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Presentation Outline. Background: Public Health Workforce Task Force Nurses in the Public Health WorkforceChanges to the State Sanitary CodeDeveloping Continuing Education Opportunities. Background. 2001: NYS Public Health Council appoints Public Health Infrastructure Workgroup to assess state's
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1. State Sanitary Code Changes affecting Public Health Nursing Sylvia Pirani, MPH, MS
Director, Office of Public Health Practice
New York State Department of Health
2. Presentation Outline Background: Public Health Workforce Task Force
Nurses in the Public Health Workforce
Changes to the State Sanitary Code
Developing Continuing Education Opportunities
3. Background 2001: NYS Public Health Council appoints Public Health Infrastructure Workgroup to assess state’s public health system
2003: Workgroup releases report on Strengthening New York’s Public Health System for the 21st Century
Focuses on workforce, organizations and systems and Information Technology
Recommends that “a statewide public health training task force be convened”
4. Background 2005: NYS Public Health Workforce Task Force formed to focus on four issues:
Recruitment
Retention
Education and Training
Leadership Development
2006: Task Force releases Roadmap and establishes nine key strategy areas
5. Task Force Key Strategy Areas Strengthen academic/practice partnerships
Strengthen workplace policies and procedures
Assess leadership skills
Define workforce competencies and gaps
Market public health careers to college age students
Market public health careers to adults and mid- career professionals
Locate and advocate for new resources
Hire staff with right skills and provide career development opportunities
Implement workforce development programs
6. Enumeration of Public Health Workforce Conducted by Center for Health Workforce Studies in collaboration with NYS DOH and NYSACHO in 2006
32/58 local health departments participated
18 full service, 14 without environmental health
N = 2078 In efforts to strengthen the public health workforce, the New York State Public Health Council appointed the Public Health Infrastructure Work Group in 2002, and then the Public Health Workforce Task Force in 2005 to identify strategies to fortify the system. Since its inception, the Workforce Task Force has been working to address recruitment, retention, training education and leadership.
In 2006 A Statewide enumeration of all Local Health Departments was conducted by the Center for Health Workforce Studies, in collaboration with the New York State Department of Health (DOH) and the New York State Association of County Health Officials (NYSACHO).
Goal of the enumeration was to produce a detailed description of local public health workers and to understand how health workers’ composition, roles, educational backgrounds, and training needs affect the organizational capacity of Local Health Departments in New York to perform essential public health services.
In efforts to strengthen the public health workforce, the New York State Public Health Council appointed the Public Health Infrastructure Work Group in 2002, and then the Public Health Workforce Task Force in 2005 to identify strategies to fortify the system. Since its inception, the Workforce Task Force has been working to address recruitment, retention, training education and leadership.
In 2006 A Statewide enumeration of all Local Health Departments was conducted by the Center for Health Workforce Studies, in collaboration with the New York State Department of Health (DOH) and the New York State Association of County Health Officials (NYSACHO).
Goal of the enumeration was to produce a detailed description of local public health workers and to understand how health workers’ composition, roles, educational backgrounds, and training needs affect the organizational capacity of Local Health Departments in New York to perform essential public health services.
7. Formal Job Titles of LHD Employees (n=1930) Source: University at Albany School of Public Health Center for Workforce Studies Enumeration of the Local Public Health Workforce
in New York: 2006;
N = 1930
Nursing = 24%
Support Personnel = 25%
Administration = 16%
Other = 7%
Scientific Investigation = 14%
Education/Outreach = 9%
Other clinical (incl. MD) = 4
Epi/disease control = 2%Source: University at Albany School of Public Health Center for Workforce Studies Enumeration of the Local Public Health Workforce
in New York: 2006;
N = 1930
Nursing = 24%
Support Personnel = 25%
Administration = 16%
Other = 7%
Scientific Investigation = 14%
Education/Outreach = 9%
Other clinical (incl. MD) = 4
Epi/disease control = 2%
8. Formal Job Titles of LHD Employees Group While Nurses represent 24% of all local health department employees, the represent almost half of all employees in “part service” LHDs and less than 20% in full service. While Nurses represent 24% of all local health department employees, the represent almost half of all employees in “part service” LHDs and less than 20% in full service.
