Need Assesment Data
Introduction
Northeast Oregon AHEC, in partnership with Cascades East
AHEC and Oregon Health Sciences University School of
Nursing at Eastern, contracted with Regional Services
Institute at Eastern Oregon University in La Grande to
conduct a census of the health care providers in the two
AHEC regions. The intention of the census was to assess
professional education needs of health care providers and
to explore current and future health care workforce
issues. The professionals surveyed were located within
the Oregon counties of Baker, Crook, Deschutes, Gilliam,
Grant, Harney, Jefferson, Klamath, Lake, Malheur, Morrow,
Sherman, Umatilla, Union, Wallowa, Wasco, and Wheeler.
The information collected will be used in program
planning for continuing education and career advancement
training for health care providers; to improve support
for health professional students in training in Central
and Eastern Oregon and to strengthen current health
careers education for Oregon's youth.
Methodology
Regional Services Institute (RSI) purchased mailing lists
from licensing boards and commissions to develop a
database of all licensed health care professionals in
Central and Eastern Oregon. This database served as the
mailing list for the four survey tools developed (see
appendix). The survey tools were targeted toward
different professions with questions that pertained
specifically to that group. The four surveys were
targeted toward employers, physicians, nurses, and allied
health. Within the allied health group, 16 different
professions were targeted.
There were three mailings sent to each of the four
groups. The first mailing included a questionnaire and
letter explaining the purpose of the survey; the second
mailing was a thank you/reminder postcard; and the third
mailing was an appeal letter and a second questionnaire.
The source of the mailing lists, mailing dates, and
response rates are displayed in the chart on the
following page. Dates for the initial mailing were varied
for each of the professions because lists became
available at different times and required work to convert
to a common database.
Census Summary
Following is a summary of the comments and general trends
indicated by attached data. The information is
categorized into three areas consistent with the order of
the questions. Following each narrative is a bulleted
list of action items.
The census covered all eastern Oregon counties and
encompassed over 12,000 health care providers. However,
when doing decision making or program planning based on
findings in this census, remember that the response rates
represented less than one-half of the providers who are
in this area. The overall response rate to the survey
was: employers 35.5%, physicians 17.8%, nurses 26.7%, and
allied health 39.8%.
Workforce Issues
Employers, physicians and allied health professionals
were asked to identify any unmet workforce needs (see
table in Appendix D). A shortage of mental health
professionals were mentioned by employers, physicians and
allied health. Some professionals were general in listing
mental health shortages but others specifically indicated
a shortage of psychiatrists and counselors. This
reinforces data collected in a 1995 NEOAHEC mental health
survey. People responding to this question repeatedly
indicated a concern for the lack of access to mental
health services as well as medical services.
Allied health professionals indicated a strong support
for more nurses and physicians. Most of the comments
listed specialists but there were no consistent numbers
in any specialty groups. They also indicated more
physical therapists are still needed. Employers selected
physical therapists as their top choice for hiring within
the next five years though didn't indicate there was a
shortage when asked about unmet health profession needs.
Prior assessments done by NEOAHEC showed a need for
physical therapists (PT). This assessment shows a
continued strong interest in recruiting PTs.
Dieticians were listed as a top choice by physicians to
contract or hire within the next five years but were not
on the list of unmet workforce needs. This is new
information that had not surfaced in previous studies.
Employers were strongly interested in
employing/contracting with dieticians, occupational
therapists, radiologists and physical therapists.
Licensed pharmacists and pharmacy technicians were high
on the list of needed professionals according to the
allied health group and employers. Pharmacists responding
to our survey from several years ago had also indicated a
future need for licensed pharmacists and pharmacy
technicians.
It is important to note, when asked about their
retirement plans, 37% of the physicians responding were
planning on retiring within the next ten years. Consumer
comments concerning physicians not taking new patients
along with the loss of these physicians could
significantly impact the access to medical treatment in
the near future.
Recommendations for NEOAHEC are to:
- share information with mental health partners about the shortage of mental health professionals, physicians interest in contracting with mental health professionals, and the comments about the lack of access to mental health services
- continue to include mental health as a priority profession facilitate focus groups involving physicians, mental health professionals, and consumers
- analyze data to better understand the demand for counselors and psychiatrists and then use to develop strategies to impact the need
- learn how the mental health system works so we can understand the access problems
- continue to research and advocate for physical therapy distance education programs in eastern Oregon
- to continue our recruitment and retention efforts for physicians and other needed health care providers
Employers and
physicians were asked about employing or contracting with
nurse practitioners and/or physician assistants.
