Public Health Workforce
Recruitment, Retention and
Promotion in the Civil
Service System
2004 Pfizer Faculty Scholar Award in Public Health Recipient
Patricia M. Sweeney, JD, MPH, RN
Center for Public Health Practice
Graduate School of Public Health
Funded by the Pfizer
University of Pittsburgh
Faculty Scholar Award
psweeney@pitt.edu
in Public Health
Background
• Healthy People 2010 infrastructure
objective
– Incorporate into personnel systems,
competencies in the knowledge skills and
attitudes needed to perform the essential
public health services
• Public Health Systems Research Agenda
– Impact of civil service laws upon public
health workforce unknown
Purpose
Outcomes
• Assess the use of competencies state
public health department personnel
systems
•
Create a model of competency-based
assessment criteria
• Define state public health department
personnel processes
•
Describe civil service impact on state health
department personnel procedures
• Demonstrate the impact of state civil
service laws upon the public health
personnel system
•
Demonstrate the impact of state civil
service law revision upon state health
department recruitment and promotion.
Phase One Purpose
Phase One Methods
• Identify two position for study
– The positions most difficult to recruit
1
Phase One Survey Findings
Phase One Survey Findings
n = 24
8
Reasons positions are difficult to recruit
7
Position Most Difficult to Recruit
6
Most Difficult Epidemiological Position to Fill
5
Most Vital Position
salary not competitive
Reasons positions are difficult to recruit
insufficient experience
other opportunities in area
5%
4%
4%
2% 1%
36%
general position shortage
Number of States
6%
pipeline issues
poor location
47%
6%
state cannot offer incentives
53%
system inefficiencies
no formal education program in state
4
state licensing requirements
10%
11%
3
15%
position not on state register
internal control position freezes
immigration barriers
2
1
0
Nurse
Physician
Epidemiologist
Nutritionist
Veterinarian
Division
Adminstrator
Position
Identify positions for further
study
MaxQDA
Phase One Results
9 Entry level Registered Nurse
Maxqda2.lnk
• Word / phrase frequencies
Baccalaureate degree w/ no experience
Associate degree w/ minimal experience
9 Senior level Epidemiologist
• Key words identified and coded
PhD, Physician, Senior Scientist
Manager, Director of Epi program
• Compared to stratified discipline specific
competencies
Purpose
Phase Two
• Assess the use of competencies in the
state public health department personnel
processes
• Define state public health department
personnel processes and responsibilities
2
Methods
• Survey mailed to every US state and
territorial health department
9
9
Define state agency with various personnel
responsibilities
Submit copies of tools used to assess candidate
appropriateness for employment with state
public health department
Methods
• Job candidate assessment materials received
from 38 US state and territorial health
departments
– 49 Senior level Epidemiology positions
– 55 Entry level Registered Nurse positions
MAXqda2
Competencies
Initially
• Quad Council
– Public health nursing
Maxqda2.lnk
Each competency set was entered as a word list
Each assessment tool was scanned into the software
• AACON
– Baccalaureate nursing
• Council on Linkages
– Public health core
• CSTE and CDC
– Epidemiology
Data analysis
Analysis found 0 matches.
NO state health department assessment tool
assesses registered nurses or epidemiologists for
ANY of the core public health or discipline specific
competencies….as written…..
Nursing Core Competencies and
Public Health Nursing Competencies
Critical thinking
• Key phrases and key words were isolated from
the competency statements
• Key phrases and key words inputted into word
lists and used for competency analysis
# of times in
text
2
Communication
4
Technical skills
117
Assessment
17
Analytic assessment
15
Policy development/program planning skills
8
Communication skills
23
Cultural competency skills
1
Community dimensions of practice skills
2
Public health sciences skills
7
Financial planning and management skills
0
Leadership and systems thinking
0
3
Epidemiology Competencies
Assessment and Analysis
# of times in
text
PUBLIC HEALTH CORE
COMPETENCY
# of appearances
in RN text
# of appearances in
EPI text
15
54
Policy development / planning
skills program
8
10
Communication skills
18
13
Cultural competency skills
4
4
Community dimensions of
practice
1
0
Basic public health sciences
skills
46
400
Financial planning and
management skills
6
4
Leadership and systems
thinking
29
13
Analytic assessment skills
4
Basic Public Health Sciences
217
Communication
16
Community Dimensions of Practice
2
Cultural competency
1
Financial and Operational Planning and Management
1
Leadership and Systems Thinking
22
Policy Development
1
Conclusions
Competencies
Implications
• Currently capturing all statements
Develop models of competency
based assessment criteria for
state public health department
consideration
Current state health department
personnel assessment tools
do not address
the breadth of
skills, knowledge and attitudes
needed to meet contemporary
public health challenges.
Phase Three Results will
– Define the personnel procedures utilized by
each state health department for recruitment
and retention
– Demonstrate the effect of the states civil
service laws upon the personnel system of
each state health department
4
Public Health Workforce
Recruitment, Retention and
Promotion in the Civil
Service System
2004 Pfizer Faculty Scholar Award in Public Health Recipient
Patricia M. Sweeney, JD, MPH, RN
Center for Public Health Practice
Graduate School of Public Health
Funded by the Pfizer
University of Pittsburgh
Faculty Scholar Award
psweeney@pitt.edu
in Public Health
5