Cincinnati Children’s Hospital: From High Turnover to High Retention with Project Search

Cincinnati Children's Hospital: From High Turnover to High Retention with Project Search

By Joan Leotta

Cincinnati Children's -- change the outcome

Employee searches for high-turnover positions can cost companies thousands or even tens of thousands of dollars per year. But, when faced with jobs that have a typical turnover rate of as much as 47%, how can employers break the cycle? At Cincinnati Children's Hospital Medical Center, the solution has been to employ those equally capable but most in need of employment opportunities: people with disabilities. And the idea is catching on. In addition to keeping internal human resources costs down and retaining quality employees, Project Search at Cincinnati Children's has become a model program for employers around the world.

Project Search development

Long known for its medical innovations, through Project Search Cincinnati Children's has also carved out a national reputation as a leader in employing people with disabilities. With a spark of imagination, a willing human resources department and the cooperation of many groups in the Cincinnati area, Project Search was born. Since its inception in the mid-1990s, the program has expanded from a single institution's initiative to a replicable system that the hospital helps others emulate. More than 120 businesses in 39 US states and several countries have already adopted the Project Search approach.

Erin Riehle, Cincinnati Children's Director of Disability Services, says, "About thirteen years ago as a part of the hospital's diversity initiative, we studied our budget, particularly looking for ways to fill jobs that had high turnover." The recruitment, hiring and training associated with employee turnover all cost a company valuable resources.

Although at the time the hospital's focus for diversity was on race, ethnicity and gender, what Riehle found shifted that focus to include people with disabilities. "The figures on the top twenty revenue generators showed that a lot of the hospital's revenue came from the care of those with chronic illnesses and disability." If the hospital's revenue was coming mostly from this population, why not consider their potential employability as well?

In keeping with Cincinnati Children's tradition of service to this core group, Riehle relates, "it seemed natural that we should make it a priority to hire people with disabilities."

Image of Project Search participant Eric Johnson

Project Search participant Eric Johnson. A cart stocker at Cincinnati Children’s since 1997, Johnson resupplies examination rooms in the emergency department, among other duties. Image courtesy Project Search.

Riehle made calls to local educational, vocational, and disability groups. Together they created a business model for hiring people with developmental and other significant disabilities. She adds, "Our model views hiring people with disabilities as smart business. We know that people with disabilities are an incredibly capable potential pool of employees who need hiring. We created broad funding to underpin the program's training and development, using resources from within the community."

What sets Project Search apart from other disability employment programs? Recognizing that many people with disabilities can rise to the challenge of demanding employment, Riehle relates that "the jobs we targeted for filling were ... complex but systematic, rather than only ... simple tasks." Far from a sheltered workshop mentality, the Project Search approach values retention and career advancement as assets both to the individual and the workplace. Prospective employees can be trained for jobs in material management, patient transport, clinical sterilization, etc., through Project Search.

Program Components

Project Search's emphasis is twofold: ensuring that adults with disabilities are appropriately hired and trained, and assisting students with disabilities as they transition into the workforce. The Transition Clinic focuses on creating an educational and employment path for patients age 14 and up with chronic illnesses and disabilities.

The Adult Employment Program matches qualified employees with open positions and provides on-the-job support with coaching, adaptations, accommodations--even task and travel training. Candidates for this program must be at least 18 years old and eligible for Ohio Rehabilitation Services Commission services, in addition to meeting general employment requirements.

In keeping with Cincinnati Children's mission of improving "quality of life outcomes" for patients, the Transition Clinic helps students age 14 and up to complete educational requirements so they can qualify for jobs under Project Search. Riehle says, " The Transition Clinic is just that, a Clinic -- we don't do training in the Clinic." Transition Clinic addresses individual vocational, educational, training and employment goals. This personalized (training) may include helping the student coordinate GED programs or research appropriate career choices.

Bridging these two worlds, the one-year High School Transition Program offers graduating seniors real-world experience in healthcare or business settings. Using total workplace immersion, the program offers a series of structured internships that focus on both general and task-specific job skills. Students receive daily instruction in workplace and life skills, participation in rotations on a particular job, and feedback from an instructor.

