on the job. It has to be that they're getting a formalized credential, either a degree or something that has a test behind it, or a one-year program credential that's recognized nationally," explains Beeth. "We map out the competencies, and those competencies have to equate to that higher level of learning, higher level of wages, higher level of experience."
Currently, there are 126 employees in Fairview's apprenticeship programs.
Jennifer Thew, RN, is the senior nursing editor at HealthLeaders.