Employers showed more support than physicians. Neither
employers nor physicians indicated a shortage of NPs or
PAs. Employers and physicians were also asked about
employing or contracting clinical nurse specialists. The
interest seemed to be less than in NPs or PAs. Part of
this may be due to the fact that there are fewer of them
in the region; employers and physicians may not yet
understand their potential.
Recommendations for NEOAHEC are to:
- study the future job market of NP and PA students
- be honest with prospective students about the job market if the future demand is limited
- identify further sources on valid data about the need for PAs
- consider our role in encouraging employers to examine the value PAs can contribute to their programs
- find additional data sources about employer demand for NPs and utilize that in determining the extent and nature of support strategies for NP education
- educate physicians concerning the benefits of interdisciplinary practices
- encourage and support interdisciplinary clinical rotations for students
- reassess the need for clinical nurse specialists in two to three years
- explore the attitudes of physicians towards utilization of PAs and NPs
- find physicians who currently utilize NPs or PAs to serve as models for other physicians
Education Issues
Employers, physicians, nurses, and allied health
professionals were asked to rate their preference for
delivery methods of education. Responses varied widely
across the choices, except for employer responses.
Employers clearly prefer Ed-Net. Nurses and allied
preferred video tapes but our past experience has
indicated that utilization is small.
Recommendations for NEOAHEC are to:
- continue working with instructors and students to find the best form of delivery for the particular topic
- work toward achieving diversity in educational delivery
Employers are very
interested in employing bachelor degree nurses. Nurses
were strongly interested in advancing to bachelor and
master level nursing. We can anticipate a need for more
associate degree nurses to become bachelor degree nurses
in the near future. Employers and nurses are strongly
interested in advancing their clinical skills. However,
employers' opinions on the skills needed differed from
nurses' opinions'. Of the nurses desiring to pursue a
masters degree there was a strong interest in combining
two specialty areas. The largest areas of interest were
public health/community and family nursing.
Recommendations for NEOAHEC are to:
- further discuss with employers the skills they feel are important for BS RNs and jointly plan with them the best way to meet those skills in preparing new students and upgrading the current workforce
- explore the educational opportunities available to NEOAHEC in providing BS RNs with continuing education services
Employers and
physicians showed strong support for their staff to
receive continuing education. Nurses and allied health
chose clinical topics as their top priority which is
consistent with our 1993 allied health assessment. Allied
health professionals were very interested in educational
programs for career advancement (43.6%). Their comments
indicated they wanted clinical topics within their field
that would advance their skills. Radiologists, physical
therapists, paramedics, respiratory therapists,
dieticians, occupational therapists and dental assistants
were the most interested. Over 50% of the respondents
within each of these groups indicated they were
interested. These professions are already on our list of
priority professionals to serve with education.
Recommendations for NEOAHEC are to:
- be sure that OHSU School of Nursing at EOU has looked at the nursing census and is aware of the skills employers are wanting RNs to have, plus the potential for more RNs entering their programs
- investigate the gap between the indicated shortage of mental health professionals and the lack of RNs interested in entering mental health fields at the masters level
- recognize there is still a continued market for AHEC educational offerings that include career advancement as well as continuing education
- to continue working with small groups of professionals to help define topics for continuing education
Health Career Issues
Employers, physicians and allied health professionals are
very interested in mentoring and presenting to youth.
This could be due to the fact that many are home grown
professionals. This information is useful in encouraging
youth: they too can become a health care professional.
Some nurses were interested but the low numbers could be
due the nature of the work performed by nurses which does
not always lend itself to serving on outside committees
and mentoring youth.
Recommendations for NEOAHEC are to:
- provide documentation to funders and others about the value of educating and encouraging youth to pursue health careers
- publish a directory for those who are willing to present and/or mentor
- provide the directory to schools, extension service, JTPA programs and others involved in careers education for youth
- educate all health care professionals about our purpose and programs for growing our own health care professionals
- educate health professionals about the concept of mentoring
For a complete
copy of the report, please click here.
