A critical shortage of surgical technologist creates collaboration between rivals

AORN Journal,  March, 2005  by Elizabeth Weindorfer,  Brenda G. Larkin

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On Dec 5, 2003, 21 new surgical technologists graduated from the first collaborative Aurora-Covenant Surgical Technologist Training Program in Milwaukee and prepared to take their place in the demanding and exciting world of perioperative services. The program offers an example of how an innovative venture can positively affect a community's health care system.

ADDRESSING A NEED

It is common knowledge that the availability of technically skilled, professional health care personnel is dangerously low. For example, a Wisconsin Hospital Association report on the health care workforce projects a 35% increase in need for surgical technologists between 2002 and 2012. (1) In January 2000, a Minnesota Hospital Association report showed that although seven surgical technologist education programs graduated 86 students in May 1999, 57 hospitals still reported a 3.7% vacancy rate. (2) Based on this, a six-suite OR would be able to use only five rooms for eight hours and a sixth room for only 6.4 hours on a day shift.

In Florida, the surgical technology specialty is growing at an annual rate of 6.2%, but the technical schools cannot produce enough students to meet demand. (3) The Milwaukee metropolitan area is no exception. Four major health care conglomerates compete for health care business from Milwaukee-area residents. The competition is exhibited by aggressive advertising campaigns, community outreach programs, open houses, and promotional gifts that are designed to attract individuals and groups to these organizations. The organizations also compete for health care personnel at all levels, providing incentives such as tuition reimbursement and sign-on bonuses.

Despite this competitive climate, two major health care systems in the Milwaukee area, Aurora Health Care and Covenant Health Care, put their rivalry aside to solve the pressing issue of a surgical technologist shortage. Aurora Health Care and Covenant Health Care staff members collaboratively drafted a proposal to begin a surgical technologist school and submitted it to the Private Industry Council (PIC) of Milwaukee County, a partnership between government and business that plans, administers, and coordinates employment and training programs in Milwaukee County. Shortly thereafter, the PIC awarded $300,000 to finance this endeavor. That is when the real work began.

PROGRAM PLANNING

A steering committee of Aurora Health Care and Covenant Health Care representatives convened to begin planning and developing the surgical technologist training program. The committee consisted of two OR directors (ie, one from each system), managers from hospital sites, clinical nurse specialists (CNSs) from Aurora Health Care, nurse educators from Covenant Health Care, and human resources (HR) specialists from each system.

The work of the steering committee members was multifaceted. First, they developed a mission statement--to internally prepare and graduate competent surgical technologists with entry-level, industry-recognized competencies. The mission statement reflected the philosophy of the PIC program and integrated the missions and values of both health care systems. The PIC's philosophy is to partner with private industry to coordinate employment and training programs for Milwaukee County. The partnership's mission is to develop solutions to the local and regional health care workforce crisis through the creation of innovative industry-related employment and training programs. They also created a student handbook that incorporated HR policies and system-specific issues from both systems, providing students with a resource for HR and employment issues. The student handbook contained the strict guidelines developed by steering committee members regarding grading, attendance, and behavior. A subcommittee was formed to develop criteria for student selection, and another subcommittee began to develop the educational program.

STUDENT SELECTION AND PROGRAM STAFFING

Student selection was a major undertaking. The HR representatives from both systems met to establish the selection process. The PIC is an organization dedicated to workforce development in underserved populations; thus, there were stringent guidelines for participant eligibility. The PIC required that

* students have an income no greater than 300% above poverty level;

* students be residents of Milwaukee County; and

* male students be registered for selective service. (4)

An applicant's family size was factored into the income calculations. The two hospital systems added further criteria for candidate selection. Another factor in the selection process was that total class size would not exceed 26 students--13 from each system. All students would be selected from a pool of current employees who were interested in advancing from their current position into a career track position.

Openings in the surgical technologist program were posted and advertised according to each system's standards. Human resources personnel were solely responsible for interviewing the candidates and for determining through behavioral interviewing techniques which applicants would qualify for the program. The applicant group was limited by strict adherence to the PIC grant criteria. Furthermore, applicants had to meet their system's existing policy requirements for transferring to a new position (eg, not currently in a disciplinary situation, no attendance issues).