Promoting an Engaged Workforce

Description of LHD: Seminole County is located in East Central Florida just north of Orlando. With an estimated population of 455,479 in 2016 it ranks as the 13th most populous county in Florida, per the U.S. Census Bureau. Seminole County is also the most densely populated county in Central Florida with a total land area of 309.5 square miles and a population density of 1,413.17 per square miles. The racial and ethnic makeup of the county consists of Whites (79.6%), Blacks/African Americans (11.6%), Asians (4%), Native Americans (0.2%), and Native Hawaiian and Other Pacific Islanders (0.1%).  The population identified as Multiple Races comprises 3%. Hispanic origin of any race comprised 18.7% of the population. Languages other than English are spoken in 19% of homes. Families living below poverty level in 2013 ranged from 4% to 13% by zip codes.

The Florida Department of Health in Seminole County (DOH-Seminole) has four service centers located in Sanford (2), Casselberry and through our Mobile Health Unit. DOH-Seminole offers clinical services through the main Sanford location which include family planning, immunizations, STD/HIV prevention and treatment, breast and cervical cancer early detection, men's health screenings, school health screenings and dental care services. A total of 15,358 clients received clinical services during the 2016-17 fiscal year with just over a third (36.8%) being children under the age of 13. Additional services provided by the health department include the Florida Healthy Babies program, Environmental Health, Women Infants and Children (WIC), Vital Statistics, Tobacco Prevention, Refugee Health, Tuberculosis, Epidemiology, Hepatitis, School Health, Public Health Preparedness, Community Partner Referrals, Insulin and Epilepsy Medication Distribution.  Supporting departments include Health Promotion and Education, Clinical and Non-Clinical Internships, Quality Improvement and Performance Assessment, Information Technology and Workforce/Employee Wellness.

Additional information regarding the Florida Department of Health in Seminole County can be found at our website: http://seminole.floridahealth.gov/index.html

Public Health Issue: In 2015 an organization-wide employee survey revealed meaningful gaps in employee development both short and long term. At that time, thirty-seven percent of DOH-Seminole staff felt that the organization did not provide adequate training and educational opportunities to help them improve their knowledge, skills, abilities and prepare them for future advancement opportunities. Additionally, less than 60% of staff felt that their supervisor engaged them routinely to review career goals and establish a development plan to support or accomplish those goals. While a communication plan had been previously established, the survey revealed that there wasn't sufficient follow-through as only 50% of staff felt that DOH-Seminole had established an effective method of communication in regards to upcoming development opportunities.

Goals and Objectives: The 2017-2020 DOH-Seminole Strategic Plan includes a priority area for workforce development (WFD) with a goal of developing an engaged and satisfied workforce. Two of the objectives for this goal are:

• Increase employee satisfaction with the organization's method for communicating of upcoming development opportunities from 65% in 2016 to 70% by December 31, 2018
• Increase the percentage of employees with complete Individual Development Plans (IDPs) on file from 82% in 2016 to 90% by June 30, 2018

Implementation: To meet objectives specific to workforce development needs, DOH-Seminole took measures to include goals, objectives, and key strategies within its Workforce Development Plan (WDP). These included:

• An update and distribution of the Communication Plan that reflects employee preferences to all staff via the WFD email and posting of plan on SharePoint site
• Supervisory staff SMART expectation to reflect at a minimum quarterly conduction of IDP review, analysis and planning with staff member
• Best practices review of IDP template to support the collection of staff training needs
• Utilization of identified strategic goals and training needs assessment to update the DOH-Seminole WDP and support continuous development

The DOH-Seminole WFD team initiated the development of a specific WFD email to alleviate and address communication discrepancies. A SharePoint site for WFD was developed which includes a training calendar, local and state WFD resources, and outside agency training and education resources all at no cost to employees and the organization.

DOH-Seminole increased education and focus of IDPs using training sessions dedicated to giving supervisors the tools and knowledge needed to complete and provide useful information within IDPs for their staff.

