Hawaii education system offers key link to solving the health workforce crisis

Hawaii’s health system continues to face dual strain from the COVID-19 pandemic and a significant workforce shortage. A recent report from the University of Hawaii (UH) John A. Burns School of Medicine found a statewide shortage of up to 1,000 physicians—a deficit the report says would be “difficult to manage” even without the pandemic preventing providers from working full-time.

 

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Dubbed by one doctor as the “most hostile health environment to practice in,” Hawaii’s low reimbursement rates relative to cost of living, aging workforce, and compound health taxes also continue to drive the provider shortage. 

The dilemma has spurred not only the creation of the Hawaii Physician Shortage Task Force, but concentrated recruitment efforts in the state’s health education systems. Lisa Radak, Dean of Health Academic Programs at Kapi’olani Community Colleges, said care facilities are not the only places feeling the impacts of the workforce shortage.

“From an educational standpoint, the barriers we have right now are attracting qualified [faculty members]. We cannot attract or find instructors who are able [to teach] because there is a shortage. They’re staying out in industry where they’re needed.”

To respond to both the public health crisis and bring more people into the health workforce during the pandemic, the UH system and Kapi’olani Community Colleges have worked in conjunction with the Department of Health (DOH) to create contact tracing and community health worker programs. Over 500 contact tracers and 130 community health workers have completed their training as of late 2021.

Ensuring that recruitment efforts were as widespread and diverse as possible were key to the programs’ development. According to Radak, the community health worker program received an additional grant from DOH to specifically increase recruitment from the neighboring islands.

“We realized that community health workers are the ones who are going to be out in the communities, boots-on-the-ground, supporting folks.”

The recruitment efforts also included matching program acceptance rates from each county zip code to their percentage of the state population and partnering with local high schools to provide the training through English as a second language (ESL) courses.

Another solution included a training program for people looking to transition to new jobs. For example, Hawaii’s leisure and hospitality sector lost nearly 35,000 jobs due to the pandemic, according to the Hawaii and Budget Policy Center. UH Community Colleges (UHCC) worked with the City and County of Honolulu to provide subsidized job training opportunities, according to UHCC Associate Vice President for Academic Affairs Tammi Oyadomari-Chun

“These were more entry-level openings and short term training. People would transition from whatever their pre-pandemic employment was into different health care occupations.”

So far, the program has trained hundreds of participants to fill certified nursing assistant (CNA), pharmacy technician, phlebotomy, and patient services jobs. 

The education system is also thinking of more long-term solutions as well, such as strengthening the health education to workforce pipeline. John White, the health workforce liaison for UHCC, said even with targeted recruitment and retention efforts they haven’t “created the kind of output that we would like to have.”

“[We’re] thinking about, ‘Why is that?’ and trying to develop root causes. Then [we’ll] see if we can go both back into the colleges and forward to the employees and figure out if there is something to adjust or address that’s going to help these folks find work and keep work.”

White referenced a report from the Healthcare Association of Hawaii that detailed pre-pandemic health workforce shortages across the state, including approximately 450 CNA openings. He suspects that number has likely doubled due to the pandemic.  

White is working to release a survey in the next few weeks that analyzes motivation in light of the pandemic, particularly the workforce decisions people made as they had to transition to different jobs. As 2022 marks another year of the pandemic, White emphasized the importance of cross-silo partnership and flexibility in creating a sustainable health workforce in Hawaii.

“I think the pandemic has opened people’s minds to change, that they stepped outside of their traditional roles and are thinking more about training …  that’s the biggest thing I see going forward in general terms—the mindset change on the part of everybody in the marketplace.”

This story was edited to reflect that UH trained 500 contact tracers, not 600.