At Legacy Health, a career progression mapping program aids workforce development
John Jay Kenagy, senior vice president and chief information and administrative officer at Legacy Health, a health system based in Portland, Oregon, has had “a labor of love” when it comes to workforce development.
That labor was to implement career progression mapping with job descriptions, skills (technical and soft) development with protected time, clear lines from entry level to principal engineer/senior analyst, and a strong culture to hire entry level positions from outside but promote from within for senior level.
“When I got here in 2012, that was not the standard operational procedure, and staff did not really feel we were a place to grow their careers,” Kenagy said.
But the times have changed. Here’s how.
A large psychic impact
“I arrived at Legacy about one month after a really tough layoff process, which netted over a 10% reduction of staff in IS,” he recalled. “In a values-consistent approach to maintain staff’s employment, vacancies and contract staff were the first to be cut, then voluntary departures through retirement or relocation, and finally severance. While the actual number of affected staff was low, the psychic impact was large. And the randomness of vacancies led to lopsided results.”
"In a group discussion on the topic, our managers said in fact that they hire for the soft skills – it’s a differentiator."
John Jay Kenagy, Legacy Health
Collectively, the IT management team started a multi-year effort to write effective and relevant job descriptions, draw career ladders, compensate the staff at market competitive rates, establish 5% protected time for professional development, build succession planning for lead workers to the CIO, and set a strong commitment for internal promotion, he explained.
“As we had just completed our enterprise-wide Epic deployment, a huge amount of skills development investment went into Epic certification,” Kenagy said. “We had online technical training but it was really haphazardly utilized. We also had invested in project management skills and professional development. These were very defensible investments but it did lead to a lot of noise about disproportionate investment in some groups and not others.”
At Legacy Health, equity and stewardship are core values – sometimes aligned, but sometimes in some conflict. In the end, the health system strove to create an employment environment that recruited, retained and developed the best talent in health IT.
“The words can make it all sound more complex or revolutionary than it is,” Kenagy said. “The core of it is a set of job families from entry-level positions (System Engineer I and Applications Systems Analyst I) to Level 5 (Principal Engineer and Systems Architect and Applications Systems Consultant). This was a great deal of work to clean up.”
The need to update job descriptions
For instance, in the technical and infrastructure department, there were more than fifty different job descriptions, and half had one or two incumbents. Some job descriptions were more than a decade old. Skills requirements hadn’t been updated. Across all of IT, some job descriptions at higher pay required less experience and education than more junior roles.
“As part of developing a new set of updated job descriptions, we engaged staff and managers,” Kenagy explained. “We built the hard and soft skills expectations that would be required at each level. We added a requirement for senior level positions to have some type of certification that Legacy would invest in, so this went beyond just Epic certification.”
This was shared widely with the entire division at team meetings and individual group meetings. Managers use the job families to have conversations with staff about their career aspirations and use their protected 5% time to build the skills for their current and immediate next jobs (they own their long-term career).
So how are technical and soft skills developed? And what exactly are soft skills?
“It’s an interesting question related to soft skills and our management team is talking about that right now,” Kenagy said. “We did bring in Ouellette and Associates to provide a mandatory half-day seminar on customer service for every single role in IS and informatics. It was really effective and well received. That’s just one component.”
Explaining soft skills
One of the tech managers recently boiled down this issue well, he added. Talking about Legacy’s “Kudos” system where anyone can “badge” a coworker for exceptional work online, he said every one he receives for his team describes their empathy, concern, accountability, follow-through and professionalism.
“It wasn’t about their fantastic wireless access point troubleshooting ability,” Kenagy reported. “In a group discussion on the topic, our managers said in fact that they hire for the soft skills – it’s a differentiator. In our ideal situation, we are hiring outside talent for more entry-level positions, so basic technology domain skills are ideal.”
Orientation and development is a work in progress and Legacy Health has built formalized programs to learn how to be an analyst or engineer in the IT division. IT has a mix of presentations and shadowing opportunities. Team leads and senior-level staff help training and orient staff. To reach higher positions, certification is needed and that confirms technical knowledge.
“Promotion does come to those with both the hard skills but also how to interact with users, diffuse a hard situation, ‘interview’ users to elicit the real problem or real need, collaborate with others inside and outside IS,” he added.
Moving on up
In the end, Legacy Health is attempting to make it easier for an entry level employee to become a principle engineer/senior analyst while having all the skills they need.
“Here’s generally how it would go,” Kenagy explained. “An entry level employee joins our organization in the Service Desk, Desktop Support, Application Production Team, or Production Engineering Team. These four teams are classic entry points for people and where many ‘level 1’ positions live. An enterprising Service Desk or Desktop Support person can make the leap to an Applications or Engineering team, often at the ‘level 1’ but a high pay for higher complexity work.”
In those paths, going from a 1 to a 2 (mostly a 15% pay increase) is pretty much a time-in-role promotion. The 2 levels are more independent and work on repeatable, standardized work. They surely can get exposure to major incidents (all hands on deck but rare) or projects, which spreads their knowledge and experience.
“From a 2 to a 3 is a competitive process; we do not ‘tap on the shoulder,’“ he said. “There are fewer 3 slots generally than 2s. When a 3 or 4 level role leaves, we strive to recruit to that level from within and then open a 1 or 2. Level 4, Principal or Architect does require certification but an internal promotion to these levels is offered the funds by Legacy to pursue it but must commit to a stay-or-repay contract and complete the certification within one year.”
Kenagy has been happy with the results of the career progression mapping program. Formal measures are coming.
“We are just starting to discuss formal measurement with employee engagement scores, including a career question, and getting data on our performance on internal promotion,” he concluded. “Anecdotally, it is working. Our major restructuring with the new job descriptions and job families is now about 15 months old. But having data will really inform our current and goal state.”
Focus on Workforce Development
In July, we'll speak to experts about how they're managing their workforces – not just clinicians, but IT departments, data scientists, care managers, back office staff and others.