Michigan Association of United Ways
211 Connect System
PPA is providing strategic thinking and technical assistance to the Michigan Association of United Ways and, through them, to the Michigan Department of Information Technology to assist in portions of the work related to the statewide rollout of the 2-1-1 Connect system in Michigan. Tasks involved include providing coordinating assistance to an internal committee of state employees collecting data in state agencies relative to 800 numbers that might be converted to the 211 system—service areas that might utilize the outreach and communication capacities of the 211 system—and other related tasks.
Iowa Hospital Association, Iowa Organization of Nursing Leaders
Staffing Ratios and Mandatory Overtime for Nurses
PPA was retained by the Iowa Hospital Association to provide comprehensive education to hospital nursing executives throughout the state of Iowa concerning patient-to-nurse staffing ratios and their implications. Training was provided at Iowa State University and consisted of a series of five lectures on the following topics: (1) the political status of staffing-ratio and mandatory-overtime legislation in Congress and among the individual states; (2) the financial implications, patient safety, quality of care, quality of work life and other issues related to the imposition of staffing ratios and mandatory overtime; (3) the business case for reducing patient-to-nurse staffing ratios; (4) preparing a model of the costs and benefits of implementing mandatory overtime and/or patient-to-nurse staffing ratios for individual hospitals; and (5) an analysis of the current and projected shortage of registered nurses in the United States along with a discussion of creative staffing strategies and model practices across the nation.
Capital Area Michigan Works!
Health Care: The Jobs Machine
Capital Area Michigan Works!, the regional workforce investment board, in cooperation with Ingham Regional Medical Center, Sparrow Health System, the Ingham County Medical Society, and Lansing Community College, retained PPA to conduct an analysis of the economic impact of the health care industry for the Lansing, Michigan metropolitan area. Among the topics included in this study was consideration of the impact of salaries and wages from each of the regions health systems as well as the faculty and staff of Michigan State University’s Colleges of Human Medicine and Osteopathic Medicine. Additional data were compiled from a variety of sources that detail the overall financial impact of these institutions as well as the impact of long-term care, allied health professions, and other related activities. Salary and employment levels for several key industries in the region were prepared, and most significantly, comparisons of the long-term trends in employment for several of the larger and historically most significant industry sectors in the region clearly demonstrated the decline of manufacturing employment and the concurrent expansion of health care employment and the growth of health care-based earnings. Educational resources devoted to health careers education—including medicine, nursing, and a variety of allied health careers—were also highlighted in this analysis.
Six County Employment Alliance
U.P. Health Care Roundtable
PPA provided consulting services and technical assistance to The Job Force! as part of their development of a health care workforce-oriented Regional Skills Alliance. PPA provided facilitation for a meeting with all key regional stakeholders and provided technical assistance in formulating a strategic plan and an initial set of goals and activities for the Regional Skills Alliance. Additional technical assistance was provided to the The Job Force! to revise and update this plan after it had been presented to all key stakeholders and implemented within the Central Upper Peninsula.
Michigan State Medical Society
Supply and Demand Forecasts for Physicians
The Michigan State Medical Society contracted with PPA to analyze the characteristics of Michigan’s physician workforce and to prepare a series of forecasts of the future supply and demand for physicians in Michigan to the year 2020. In response to this request, PPA prepared a profile of Michigan’s current physician workforce based on the most recent American Medical Association Master File of physicians, including analysis of the age and gender of the physician workforce, where in Michigan they are located, where they attended medical school, and where they received their graduate medical education. The supply forecast was conducted through use of a cohort-component technique; the demand forecast was driven by population projections provided by the U.S. Bureau of the Census. In each case, a number of alternative assumptions about the work effort of physicians and the potential impact of the aging population were employed in order to produce alternative forecast scenarios. The findings of this project were shared extensively with a variety of, physician groups and other audiences. These findings were presented to the Blue Ribbon Panel on Michigan Supply and Demand, and a summary of the findings was published in the August, 2005 issue of Michigan Physician.
Michigan Department of Labor and Economic Growth
Staff-Management Relations in Michigan Hospitals and Health Systems
PPA is performing an analysis of best practices in staff-management relations in both labor organized and nonorganized hospitals and health systems. Among organized hospitals, both Interest-Based Bargaining and traditional bargaining results will be examined; among nonorganized hospitals, best practices for scheduling, alternative dispute resolution, and staff involvement in management decisions, will be examined.
