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Child, Elder Care Benefit Programs Succeed in Minimizing Healthcare Workforce Shortage

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It is common knowledge the health care industry is facing a workforce crisis due to an aging population and fewer primary care physicians and nurses entering the field. The American Medical News survey of hospital CEOs reports an 11 percent vacancy rate already for doctors, while a July/August 2009 report from Health Affairs states the U.S. nursing shortage is projected to grow to 260,000 registered nurses by 2025.

This workforce shortage is more than a pain point for the executives and HR managers who staff for them. It’s also taking a toll on current employees within health care organizations, impacting job satisfaction, and driving many health care providers to leave the profession. Personal life stressors, such as child care or elder care issues, also contribute to increased absenteeism, which can magnify the workforce shortages when there are fewer employees to cover shifts.

To solve this dilemma, many leading health care organizations have found success through a comprehensive work/life benefits strategy. Organizations today are working diligently to create a better work environment through increased flexibility in scheduling, sponsoring child care, backup care and providing assistance with elder care. These "care" benefit programs are proving invaluable in the fight to reduce absenteeism, help recruitment efforts of younger nurses and retain older, more experienced health care workers.

Reducing absenteeism by closing child care gaps for employees
"Family issues" accounted for 22 percent of unscheduled absences, according to the 2006-7 Unscheduled Absenteeism Surveys by CCH Incorporated. Unscheduled absenteeism costs some large employers an estimated $850,000 per year in direct payroll costs and even more when morale, temporary labor costs and lost productivity are added. By having on-site or near-site child care and backup care programs, health care facilities afford working parents access to reliable services on a daily basis, so they have fewer unscheduled absences.

HR managers often report that employees admit they feel more productive at work because they know their children are well cared for and nearby. Moreover, working mothers are less likely to leave their job to pursue other opportunities and more likely to return to work after the birth of a child because of the benefit.

Attract younger workers to the field
In July 2007, a report released by PricewaterhouseCoopers’ Health Research Institute found that average voluntary turnover for first-year nurses was 27.1 percent. Healthcare organizations seeking to attract and retain these workers—many of whom may be parents of young children –have found that near-site or on-site child care helps them achieve this goal. Many young job seekers consider work/life benefits such as this an important factor in their decision to join an organization. When they look for an employer, they are more likely to seek out organizations that understand the challenges employees face in trying to strike a healthy work/life balance.

A study by researchers at Simmons College found that at companies with on-site child care, 42 percent of employees cited child care as the reason they’d joined the company, and one out of five said they’d passed up an opportunity elsewhere because they wanted to keep their kids at the company center.

Retain experienced, highly-skilled workers by reducing elder care stressors
Baby-boomers are often referred to as the "sandwich generation," assuming responsibilities for taking care of grandchildren and aging or sick parents. One in four employees currently provides some kind of care for an elderly relative. And, a recent national study by the MetLife Mature Market Institute, the National Alliance for Caregiving and the National Center on Women and Aging found that to balance work and elder care duties, more than a third of these caregivers cut their hours. Further, nearly a quarter took a leave of absence, 16 percent quit their jobs and 13 percent retired early.

These statistics indicate a knowledge and experience gap that is getting harder to fill. For older, highly skilled workers, many forward thinking organizations are helping by providing information on local support services and resources available to help with elder care while the caregiver works. Still others host seminars and support groups to help co-workers deal with the legal and emotional issues that can arise and affect their work/life balance. By offering referrals to resources as well as flexibility in scheduling, health care facilities will likely retain more workers and build employee loyalty.

Cleveland Clinic minimizes employees’ worry about child care
A growing number of health care organizations are offering work/life benefit programs today including non-profits, and those associated with nursing or medical schools.

The Cleveland Clinic, a multi-specialty academic medical center headquartered in Ohio, is an employer of choice for more than 40,000 workers. It prides itself in developing what it calls the "Cleveland Clinic Experience," an atmosphere where employees are valued and rewarded with great benefits such as competitive base pay, wellness programs and a generous tuition reimbursement offering.