9. Specific Job Titles of LHD Employees in Nursing Jobs Employees in Nursing job titles most commonly described themselves as public health nurses (29%), while relatively few described themselves as community health nurses (9%). Twenty five percent responded their specific title as other registered nurse, and a small number reported they were nurse practionners
Employees in Nursing job titles most commonly described themselves as public health nurses (29%), while relatively few described themselves as community health nurses (9%). Twenty five percent responded their specific title as other registered nurse, and a small number reported they were nurse practionners
10. Recruitment 2007 survey of county civil service agencies found that 23 of 30 agencies responding reported recruitment challenges related to public health personnel
Agencies expressed difficulty recruiting for 25% of their positions.
Highest concentration of recruiting difficulties found in nursing professions, esp. in four titles:
Registered professional nurse
Public Health Nurse
Community Health Nurse
Supervising Public Health Nurse Municipal Service Division of the NYS Department of Civil Service conducted email survey in 2007, at our request.
Recruitment difficulty for 599 positions out of 2260 total positions reported as existing in their agencies
Municipal Service Division of the NYS Department of Civil Service conducted email survey in 2007, at our request.
Recruitment difficulty for 599 positions out of 2260 total positions reported as existing in their agencies
11. Recruitment Only 9 of 23 agencies provided reasons for recruitment difficulties. These are:
Salary
Educational Requirements for Position
Other Job Criteria including Experience requirement
Location of Agency
12. Retention Median age of local public health worker is 49, compared to median age of U.S. civilian worker of 40.
Public Health Nurses have median age of 50.
62% of local public health workers are between the ages of 45 and 64
Almost 20% of local public health workers report plans to retire within next five years.
Source: Center for Health Workforce Studies. 2007. New York State Public Health Workforce Enumeration Survey
13. Marketing Strategies
Establish comprehensive web-based clearinghouse on public health careers http://www.nyhealth.gov/prevention/public_health_works
Conduct survey of public health students to guide future strategies in supporting the public health pipeline
Conduct survey of recently hiring SDOH employees to guide future marketing efforts
14. Public Health Works! Website
17. Task Force Key Strategy Areas Strengthen academic/practice partnerships
Strengthen workplace policies and procedures
Assess leadership skills
Define workforce competencies and gaps
Market public health careers to college age students
Market public health careers to adults and mid- career professionals
Locate and advocate for new resources
Hire staff with right skills and provide career development opportunities
Implement workforce development programs
18. State Sanitary Code Changes NYS DOH revised definitions and minimum qualifications for key public health professionals to ensure they:
Reflect up to date professional job descriptions and qualifications
Address training needs
Support career ladders
19. SSC Code Changes Revise definition of Public Health Nurse and Supervising Public Health Nurse to reflect role in population health as well as individual patient care
Maintain requirement for public health nurses to have BSN LHDs benefit from having Bachelor’s prepared nurses because the BSN provides training in population and community health, and the training to work independently, while an RN degree does not.LHDs benefit from having Bachelor’s prepared nurses because the BSN provides training in population and community health, and the training to work independently, while an RN degree does not.
20. SSC Code Changes “The term public health nurse 1 shall mean a nurse who plans, provides, directs and evaluates nursing care in a variety of settings with the goal of improved health outcomes and [offers instruction and guidance in health practices for] is actively involved in the planning, development, provision and evaluation of public health programs designed to prevent disease and improve the health of individuals, [and] families, specific populations, high risk groups and/or communities.” LHDs benefit from having Bachelor’s prepared nurses because the BSN provides training in population and community health, and the training to work independently, while an RN degree does not.LHDs benefit from having Bachelor’s prepared nurses because the BSN provides training in population and community health, and the training to work independently, while an RN degree does not.
21. SSC Code Changes Add new job definition: Public Health Nurse 2
In addition to working with individuals, groups and families to improve health in the community, a public health nurse 2 will administer programs, develop program budgets, and lead monitoring and/or quality care initiatives
Provides career ladder to retain public health nurses with experience in LHDs LHDs benefit from having Bachelor’s prepared nurses because the BSN provides training in population and community health, and the training to work independently, while an RN degree does not.LHDs benefit from having Bachelor’s prepared nurses because the BSN provides training in population and community health, and the training to work independently, while an RN degree does not.