The High School Program in action

Recruits in the internship program are first asked what jobs they would like to have: They are asked to express their dreams. Their training then focuses on general skills for their chosen profession, specific skills for a targeted job, and life skills in how to become a valued employee. Says Riehle, "We show them how to relate to others in the workplace, how to get to work, and more." Through a series of ten-week internship modules, students accomplish their training goals one at a time. The program offers flexibility for students who change their minds about their chosen field mid-course.

At present, the Project Search has five such internship programs in place in Hamilton County, Ohio.

"We also teach a high school job transition program for adults that puts a single class of 12 adults with disabilities ages 18-21 in a business for an entire school year, to show them how the business world works," Riehle relates. "We require a 95 percent attendance rate in order to take part in the program."

Making Dreams Come True

But what if a disability is at odds with a career dream? Through technology and training, such dreams can come true. Riehle relates the example of a young woman who, though affected by speech difficulties, desired a job greeting the public at a front desk. In her first internship, in addition to learning how to transfer calls, use call waiting, and take messages, she was trained to use a telephone with voice enhancement software. In the second module, her training focused on appointment and datebook software and procedures. Finally, "we introduced her to Dragon Speaking software," Riehle relates, "and in the third rotation we showed her how to make security badges, sign people in and out of an office, and greet people. By the end of the process, she was able to function as a front desk receptionist."

Advancement and retention

Most of the positions targeted for Project Search were in-house and entry-level at first. Some, which involved repetitive tasks, typically have a turnover of more than 47% in one year, according to the Society for Human Resource Management . In general, people who work these types of repetitive, entry-level jobs do not stay around for promotion.

But Riehle's team changed that.

Riehle found that after five or six years, employees hired through Project Search wanted more responsibility. "We began to see that simple tasks often underutilized the abilities of the target work force," she says. And so the hospital began to institute ways to promote individuals or change responsibilities to keep them engaged on the job. Some of the employees have been with the program for ten years or more. "Keeping them engaged on that job and interested in the work and helping them to go on to other employment in the hospital is a key part of our work as well."

Riehle notes, "In one department alone, a position that never held anyone for longer than 2.4 years now has employees who have stayed in that job for more than three times as long."

"Key to the success of the employee on the job is the right training," says Riehle. "Over the life of the program we have hired more than 100 people with significant disabilities to various jobs. Seventy are still on staff."

Although of course some Project Search employees leave for all the usual reasons, Riehle maintains that "the turnover is low: far better than the forty-seven percent national reported in similar hospital positions."

Individual success

One of Project Search's success stories is Eric Johnson. A Cart Stocker at Cincinnati Children's since 1997, Johnson resupplies examination rooms in the emergency department with medical necessities and linens, among other duties. Johnson, who has a cognitive disability, takes the bus to work when his parents cannot drive him. A graduate of Hughes High School, Johnson is also involved in numerous activities such as the local volunteer organization Give Back Cincinnati and the disability-friendly social group Star Fire Peer Groups.

Replication

Although Riehle relates that "we do not aggressively market ourselves," news of the program's success has reached all corners of the world. Part of Project Search's mission statement is to educate employers about the potential of people with disabilities to meet their human resource needs.

As a result, many companies in healthcare and other fields approach the hospital, eager to create programs like Project Search in their own communities and workplaces. For a nominal fee, groups can schedule a conference to receive instruction on garnering support from community public and nonprofit organizations to establish similar employment programs in their own areas.

Awards

Several groups, including the National Alliance for Youth with Disabilities, have named Project Search a model organization. Honors include the Secretary of Labor's New Freedom Initiative Award (2004), many local and state awards, the Ohio Governor's Council on People with Disabilities Large Employer of the Year, and the Ohio Public Images Award.

The program will continue to work toward meeting the needs of individuals with disabilities in the Cincinnati community, in its own workforce, and anywhere else that a similar employment approach can lead to communal success.

For more information about Project SEARCH, contact projectSEARCH@cchmc.org or call 513-636-2516. Project SEARCH Web site: www.cincinnatichildrens.org/ps.

Edited by Mary-Louise Piner.