Results/Outcomes: Since implementation of selected countermeasures, DOH-Seminole has seen an increase in IDP completion from 82% in 2016 to 100% in 2018. IDPs have been utilized to support selection of focus trainings that develop staff and support long term objectives. The development of a WFD email has increased communication of identified training opportunities and the WFD SharePoint site provides up to date training calendar, additional training opportunities, best practice sharing and an employee feedback loop. In 2018 an updated employee satisfaction survey was provided to all staff. Results reflected an increase in employee satisfaction with development opportunities from 63% in 2015 to 80% in 2018. Employee satisfaction with supervisor engagement also increased from 60% in 2015 to 85% in 2018.

One of the Public Health Ten Essential Services is to assure a competent public health and personal health care workforce.” Coupled with the Public Health Accreditation Board's standard 8.2 Assess staff competencies and address gaps by enabling organizational and individual training and development opportunities,” it's vital for public health organizations to ensure that their workforce is both competent and satisfied to meet the needs of the communities they are serving. DOH-Seminole has made a commitment to addressing these areas by implementing workforce development objectives within the Strategic Plan, as well as a stand-alone Workforce Development Plan.

In 2015, the Florida Department of Health conducted an Employee Satisfaction Survey (ESS) for all employees. Survey results specific to DOH-Seminole on the question Leadership opportunities are available to me” showed that only 53.49% of employees either agreed or strongly agreed with the noted survey question. Engagement with employees, based on this question, found there was: a lack of consistent approach to development, a lack of consistent approach to communication of development, a lack of supervisory follow-up, and a lack of a process owner. The Executive Leadership Team (ELT) identified and prioritized an employee development quality improvement project. In January 2016, the ESS QI Project Team met with the purpose of increasing utilization of leadership development opportunities by way of a higher rate of completion of Individual Development Plans (IDPs) for career service and SES employees. A root-cause analysis came to three conclusions as to why DOH-Seminole employees answered the way they did based on feedback and brainstorming:

• No defined process for getting leadership training
• No communication regarding types of training staff want
• No clear definition of how candidates are selected for leadership training

In April and May, 2016, career service, SES staff and supervisors were provided training on the IDP process to increase engagement and identify areas of developmental needs associated to core competencies and leadership development objectives. Supervisors also had a SMART expectation related to IDPs added to their annual performance reviews. The Office of Performance and Quality Improvement (OPQI) was involved to develop a Workforce Development Plan to set a clearly defined process for completion and utilization of IDPs, as well as addressing ownership and support of IDPs and communication between departments for addressing identified gaps in employee training and development.

In August 2016, the first quarter IDP were completed and shared between Human Resources and OPQI to identify training opportunities and develop a 2017 training plan. OPQI, in conjunction with the ESS QI Project Team, sent out an internal Workforce Development survey in September meant to gage the progress of addressing the identified root causes. The survey revealed gaps in support for both current and future career goals, and effective communication of training opportunities. Thirty-seven percent of staff felt that the organization did not provide additional training and education opportunities to help them improve their knowledge, skills and abilities and prepare them for future advancement opportunities. Less than 60% felt that their supervisor engaged with them to review career goals and establish a development plan to support or accomplish those goals. While a communication plan had been previously established, the survey revealed that there wasn't sufficient follow-through as only 50% felt that DOH-Seminole had established an effective method of communication in regards to upcoming development opportunities.

By the close of 2016, the quality improvement project had been closed out and much had been done to achieve a 90% completion rate of IDPs for selected DOH-Seminole staff.

