Cincinnati Children’s Hospital
Medical Center
Project
SEARCH -- An Employment Approach Based on Community Collaboration
Cincinnati Children's Hospital Medical
Center is dedicated to providing the highest level of pediatric care to
meet the medical needs of infants, children and adolescents. Children's
Hospital is recognized nationally for excellence in diagnosing and
treating complex pediatric diseases. They are committed to bringing the
very best in family-centered medical care to the children they serve
from the local community as well as to those who come from around the
country and the world. The center employs over 7,000 people in support,
clinical care, teaching, and research capacities.
Motivating Forces
Seven years ago, Erin Riehle, clinical director of the Emergency
Department at Children's Hospital, had a revelation. She had been
struggling to solve a performance problem that plagued the efficient
operation of the ER department that involved restocking supplies in a
timely and dependable manner. It was no problem to fill these
entry-level jobs with students and other part time workers hoping to
pursue careers in health care professions, however, their turnover was
continuous due to the repetitious nature of this task, though critically
important, restocking of ER supplies was not valued nor reliably
performed.
Then,
Children's adopted a major diversity initiative in
their hiring practices. As a supervisor of a large department, this initiative would
be an important directive for Erin. At this same time, Erin saw that
Children's had adopted a policy statement from the American College of
Healthcare Executives which reads, "Healthcare organizations must lead
their communities in increasing employment opportunities for qualified
persons with disabilities and advocate on behalf of their employment to
other organizations." She recognized that virtually every child with a
disability is a customer at Children's at some point in their growing
years, yet they encountered almost no role models with disabilities
among the staff they saw.
Putting these factors together, she realized that the solution to her
staffing problem could also help fulfill the diversity mission of her
hospital in a more complete way. And so, the idea for Project SEARCH was
born--a program that would provide employment for individuals with
significant disability barriers to employment.
Developing Collaboration with
Community Partners
Erin realized that the hospital would need community partners to achieve
her goal of bringing people with significant developmental disabilities
such as mental retardation into the Emergency Department to fill these
jobs as productive employees. The two collaborating partners are Great
Oaks Institute of Technology and Career Development, a public human
services agency that serves people with disabilities, and Hamilton
County Board of Mental Retardation and Developmental Disabilities. Great
Oaks is a very large career and technical school, serving 36 school
districts and preparing more than 6,000 youth in full and part-time
programs per year. The Hamilton County MR/DD Board provides educational,
vocational, coordination and residential services to adults and children
with mental retardation and other developmental disabilities. More than
10, 000 participants are currently involved with the MR/DD Board.
These partners recognized Children's Hospital as a highly desirable,
large local employer with good jobs in a wide array of vocational areas
that would result in a win-win situation for all. The partners committed
themselves to providing staff who would be devoted to this employer and
become truly knowledgeable about the work site. In addition, there was a
commitment to provide training and support services that will enable
carefully selected and motivated candidates to perform successfully and
reliably the necessary functions of identified jobs.
How Does It Work?
Project SEARCH is located at Children's Hospital. Staff are provided by
each organization, with Erin directing the overall program as Director
of Disability Services. There are now several pathways for young people
with disabilities in this program, including training programs in health
care occupations and a transition to work program for high school
students. But the payoff for the hospital is the employment program that
started it all.
The partner agencies assist in preparing and screening their
participants to meet several eligibility requirements (e.g., social and
communication skills, independent in self care, able to take direction,
desire to work) to enter the program. Program staff identifies open
positions and analyze the tasks and demands of these jobs to match with
program participants who are qualified to perform them. After
coordinating the hiring process, program staff provides support on the
job to these new employees.
"The key to our program is having the professionals from the Great Oaks
Institute of Technical and Career Development and Hamilton County Board
of Mental Retardation and Developmental Disabilities working on site",
Riehle explains. "All the managers know them and they know the jobs and
what it takes to succeed in them." All of the employed individuals
report to their department supervisors, like traditional employees. But
in addition, follow-along services assist the worker in resolving
problems and adapting to changes that may seem minor or embarrassing for
supervisors to address (scheduling special transportation, dealing with
co-worker requests, hygiene), yet can lead to termination for these
workers if effective and knowledgeable support is not provided.
Each participant receives up to 8 hours of follow-along services per
month of employment from program staff dedicated to the program site.
Thus, the amount of staff allocated to the site increases with the
number of people placed in employment. This keeps the program cost
effective for the agencies and adequately staffed to meet the needs of
the employer and the workers.
