By Isis Monteiro and Serena Bernthal-Jones

Many organizations struggle to recruit and retain nurses in the home health setting. Prior to Covid-19, the demand for home health care services was expected to grow due to an aging population. Covid-19 has accelerated this trend, highlighting the need for organizations to strengthen their home health nursing workforce.

We recently spoke with Mary Gibbons Myers, President and CEO of Johns Hopkins Home Care Group, about the system’s approach to building a pipeline of home health nurses. Like many systems, Johns Hopkins Medicine is seeing more patients opt to receive non-acute care at home to avoid going to the hospital. To meet the increasing demand for home health services, Johns Hopkins Medicine is taking three steps to strengthen their pipeline of home health nurses.

1. Partner with colleges and universities to expose nursing students to a career in home health: Johns Hopkins Home Care Group is working with colleges and universities, including their affiliated nursing school, to embed home health education and training into the curriculum. In 2018, they created a summer internship program to expose nursing students to the home care environment early in their career. During this internship, students are paired with an experienced home health nurse. To monitor the program’s success, Johns Hopkins plan to track the number of participants that go directly into home health after graduation.
   
   
2. Hire new graduate nurses directly into home health to build expertise early: Johns Hopkins is challenging the traditional mindset that new nurses need two or more years of experience in acute care at the start of their career. Instead, they hire new graduate nurses directly into home health. To ensure these new graduates are properly supported, Johns Hopkins is investing in dedicated home health training programs for nurses with less than two years of experience.
   
   
3. Help experienced nurses re-imagine their career in home health: To retain experience within the system, Johns Hopkins created the Cross-Continuum Nurse Fellowship to train experienced acute care nurses in home health care. The two-year fellowship, which is the first of its kind in Maryland, consists of didactic, experiential, and simulation learning. Full-time adult or pediatric nurses with at least two years of experience in med-surg, emergency, or oncology departments are eligible to apply.
   
   The first six months of the program consist of an intensive home care training period during which fellows work with a full-time home health preceptor. Fellows then complete a 12-week rotation with Johns Hopkins Home Care Group, followed by 12 weeks of independent practice with continuing education and 18 months rotating between inpatient and home care settings.
   
   After completing the program, fellows have the option to stay in home health, return to acute care, or split their time between acute and home care as cross-continuum experts. To incentivize the latter option, cross-continuum experts are awarded differentiated title and pay. Mary believes the program still holds value for nurses who decided to resume practice in acute care, as they are better prepared to deliver culturally-competent care to complex patients across the care continuum. The fellowship program is currently on hold due to Covid, with plans to resume in September.

Across the coming year, Johns Hopkins plans to expand the Cross-Continuum Nurse Fellowship into the National Capital Region and increase the number of fellowship positions available. As Mary notes, “The future of health care is in the home. This seemed futuristic before, but during Covid, that’s exactly what we saw.”

How is your organization promoting home health to nursing students, new graduates, and/or experienced nurses? Please email us at nec@advisory.com—we’d love to learn from you!