22. SSC Code Changes “The term public health nurse 2 shall mean a nurse who plans, provides, directs and evaluates nursing care in a variety of settings with the goal of improving health outcomes and is actively involved in the planning, development, provision and evaluation of public health programs designed to prevent disease and improve the health of individuals, families, specific populations, high-risk groups and/or communities. The public health nurse 2 is also involved in program administration and/or program budget development and monitoring and/or quality improvement initiatives, and/or acting as advocate and liaison for constituents.” LHDs benefit from having Bachelor’s prepared nurses because the BSN provides training in population and community health, and the training to work independently, while an RN degree does not.LHDs benefit from having Bachelor’s prepared nurses because the BSN provides training in population and community health, and the training to work independently, while an RN degree does not.
23. SSC Code Changes Require Public Health Nurse 2 and Supervising Public Health Nurse to complete 15 hours of continuing education in public health topics approved by the DOH within their first year of employment in each position.
Topics can include education about supervision At a focus group meeting with over two-thirds of the LHDs represented, public health nurse managers voiced their overwhelming support for a continuing education requirement to ensure nurses obtain additional public health nursing training, including training for supervisors, when they are on the job. On-the-job training can improve employee satisfaction and assist in retention of staff. At a focus group meeting with over two-thirds of the LHDs represented, public health nurse managers voiced their overwhelming support for a continuing education requirement to ensure nurses obtain additional public health nursing training, including training for supervisors, when they are on the job. On-the-job training can improve employee satisfaction and assist in retention of staff.
24. Developing CE Program for PHNs Discuss typical work activities for each PH Nurse title
Identify most important core competencies for public health nurses in these titles
Identify on-line and in person courses related to those competencies that public health nurses could complete to comply with this requirement.
Create new programming to address gaps
25. Quad Council Competencies 8 Domains
Analytic Assessment Skills
Policy Development/Program Planning Skills
Communication Skills
Cultural Competency
Community Dimensions of Practice Skills
Basic Public Health Science Skills
Leadership and Systems Thinking
Financial Planning and Management Skills
3 Levels
Awareness
Knowledge
Proficient
At previous summit, a workgroup took on the task of examining the Quad Council competencies
Obtained information via survey to identify those competencies that should be taught in Schools of Nursing versus those that could be learned on the job.
At previous summit, a workgroup took on the task of examining the Quad Council competencies
Obtained information via survey to identify those competencies that should be taught in Schools of Nursing versus those that could be learned on the job.
26. Typical Job Duties – PHN 1 Assesses health status, resources and risk factors of community/population to determine priorities for targeted interventions
Works with communities to develop/deliver targeted health promotion and disease prevention activities
Participates in assessing and evaluating health care services to ensure people are informed of programs and assisted in utilization of services
Provides health education, care management and primary care to individuals and families
27. Add’l Typical Job Duties – PHN 2 Assists in development of policy and programs to address health concerns in community
Recommends strategies to meet identified community needs
Assists in preparation of program budgets
Conducts studies and or evaluation of qualify of health department programs
Acts as liaison with community groups
28. Typical Job DutiesSupervising PHN PHN 1 or 2 duties, plus supervisory responsibilities
29. How Well Prepared are BSN Nurses? Workgroup #2 examined issues related to public health practice setting and links to BSN Education. Obtained information via survey to identify those competencies that should be taught in Schools of Nursing versus those that could be learned on the job.
Question #3:
Competencies were assessed within the context of population focused practice.
Analysis revealed the following:
LHD BSN new hires are not proficient in any competency
LHD BSN new hires have knowledge in the following three areas
Thinking: 67%
Cultural competency: 64%
Communication: 60%
LHD BSN new hires have no knowledge for 2 competencies: Policy Development and Financial Planning
LHD were almost evenly divided on BSN new hires having between no knowledge and knowledge for 3 competencies: Planning, Management and Leadership.
Question #4:
When asked to rate the importance of these competencies for the practice setting, the LHD rated the highlighted areas in order of importance. The top 4 are:
Thinking abilities
Communication skills
Cultural Competency and Community Dimensions tied for third place and
Analytic Assessment & Planning skills tied for 4th place.Workgroup #2 examined issues related to public health practice setting and links to BSN Education. Obtained information via survey to identify those competencies that should be taught in Schools of Nursing versus those that could be learned on the job.
Question #3:
Competencies were assessed within the context of population focused practice.
Analysis revealed the following:
LHD BSN new hires are not proficient in any competency
LHD BSN new hires have knowledge in the following three areas
Thinking: 67%
Cultural competency: 64%
Communication: 60%
LHD BSN new hires have no knowledge for 2 competencies: Policy Development and Financial Planning
LHD were almost evenly divided on BSN new hires having between no knowledge and knowledge for 3 competencies: Planning, Management and Leadership.