Michigan Department of Labor and Economic Growth
Health Career Worforce Development in Michigan
The Michigan Department of Labor and Economic Growth engaged PPA to compile and consolidate critical information about 30 selected health care careers in Michigan as the basis for implementing a major initiative with local public-private consortia to expand the health care workforce in Michigan. Major tasks included establishing a statewide advisory board of key stakeholders from health care providers, health professions, education, labor, and government; forecasting the supply and demand for each occupation both statewide and regionally to the year 2015; profiling each occupational category, including licensure/certification requirements and best practices for increasing new entrants to the health workforce, career expansion and improvements for incumbent workers, and best practices for transitioning displaced workers to new careers in health care. PPA was entirely responsible for all aspects of this project, including regularly scheduled reports to the client and monthly meetings with the advisory board. This project was conducted for and with the cooperation of the executive offices of both the Michigan Department of Labor and Economic Growth and the Michigan Department of Community Health. The results of this project were presented to the relevant public-private consortia and the executive staffs of both departments and were incorporated into final reports that have been posted on the Internet for public access (www.michigan.gov/dleg). This project took five months, involved a project team of five (senior consultant, project manager, two research associates, and an editor).
Michigan Nurses Association
Economic Assessment of RN Staffing Ratios and Mandatory RN Overtime in Michigan
During the early spring of 2004, the Michigan Nurses Association (MNA) was preparing to have legislation introduced into the Michigan Senate entitled "Safe Patient Care Act." The purpose of this legislation is to reduce some of the most serious threats to patient safety and quality of care by eliminating mandatory overtime for registered nurses and by establishing patient-to-RN ratios that are more favorable to high-quality care. Public Policy Associates was retained by MNA to conduct an economic assessment of reduced patient-to-nurse ratios and mandatory overtime in Michigan as background information for use by MNA in discussing this legislation with the Michigan Legislature and as a basis for responding to questions from health care professionals, health care administrators, and the public regarding the potential costs associated with this proposed legislation. PPA examined an extensive amount of literature regarding the relationship between nursing staffing levels, quality of care, and costs of care. Based on this research, PPA prepared two reports for MNA on this issue. The first report, "The Business Case for Reducing Patient-to-Nursing Staff Ratios and Eliminating Mandatory Overtime for Nurses,"; examined both the costs associated with reducing patient-to-RN staffing ratios and the potential cost savings associated with reduced complications and adverse events, reduced patient stay length of stay, and reduced staff turnover. A second report, "The Model Case for Reducing Patient To Nurse Staffing Ratios In Michigan Hospitals: Two Scenarios"; modeled the financial impacts of an expanded RN staff involved in direct patient care and reductions in costs associated with improved care for a 50-bed hospital and a 200-bed hospital based on recent Michigan hospital data and research results from health care literature. For further information, please contact the Michigan Nurses Association (www.minurses.org).
Michigan Department of Natural Resources
Evaluation of the Infant Safe Sleep Project
PPA was retained by Tomorrow’s Child/Michigan SIDS to evaluate a Skillman Foundation-funded demonstration called the Infant Safe Sleep Project. The demonstration will involve providing information and training to hospital personnel and new parents at two Detroit-area hospitals. It is hoped that this will encourage hospital personnel to model infant safe sleep behaviors in their interactions with new mothers and will provide mothers with increased knowledge of safe sleep practices. Ultimately, the goal of the project is decreased infant mortality due to unsafe sleep practices. PPA’s role in the evaluation is to develop a logic model and data-collection protocols and to analyze data collected by the project staff.
Michigan Health and Hospital Association
2001 MHA Community Benefits Survey Project
The Michigan Health & Hospital Association conducts an annual survey of nonprofit Michigan community hospitals to quantify the value of the benefits that these hospitals return to their communities. In addition to an analysis of the traditional financial measures, such as charity-care provision, level of bad debt, and the unpaid cost of public programs, the project quantifies the volume and impact of programs and services that address community needs and target underserved populations, but are provided at a financial loss. In 2001, MHA retained Public Policy Associates to provide overall project direction, to participate in all aspects of planning and annual instrument design, and to conduct the data analysis for the 2001 MHA Community Benefits Survey. In this capacity, PPA provided summary data with benchmark comparisons by various community/hospital characteristics, provided detailed data analysis to the MHA, contributed to final reporting and presentation, and developed recommendations for continual project improvement.
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