The aging of the U.S. population presents another challenge for health care organizations: an aging workforce. With the health industry already facing staffing shortages, a looming retirement boom could prove problematic.
Research by Lee Ann Runy
The graying of America presents a unique challenge for hospitals: They must address the needs of a general population that is getting older while also accommodating their own aging workforce. The number of Americans ages 65 and older will increase by 19 million between 2000 and 2020, according to a report by the Center for Health Workforce Studies at the University of Albany. With health care already facing staffing shortages, the prospect of mass retirements is chilling. The pipeline of new workers will not meet the demand. Hospitals will have to recruit and retain older workers to meet staffing needs. Every type of job will be impacted.
The good news is that retirement patterns are changing. About 69 percent of baby boomers plan to work past the traditional retirement age, according to AARP. And hospitals can take steps to better recruit and keep older workers, says Deborah Russell, AARP’s director of workforce issues. AARP in November received a $10 million grant from the Robert Wood Johnson Foundation to create the Center to Champion Nursing in America. The center aims to draw attention to the nursing shortage, secure more state and federal funding to expand nursing education and place more nurses on governing boards in hospitals to ensure their voices are heard.
Hospitals should look at workforce demographics and retirement patterns and develop a strategic plan. That should be done on a unit and department basis, says Ed Coakley, R.N., project director of the Aging Nurse Project at Massachusetts General Hospital in Boston. Many organizations may be surprised to learn that some units are made up primarily of younger employees while others are composed almost entirely of older workers. Judy Warmuth, vice president of workforce development at the Wisconsin Hospital Association, also advises hospitals to look at regional population projections. Some states, for example, are aging faster than others.
The next step is to develop benefits plans, schedules, jobs, support services and environmental changes that will attract and retain older workers. It’s important to solicit input from employees during this process through focus groups and surveys. “The message we want to send is that we value our older workers,” says Jeff Davis, senior vice president of human resources at Mass General. “We have to grow our own workforce because people are not moving to Massachusetts. We have to keep our existing workforce as long as possible.”
Jon Cecil, chief human resource officer at Lee Memorial Health System, Fort Myers, Fla., agrees. “In the past, we’ve watched seasoned, knowledgeable employees retire when they really didn’t want to retire,” he says. “They couldn’t handle the work. Now we have programs that help keep these employees on the job or place them in different roles.”
The process isn’t easy, notes Javon Bea, president and CEO of Mercy Health System, Janesville, Wis. “At first it can seem a daunting task to get out of the set routine of schedules, staffing and benefits,” he says. However, “if you put the effort in up front, it is worth it. We have kept people we would have lost in their early 50s. Our efforts have paid off.”
Providing greater benefits options, flexible scheduling and support services even helps attract and retain younger workers. “It’s surprising to us that the things we think will appeal to a small segment of our population appeal to the broader population,” says Vic Buzachero, senior vice president of human resources for Scripps Health, San Diego.
Key steps to recruiting & retaining older workers
Each year, the AARP recognizes 50 organizations for their best practices and policies to address aging–workforce issues through the AARP Best Companies for Workers Over 50 program. In 2007, 23 hospitals and health care organizations made the list. Here’s a look at key steps to addressing the needs of the aging workforce, along with best practices by four of this year’s winners.
| Lee Memorial Health System Fort Myers, Fla. |
Workforce stats • 35% of employees are 50+ • 50% of the hospital’s executives are 50+ • 14 years: The average tenure of employees 50+ |
| Massachusetts General Hospital Boston |
Workforce stats • 29% of employees are 50+ • 9% of the hospital’s hires in the last 12 months are 50+ • 15 years: The average tenure of employees age 50+ |
| Mercy Health System Janesville, Wis. |
Workforce stats • 30% of employees are 50+ • 15% of the hospital’s hires in the last 12 months are 50+ |
| Scripps Health San Diego |
Workforce stats |
1 -- Flex-scheduling
As workers near retirement age, many desire more flexible schedules to allow time for travel, family and other interests. Long shifts may be more difficult and strenuous for older workers as well. Providing alternative options for workers may keep them on the job longer. Examples include reduced shifts, job-sharing and seasonal months off.
• At Lee Memorial, employees can take advantage of a seasonal months-off program. The program offers up to six months off to full- and part-time workers during the slow season (typically the summer months). During the off-period, employees can continue to receive the same benefits at the same cost as when they are working.
• Mercy Health allows employees ages 55 and older to work seasonally for 1,000 hours a year at their discretion while maintaining benefits.
• Massachusetts General offers nontraditional scheduling, such as four- and six-hour shifts, to older nurses and job-sharing opportunities.
2 -- Phased retirement
Phased retirement programs allow workers to gradually reduce their hours of employment without losing their benefits. Many older workers do not wish to leave work entirely but want more flexibility.
• Employees at Lee Memorial can work as few as 16 hours a week and still be eligible for benefits.
• Scripps Health altered its retirement plans to assist workers nearing retirement. Under its 401(a) plan, older workers can make catch-up contributions or in-service withdrawals from their accounts.
• Mercy Health’s phased-retirement plan allows workers ages 50 and older to reduce the number of hours worked while maintaining benefits.
3 -- Benefits
In addition to providing benefits to part-time workers, these organizations offer a host of benefits that appeal to older workers. One-size-fits-all benefits programs often provide few incentives for older workers to remain on the job and might even encourage early retirement.