Question #4:
When asked to rate the importance of these competencies for the practice setting, the LHD rated the highlighted areas in order of importance. The top 4 are:
Thinking abilities
Communication skills
Cultural Competency and Community Dimensions tied for third place and
Analytic Assessment & Planning skills tied for 4th place.
30. How Important are These Competencies? Preliminary data indicate that there are essential skills for public health nursing practice which BSN graduates are not well prepared and skills which can be learned on the job.
Of the competencies that BSN New Hires were judged to be knowledgeable about, THINKING SKILLS and COMMUNICATION, the LHD thought these skills were of high importance and essential to the job.
One Competency, CULTURAL COMPETENCY that BSN new Hires were judged to be knowledgeable about, the LHD PHNs were evenly divided on whether they thought this skill was of medium importance and could be learned on the job or it was of high importance and essential to the job.
The other five competencies (PLANNING, MGMT SKILLS and LEADERSHIP, ANALYTIC ASSESSMENT, and COMMUNITY DIMENSIONS OF PRACTICE) were all judged to be of medium importance and could be learned on the job.
Of the 2 competencies that BSN New Hires were judged to have no knowledge in FINANCIAL PLANNING and POLICY DEVELOP, the LHD PHNs thought these skills were of medium importance and could be learned on the job.Preliminary data indicate that there are essential skills for public health nursing practice which BSN graduates are not well prepared and skills which can be learned on the job.
Of the competencies that BSN New Hires were judged to be knowledgeable about, THINKING SKILLS and COMMUNICATION, the LHD thought these skills were of high importance and essential to the job.
One Competency, CULTURAL COMPETENCY that BSN new Hires were judged to be knowledgeable about, the LHD PHNs were evenly divided on whether they thought this skill was of medium importance and could be learned on the job or it was of high importance and essential to the job.
The other five competencies (PLANNING, MGMT SKILLS and LEADERSHIP, ANALYTIC ASSESSMENT, and COMMUNITY DIMENSIONS OF PRACTICE) were all judged to be of medium importance and could be learned on the job.
Of the 2 competencies that BSN New Hires were judged to have no knowledge in FINANCIAL PLANNING and POLICY DEVELOP, the LHD PHNs thought these skills were of medium importance and could be learned on the job.
31. Top Three Recommendations From Practice to Academia Increase the amount of time students spend in the public health clinical arena
2. Stress with students the distinct difference between community health and public health nursing
3. Develop an educational component to the community health course that focuses on population-based practice and public health nursing in the LHDs
Approximately 37 recommendations were received from 21 responders. The top three recommendations were:
Increase the amount of time students spend in the public health practicum – 24%
The distinct difference between community health and public health nursing should be stresses – 16%
Develop a cognate to the community health course that focuses on public health nursing in LHDs – 11%
Although not an overwhelming voice for change, these recommendations serve as a jumping off point for further discussion.
(#3 will change color after clicking…this is to provide a sag way into to development of training) So you can say something like…..which bieng us to the next steps relating to this topicApproximately 37 recommendations were received from 21 responders. The top three recommendations were:
Increase the amount of time students spend in the public health practicum – 24%
The distinct difference between community health and public health nursing should be stresses – 16%
Develop a cognate to the community health course that focuses on public health nursing in LHDs – 11%
Although not an overwhelming voice for change, these recommendations serve as a jumping off point for further discussion.
(#3 will change color after clicking…this is to provide a sag way into to development of training) So you can say something like…..which bieng us to the next steps relating to this topic
32. Next Steps Identify already existing courses or on-line training that could be used to provide these 15 hours
Identify gaps
Who can volunteer to review existing training?
Who can volunteer to conduct new training?
Let’s discuss: typical work activites for each title PHN1, PHN2, and Supervisor
The most important core competencies for 15 hours (You can refer back to slide looking describing the importance of the competencies)
What courses or online training could be used to provide these 15 hours
Who can help volunteer to do the training?
Let’s discuss: typical work activites for each title PHN1, PHN2, and Supervisor
The most important core competencies for 15 hours (You can refer back to slide looking describing the importance of the competencies)
What courses or online training could be used to provide these 15 hours
Who can help volunteer to do the training?
33. Contact Information Sylvia Pirani
Director, Office of Public Health Practice
New York State Department of Health
Corning Tower, Empire State Plaza
Albany, NY 12237
sjp03@health.state.ny.us
phworks@health.state.ny.us