Introduction: An academic medical center in the Midwest has experienced steady growth in ambulatory clinic visits. Our staffing model relied heavily on RNs and LPNs, which did not allow top of license work for the RNs. Certified medical assistants (CMAs) were identified as a versatile and largely untapped role that could be introduced into the ambulatory care mix. Statewide statistics however, showed a limited talent pool of LPNs/CMAs. A program to GROW our own CMA talent was the identified solution for both turnover and vacancy concerns.

Methods: The Health Care Institute (HCI) was created to reduce the use of RNs and LPNs in roles that are within the CMA skills set, reduce vacancies, and invest in development and retention of internal high potential employees.

The goals were:
• Identify high potential current employees and sponsor them to become qualified for the CMA role.
• Reduce labor costs.
• Create career pathways.
• Meet the needs of our patients today and in the future.

The first cohort of five employees began online classes in November of 2015. MUHC covered all costs of the program and provided a scholarship to cover the 8-week unpaid externship in our ambulatory care clinics. After successful completion of the program (8 months) and externship (8 weeks), candidates were placed in a clinic and had 12 months to become certified. Two additional co-horts of Grow Your Own (GYO) employees followed a similar plan beginning in spring and fall of 2017.

In August of 2017 the program was expanded to include a pilot high school graduate co-hort called Health Care Support Trainees (HCST). MUHC partnered with area public schools and a local higher education institution for this program. The goals were to develop students who traditionally might not be able to attend college and to partner with a local higher education institution to create a collaborative approach for content and scheduling. The effort allowed the educational institution to create a model that is being shared with other health care organizations.

Results: A total of 31 GYO and HCST students have successfully completed the CMA training program. We currently have 16 HCST and 3 GYO who have started online classes and 10 other GYO students who are in externships. Recruitment is underway for a new co-hort of GYO students that will start in January 2019.

The combined vacancy rate of LPN and CMA improved from 44.11 prior to the start of the program to 5.34% in October 2018. LPN turnover has decreased from 16.9% to 12.28% and CMA turnover has decreased from 38% to 13.8%. In addition, use of simulation increased comfort with select skills from 37.5 % pre-training to 79.5% post-training.

Jeanette Linebaugh MSN, RN, OCN

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