The 2017-2020 DOH-Seminole Strategic Plan identified workforce development as a priority area with a goal to develop an engaged and satisfied workforce. It set the following objectives:

• Increase the percent of employees who are satisfied with employee recognition by 10% on the DOH-Seminole Workforce Development Survey from 2016 to 2018.
• Increase employee satisfaction with the organization's method for communication of upcoming development opportunities from 65% to 80% from 2016 to 2018.
• Increase the percentage of employees with complete Individual Development Plans (IDPs) on file from 82% to 90%

With these objectives in mind, OPQI established a Workforce Development Consultant position that was to start in July 2017. The Workforce Development consultant and Human Resources formed a Workforce Development (WFD) team to address the previously unmet aims. To meet objectives specific to workforce development needs, DOH-Seminole took measures to include goals, objectives, and key strategies within its Workforce Development Plan (WDP). These include:

• Update and distribution of the Communication Plan that reflects employee preferences to all staff via the WFD email and posting of plan on SharePoint site
• Development of committed workforce development SharePoint page
• Development of committed employee learning center which provides staff with development resources and space to take online classes
• Supervisory staff SMART expectation to reflect at a minimum quarterly conduction of IDP review, analysis and planning with staff member
• Best practices review of IDP template to support the collection of staff training needs
• Utilization of identified strategic goals and training needs assessment to update the DOH-Seminole WDP and support continuous development

The DOH-Seminole WFD team initiated the development of a specific WFD email to alleviate and address communication discrepancies. A SharePoint site for WFD was developed which includes a training calendar, local and state WFD resources, and outside agency training and education resources all at no cost to employees and the organization.

The DOH-Seminole WFD consultant increased education and focus of IDPs using training sessions dedicated to giving supervisors the tools and knowledge needed to complete and provide useful information within IDPs for their staff. As a result, DOH-Seminole saw an increase in IDP completion rates from 82% in 2016 to 99% in 2017 and 100% in 2018. IDPs have been utilized to focus training and development of staff based on their own desires. As part of the continued improvement cycle, opportunities for improvement related to the IDP forms were identified during the 2018 strategic planning process, including specific focus on employee emergency preparedness skills and competencies.  The WFD email continues to increase communication of identified training opportunities. In 2018 the email was updated to add alignment of identified trainings with strategic objectives and include measures of success for each training. The WFD SharePoint site was unveiled to employees during a town hall meeting in 2017 and since then the site has been updated to include a two-way ask a question” option to gain additional user feedback.

LHD and Community Collaboration

Goals/Objectives of Practice:

Goals:

• Develop an engaged and satisfied workforce
• Maintain a systematic approach towards the communication of training and development opportunities for the workforce
• Ensure analysis and follow-up on staff training needs by supervisor
• Update IDP template to support the collection of staff training needs
• Update the Workforce Development Plan
• Ensure communication approach reflects preference of staff

Objectives:

• Increase employee satisfaction with the organization's method for communication of upcoming development opportunities (2017-2020 DOH-Seminole Strategic Plan)
• Increase the percentage of employees with complete Individual Development Plans (IDPs) on file (2017-2020 DOH-Seminole Strategic Plan)
• Update and distribution of the Communication Plan that reflects employee preferences to all staff via the WFD email and posting of plan on SharePoint site (2018 DOH-Seminole Workforce Development Plan)
• Supervisory staff SMART expectation to reflect at a minimum quarterly conduction of IDP review, analysis and planning with staff member (2018 DOH-Seminole Workforce Development Plan)
• Best practices review of IDP template to support the collection of staff training needs (2018 DOH-Seminole Workforce Development Plan)
• Utilization of identified strategic goals and training needs assessment to update the DOH-Seminole WDP and support continuous development (2018 DOH-Seminole Workforce Development Plan)

Road to Goals Achievement: To achieve these goals, the Office of Performance and Quality Improvement (OPQI) created a position specific to workforce development. The creation of a Workforce Development team with members of OPQI and human resources will also ensure that WFD is prioritized within the organization. The WFD consultant led training sessions for supervisors to reinforce why IDPs are important to the organization and employees, expand supervisor's knowledge of core competencies within the public health spectrum and how those apply and relate to their employees, and to develop the supervisor's focus with regards to their employee's development and training wishes.

Additionally, the WFD consultant initiated the development of an email specific to workforce development to ensure a better line of communication. She also designed a WFD SharePoint site as a resource for employees with a training calendar, local and state WFD resources, and outside agency training and education resources all at no cost to employees and the organization.