About six years ago it began offering employer-sponsored child care at their main campus in response to requests from nurses and other employees who wished for greater flexibility to visit their children during lunch hours and breaks.

While the center is open to the local community, Cleveland Clinic employees get priority enrollment and 80 of its families currently take advantage of the benefit. The center offers a customized solution for the hospital including extended hours of care, backup care, drop-in service and other programs such as a winter break backup program for school-age children. Moreover, the center provides child care services to patients’ visitors staying at the clinic’s hotel if part- or full-time care is needed.

The response from parents has been overwhelmingly positive according to Cleveland Clinic’s Mila Henn, Executive Director of Operations. "I’m constantly getting thank you notes from parents telling me how much they appreciate the center. Parents say they work more effectively knowing that their children are nearby and in a safe, loving environment."

Getting started: first, evaluate the need, then structure the program
Healthcare organizations considering offering child care programs as part of their work/life benefits should consider some initial steps to take. Oregon Health & Science University (OHSU) in Portland, Oregon, recently announced the intention of opening a near-site child care center in the fall of 2010.

For several years, OHSU knew there was a strong demand for a child care center based on frequent queries from current and potential employees and a 2008 survey of students and employees. Although they didn’t track reasons for absences, executives also suspected employees often stayed home because of sick children or because they didn’t have reliable day care. Child care and backup care, executives believed, would help reduce absences as well as the need for temporary help, and aid retention and recruitment.

As a first step, OHSU began the process of finding an experienced care partner by forming a Child Care Advisory Council to aid in the process. The council, representing a broad spectrum of employees, met regularly to review survey data, information they gathered on other organizations’ child care programs, and to evaluate providers based on the criteria they wanted to meet.

"Ultimately the vendor we selected had extensive experience in setting up unique, high-quality child care programs for other health care organizations nationwide," said Rick Bentzinger, Vice President of Human Resources. "Their corporate values aligned well with OHSU from an emphasis on creating a positive learning environment, to their experience and focus on eco-construction. On a practical level, the location they secured and the number of kids they could accommodate was favorable, and they could work with our funding needs."

Location of the child care center was a major factor for OHSU. Due to space constraints on its campus, building on-site wasn’t an option, nor was building a new facility because of the cost of real estate in the area. CCLC helped to locate a nearby building, secure a lease, develop remodeling plans, and devise a funding structure that fit well within OHSU’s financial parameters.

OHSU also conducted a more detailed survey later testing assumptions about likely use based on location for the center, programs available, tuition rates and hours of operation. Feedback was positive. More than 860 students and employees—representing 963 children—said they would likely enroll immediately.

OHSU is hopeful that by thoroughly assessing the need, involving employees early on, and working with an experienced child care provider their program will meet the needs of their employees, while reinforcing their positive reputation within the local community.

ROI for employers is clear
Recent studies estimate that providing backup child care for employees can cut employee turnover among users by as much as 23 percent, and a child care center could save as much as $500,000 annually in turnover costs—10 retained workers at $50,000 per worker. A typical return on investment for care giving benefits are estimated at least three to one.

The health care workforce is constantly changing and competition continues to be fierce; making it as important as ever to maintain a competitive edge, find and retain the best employees, and be seen as a great place to work. Offering work/life benefits that meet the needs of a diverse population of employees will not only reduce turnover and absenteeism, but make employees feel less stressed and more productive, enhancing the organization’s image as an employer of choice, and providing a good return on investment.

Fran Durekas is Founder and Chief Development Officer for CCLC. In this capacity, she provides executive leadership and support for new center openings, long-term strategy development for centers and client relations. She also assists with center design, construction and program recommendations. CCLC operates the Cleveland Children’s Academy for the Cleveland Clinic Foundation and is working with OHSU in developing their new on-site center in Portland, Oregon. For more information, e-mail

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