Project Summary

Responding to the region’s shortage of skilled workers in patient care, the Baltimore Alliance for Careers in Healthcare brought together local agencies, health care institutions, and other organizations to create opportunities for frontline workers to advance to higher-skilled, high-demand positions.

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“Part of the culture of this hospital is that you can learn on the job and
progress to a higher level. That’s the whole foundation of our pipeline
programs. The idea is that we, as an employer, have an obligation to
help those people move on.”
—Nurse Manager, Good Samaritan Hospital
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Frontline employees at Good Samaritan Hospital and the University of Maryland Specialty Hospital participated in a two-track training project to fill a shortage of frontline patient care workers and build a pathway to higher-skilled careers in nursing. Non-clinical staff, including dietary, transportation, and environmental services workers, trained to become certified nurse assistants. After working on the job for at least six months, CNAs could complete additional training and an internship to become patient care technicians, also known as nurse extenders. Workers who participated in the project either started with track 1 and progressed to track 2 or, if they were if already CNAs, began with track 2.

Training consisted of classroom instruction for eight hours per week during work time. Workers also gained first-hand experience in patient care by shadowing nurses and completing work tasks on the hospital floor. Community College of Baltimore County faculty partnered with the hospitals to develop three work-based learning modules: tracheotomy, urinary incontinence, and ostomy. Workers who did not initially have the prerequisite skills for the program participated in a hospital-based academic bridge course to increase their reading comprehension.

Supervisors, most of them registered nurses and licensed practical nurses, supported frontline workers through career and life coaching and mentorship. They helped workers cope with life issues (e.g., balancing work and family demands, improving time management skills). Supervisors also assumed the role of preceptors who trained workers through work-based learning assignments.

The Community College of Baltimore County offered a one-time, four-hour course to train mentors, coaches, and preceptors. BACH also established monthly peer learning sessions for training the coaches. These sessions focused on support systems, best practices, resources for learning, training opportunities outside of the Jobs to Careers project, and interactive scenarios for new employees. BACH encouraged health care providers and philanthropic organizations to pool funds to scale up the career coaching available to hospital workers.

In addition to the patient care training project, BACH mapped career ladders in five hospitals, illustrating how lower-skilled workers can advance to higher-paying jobs.

Training Outcomes

  • 55 frontline workers enrolled in the certified nurse assistant training track; 48 completed the program and became CNAs, providing bedside care and assisting patients with activities of daily living (e.g., dressing, eating, bathing, toileting).
  • 48 workers enrolled in the patient care technician training track; 34 completed the program and became PCTs, taking on such tasks as delivering meals, transporting patients, and taking vital signs. They increased their hourly wages about $4, to an average of $13.
  • Nearly 600 workers across six hospitals received coaching services.
  • 120 staff members in the participating hospitals completed training to serve as volunteer mentors for frontline workers.

Benefits to Frontline Employees

  • Participants received ongoing career coaching and mentoring support as they continue their careers in health care.

Benefits to Employers

  • Good Samaritan converted a work unit from certified nurse assistants to patient care technicians, enabling overburdened nurses to delegate responsibilities and workloads safely to newly trained workers.
  • Staff retention improved at the hospitals, as did job performance among workers receiving career and life coaching.

Changes to Institutional Practice

  • Good Samaritan revised its tuition reimbursement policy to include noncredit coursework.
  • Good Samaritan and University Specialty Hospital issued $2 per hour raises to workers who completed the training program.
  • Project partners are seeking to standardize the job description and training requirements for patient care technicians across all hospitals in Baltimore.
  • The Community College of Baltimore County is developing a work-based learning program to train ward clerks at one local hospital, and it now offers an abbreviated CNA course that is more manageable for working adults.