Results Achieved
Currently, more than 70 people with significant developmental
disabilities are working as employees of Children's through this
program, with two staff providing on-the-job support services to these
individuals. On average, these individuals have been employed for five
years and earn an average wage of over $8 per hour. Most are working an
approximately 32 hours per week and receive full benefits. These
employees work in a wide range of positions, often overlooked for people
with development disabilities. Many of these require mastering complex
functions, yet they are routine in nature, such as sterilization tech,
department sticking, lab courier, and clinical support staff.
"We see the program as a valuable recruitment source and retention
solution for us", explained Lori Southwood, Director of HR for
Children's. "They are extremely proficient in what they do. They have
helped us fill positions in different ways; so that work that was not
getting done, or done well, has been turned into jobs that can be done
by these folks, and is being done much better than before. At first you
expect many hurdles. We have learned that perception is the hurdle.
Employers need to experience it once and then they will see. When there
is a disciplinary or performance problem with an employee in the
program, the support structures that are in place and the resources are
made immediately available to the supervisor to correct and resolve the
rare problems that occur. Some of these jobs are critical to patient
safety and these employees are prepared to focus on them with a greater
level of attention and precision than was achieved before."
Cindy Jackman, Clinical Director for a large patient care unit, provides
another example. Supply carts were purchased to keep at patients'
bedsides, so RNs could provide more direct care rather than spending
valuable skilled time running back and forth for supplies. As in the ER
Department, the people hired to stock these inventories were typically
students hired part-time who were not interested in this work or
attendants who were already too busy. In both cases, the task took a
back seat, and therefore, this effort to have nurses function more
efficiently did not work.
With students trained and hired through Project SEARCH, a much higher
level of task completion and accuracy has been achieved. Employees
obtained through the program have resulted in greater efficiency and far
less frustration for the nursing staff. "We value the quality and
support of the program staff, the excellent attitude and job performance
of these employees, and their capacity to adapt to changes in our work
routine. While the program staff is available to support these staff, we
attempt to integrate these employees into every aspect of unit life as
regular members of our team."
Because of the federal funds Children's receives as a research
institution, they have a significant obligation for Affirmative Action.
"This program gives us an exciting way to fulfill our plan", says
Southwood. "We are really breaking through barriers, extending our
commitment to diversity and affirmative action in a way that sends a
message to all levels of employees and the young patients we serve. Now,
every aspect of our operation uses these staff."
"We are bringing our mission alive", adds Jackman. "We do value what
everyone brings to the world and we include them in our work force. It
is important for parents of our patients to see what's possible for
their own children when they see these staff working in responsible
positions, and it is important for our traditional staff to see that we
have a role in preparing these children for real roles in the world."
"This experience has also opened our eyes to interesting ways to meet
new needs we will have", explains Southwood. "With our partners we are
learning how we can provide training in small doses while people are
employed to prepare them to advance and fill future needs. Rather than
lament shortages in certain occupational areas, we are learning to "grow
our own", helping people advance while they are working here, in ways
that are compatible with their schedule and builds on their
achievements.
Conclusion
From the employer's point of view, the program has been enormously
successful by improving performance in high-turnover, entry-level
positions such as the ER stocking jobs. The Project SEARCH employees
have also had a low rate of absenteeism and been rated highly for their
work ethic, accuracy, and enthusiastic attitude. The program has helped
the Hospital achieve its diversity objectives and has resulted in
extensive local and national acclaim for its efforts. And the
collaborative model has benefited its community partners and their
participants in achieving their objectives, as well.
"Our program uses a business model", explains Riehle. "We provide a
single conduit for organizing and delivering employment services, in
collaboration with the community, and deliver them in an effective and
accountable way as an integrated part of the work site. It is an
appealing model to employers and it works." Large employers like
Children's are approached by many agencies representing people with
disabilities and other disadvantaged job applicants. Businesses have
little understanding of who these agencies are and why so many of them
are coming to their workplace. Businesses, especially in the health care
environment, are focused on security, access to parking, and other
issues that make it desirable to have less people walking in and out of
their facility. They want external partners to facilitate the business
conduct and professional functioning of the employer organization and
its staff with the people it serves.
Other hospitals and employers around the country have begun requesting
consultation from Project SEARCH to adopt this win-win model in
collaboration with community partners. The program has demonstrated
multiple and sustained benefits for the employer and the customers it
serves, for the people hired, and for the community.
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