Increasing concerns about quality of care and workforce shortages have motivated health care organizations and educational institutions to partner to create career ladders for frontline health care workers. Career ladders reward workers for gains in skills and knowledge and may reduce the costs associated with turnover, improve patient care, and/or address projected shortages of certain nursing and allied health professions. This study examines partnerships between health care and educational organizations in the United States during the design and implementation of career ladder training programs for low-skill workers in health care settings, referred to as frontline health care workers. Mixed methods data from 291 frontline health care workers and 347 key informants (e.g., administrators, instructors, managers) collected between 2007 and 2010 were analyzed using both regression and fuzzy-set qualitative comparative analysis (QCA). Results suggest that different combinations of partner characteristics, including having an education leader, employer leader, frontline management support, partnership history, community need, and educational policies, were necessary for high worker career self-efficacy and program satisfaction. Whether a worker received a wage increase, however, was primarily dependent on leadership within the health care organization, including having an employer leader and employer implementation policies. Findings suggest that strong partnerships between health care and educational organizations can contribute to the successful implementation of career ladder programs, but workers' ability to earn monetary rewards for program participation depends on the strength of leadership support within the health care organization.
Bibliographical noteFunding Information:
The National Evaluation of the Jobs to Careers: Transforming the Front Lines of Health Care conducted by University of North Carolina at Chapel Hill was funded by the Robert Wood Johnson Foundation 61026 with supplementary funds from the Hitachi Foundation . The first author's efforts were supported by funding from the Agency for Healthcare Research and Quality ( T32HS00032-23 ) and the National Institute on Aging ( T32AG000272-06A2 ). The authors would like to thank Thomas R. Konrad, Melissa Mann, Ashley Rice, Brandy Farrar, and Kendra Jason for their assistance in collecting the data used in this study. We would also like to thank the anonymous reviewers of this manuscript for their pointed feedback and guidance.
© 2014 Elsevier Ltd.
Copyright 2014 Elsevier B.V., All rights reserved.
- Career ladders
- Community colleges
- Frontline health care workers
- Fuzzy set qualitative comparative analysis
- Health care workforce
- Innovation implementation
- Workforce development