Timeframe: Focus on workforce development was initiated in 2015 based on a gap analysis of the state Employee Satisfaction Survey (ESS). DOH-Seminole is committed to increasing their employee's development in order to retain staff and increase their knowledge in public health. Work continues in this area as public health employees are required to do more with less.

Stakeholders: Many employees of DOH-Seminole have contributed to the ongoing efforts. The Executive Leadership Team got the ball rolling by identifying an opportunity for improvement based on the state ESS. This led to the creation of an ESS QI Project team which involved OPQI staff, supervisors, and front-line staff, as well as involving all DOH-Seminole staff for feedback and implementation. The OPQI continued work in the area with the creation of the WFD consultant. Currently, the WFD consultant, Human Resources, and additional OPQI staff make up the WFD team which continues and expands on the initial goals. The team is pursuing community partners to help in training and development opportunities.

Costs: Through utilization of employee engagement and various quality improvement tools opportunities for development were stratified and prioritized based on greatest organizational need.  With this insight targeted conversations and agreements were develop with community partners for reduced / no cost services.  In addition with the development of an IDP database, internal subject matter experts could easily be identified and utilized to provide services / trainings.  No hard costs were associated with this project.  Support costs included project members time which is estimated to have totaled $1200. 

Evaluation

Conclusions: This practice was initially instituted in 2015 based on gaps in workforce development identified in a state employee satisfaction survey. As time has passed, work continues and builds upon previous efforts.

Goal 1: Develop an engaged and satisfied workforce.

Objective 1: Increase employee satisfaction with the organization's method for communication of upcoming development opportunities. A 2016 internal survey revealed that employee communication was most preferred through the use of all staff emails, supervisors, and Microsoft Outlook calendar reminders. This led to the development of a workforce development specific email box where upcoming training and development opportunities could be relayed to both supervisors and employees. It also made communication more timely and responsive to the needs of employees.

Objective 2: Increase the percentage of employees with complete Individual Development Plans (IDPs) on file. Baseline data from 2016 showed that 82% of career service and SES employees had a current IDP on file, and the department set a goal of 90% completion rate. Through increased focus, DOH-Seminole has currently surpassed the original goal and has a 100% completion rate for specified employees. Data was tracked through the use of a database developed by OPQI.

Goal 2: Maintain a systematic approach towards the communication of training and development opportunities for the workforce.

Objective: Update the WFD Communication Plan. Ensure that clear guidance is provided on how development and other training opportunities will be communicated including method of communication, information to be communicated, frequency, and ownership. A 2016 internal survey revealed that email was the preferred method of communication for DOH-Seminole staff. This lead to the development of a specific WFD email. OPQI, in conjunction with Human Resources (HR), updated the Workforce Development Communication Plan for 2017-18 which includes guidance on frequency, media, audience, flow, and owner of itemized training and development needs and opportunities. Distribution of the WFD Communication Plan will occur via email to all staff and posting on WFD SharePoint site.

Goal 3: Ensure analysis and follow-up on staff training needs by supervisor.

Objective: All supervisory staff SMART expectation to reflect at a minimum quarterly conduction of IDP review, analysis and planning with staff member. In 2016, all supervisory staff SMART expectations were updated to reflect quarterly reviews of staff IDPs. OPQI and HR continue to ensure this measure is reached through IDP audits and trainings.

Goal 4: Update IDP template to support the collection of staff training needs.

Objective: Updated IDP template to capture staff member's current knowledge, skills, abilities and current performance gaps. As part of the 2018 strategic planning process identified opportunities for improvement related to the IDP template were identified including focused attention on linking skills assessments with emergency preparedness expectations. Updates were made to the IDP and implemented in August 2018 for the 2019 training year.

Goal 5: Update the Workforce Development Plan.

Objective: Utilize identified strategic goals and training needs assessment to update the DOH-Seminole Workforce Development Plan and support continuous development.

Goal 6: Ensure communication approach reflects preferences of staff.

Objective: Conduct employee communication survey, identify top preferred methods of communication.