• Scripps Health created a retirement health savings plan to help employees pay for health benefits when they retire. The organization created a 401(h) plan that complies with Internal Revenue Service regulations. The plan allows employees to make tax-free contributions as long as the funds are used to cover the cost of retiree health benefits.
• Lee Memorial provides a variety of benefits for retirees pre-65 and 65 and over. These include individual medical and drug coverage, individual and spouse long-term care insurance and individual and spouse life insurance or other death benefit coverage.
• After suggestions from employees, Massachusetts General’s health plan now covers hearing aids, an item typically not covered under health plans.
4 -- Mentoring
Mentorship programs provide older workers a sense of value while allowing colleagues of different generations to share their experiences and knowledge. Social interaction is often cited as one of the reasons older workers tend to stay on the job; mentorship programs can nurture meaningful relationships.
• Massachusetts General this month launches a program that will pair younger nurses with older nurses to facilitate mentoring and reverse mentoring.
• Scripps Health created a clinical mentorship program, which included full-time nurse mentorship positions.
• At Mercy Health, older nurses are valued for their knowledge and empathy in the treatment of older patients. They serve as role models to younger workers regarding the emotional, physical and clinical needs of older patients. Members of the Mercy Retiree Association may serve as mentors throughout the organization.
5 -- Alternative roles
To retain older workers, organizations may have to create more suitable roles for them. That enables employees to continue working and use their skills in less stressful and strenuous positions.
• Lee Memorial has one staff member over age 90 and four between the ages of 80 and 89. These employees serve as patient-sitters, supporting clinical staff by keeping watch over patients who need monitoring.
• Managers and supervisors at Mercy Health offer employees an opportunity to develop new skills by working temporary assignments in other departments and through a formal job rotation program.
• Steps to Success, a training program at Massachusetts General, provides employees support with career changes.
6-- Wellness
Maintaining the health of the workforce is critical regardless of age group. Wellness programs can help older workers cope with some of the physical stresses of the job as well as age-related issues.
• As part of a comprehensive health management program, Lee Memorial this year will begin providing free medications to employees with hypertension, diabetes and high cholesterol.
• Scripps Health offers an on-site massage therapy program to help employees cope with stress and tension. Employees receive six free 15-minute chair massages per year.
• Massachusetts General offers a host of wellness programs, including a Be Fit program that provides personal training and nutritional guidance to employees.
7 -- Environment
Environmental changes can reduce the strain on health care workers. Changes in lighting, flooring and patient assignments are examples that can improve the work environment for older workers.
• Scripps Health employs lift teams at all locations and acquired lifting aids for positioning patients. Ergonomic evaluations are available for all staff.
• Lee Memorial installed mechanical lifts to help reduce the physical strain on workers.
• At Mercy Health, the occupational therapy department performs more than 280 workstation ergonomic evaluations a year and assists with modifications. The Low Lift program expands the use of assistive lifting devices to help nurses move patients.
8 -- Recruitment
Hospitals need to actively recruit and rehire older workers to meet their staffing needs. Older workers bring a wealth of knowledge and experience to the work environment, in addition to filling open positions.
• Senior placement agencies help Scripps Health target mature workers and retirees for employment. The Scripps Alumni Network maintains an ongoing relationship with former employees and recruits them back to the organization. Retirees are offered temporary work assignments, consulting and contract work, telecommuting and full- and part-time work. Retirees are also encouraged to fill volunteer positions at the organization.
• Mercy Health uses e-cards and direct mail and sponsors booths at senior job fairs to recruit workers. The organization taps its retired workforce to make employee recommendations.
• Massachusetts General works with Operation A.B.L.E., a local nonprofit organization that provides training and employment services for older workers to help identify potential hires.
9 -- Support services
Benefits and flexible scheduling options play an important part in recruiting and retaining older workers. But hospitals can develop creative ways to address the needs of their aging workforce, both inside and outside of the workplace. Older workers often cite social interaction and camaraderie as reasons to continue working. And support services can help workers cope with issues that may prevent them from working or could distract them on the job.
• The Seniors Health Activities Resource Education Club at Lee Memorial, known as SHARE, targets employees ages 50 and older. The free club offers health screenings, luncheons, cafeteria and gift shop discounts, a computer learning center, medical claims filing assistance and discount prescription and vision programs. The club offers social activities and education sessions that include retirement planning and medication awareness. Retirees are eligible for membership.
• Mercy Health offers a Senior Connection program that arranges senior activities, brown bag lunches and trips. Mercy Health also provides a concierge service to assist workers with such everyday tasks as dry cleaning, film development, gift purchases, car care and reservations.
• Mass General offers a host of programs to its older workers, including eldercare monthly discussions, “single again” financial seminars and cumulative grief programs. Child care is available to employees with grandchildren, and elder care services are also available.
10 -- Training and education
Training and education can help older workers refresh their skills, learn new skills and explore different career options.
• Lee Memorial provides a nurse refresher program, along with $1,000 in reimbursement for books and tuition.
• The Return to Work program at Scripps Health provides individual assistance to workers, including an assigned, on-site nurse care manager to help keep the employee engaged and ensure the success of the employee’s job accommodation or disability recovery.
• Mercy Health offers a sabbatical leave program that allows long-term employees to take time off for charity work, social improvement and religious activities, or to further their education.
How We Did It: This gatefold was produced by researching published studies and articles and conducting interviews with industry executives.
Research: Lee Ann Runy I lruny@healthforum.com
Design: Chuck Lazar I clazar@healthforum.com
This article 1st appeared in the January 2008 issue of HHN Magazine.
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