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Grow Your Own Workforce Through the Clinical Care Extender Program

  • S. Santos

Author: Stephanie Santos, Manager

In 2005, St. John’s Regional Medical Center in Oxnard, CA, along with its sister hospital St. John’s Pleasant Valley Hospital in Camarillo, CA, launched COPE Health Solutions Health Care Talent Innovations Clinical Care Extender (CCE) program. The program has been a significant success in training future health care workers with the advantage of keeping jobs within the local community. In fact during the past three years, St. John’s hired ten former CCEs and hopes to hire more in the future.

Together, St. John’s Regional Medical Center, which has 265 acute care beds including a 23-bed rehabilitation center, and St. John’s Pleasant Valley Hospital, which has 81 acute care beds and a 99-bed extended care unit, comprise the largest acute health care organization in Ventura County and treat more than 187,000 patients annually. The CCE program recruits from local college community and provides students the opportunity to assist with patient-care tasks and observe procedures alongside nurses, physicians, and allied health professionals at St. John’s Hospitals. The goal is that the students will want to return to the hospital to work and serve their community after completing their education or finishing nursing or medical school.

The CCE program enables health care organizations (like St. John’s) to train and educate CCE students in a manner that aligns with the mission and values of the organization. This was so students can become integral and successful employees in the future. The program gives the hospital the opportunity to directly train a prospective work force within the organization’s culture and with the patient population they may serve in the future.

Initial Training

CCE participants are usually in the program for 15 months and can rotate through 20 hospital departments during that time. CCEs need 280 hours to graduate from the program, which is broken into 30 hours of didactic and hands-on training and 250 hours of patient-care-experience training. Initial training begins with a 30-hour, three-day session that includes presentations, hands-on skills training, and exams.

The presentation portion provides students with an introduction into the current state of the U.S. health care system. In addition, St. John’s presentations include hospital staff who share hospital-specific information, such as health care regulations, customer service protocols, hospital codes, and what to do in case of an emergency. Students learn the following:

  1. Palliative Care: The hospital chaplain speaks to CCEs on how the hospital approaches difficult situations using personal stories and experiences.
  2. History, Mission Statement, and Values: The Vice President of Mission Integration provides an overview of the history of the hospital, so students have a clear understanding of St. John’s progress and role in the community. The hospital’s mission and values are emphasized as well, so CCEs know their role in reflecting the hospital’s culture.
  3. Site-Specific Initiatives: The same video that is shown to all new employees is shown during the CCE training to help CCEs understand the importance of their role in a patient’s care. In the event a CCE encounters a patient that is dissatisfied, CCEs are empowered to use HEART, a service recovery tool that educates CCEs to Hear, Empathize, Apologize, Respond, and Thank patients.

Next, CCE students learn hands-on skills, such as bathing a patient, repositioning a patient, changing the bed, and transitioning a patient from the bed to a gurney or bed to a wheelchair. CCE students will not be allowed to perform most of these items on their own in the hospital setting, but they can assist nurses and patients. This training provides mock situations to help the students become more comfortable with these skills. Finally, CCEs take an exam and are placed in their first hospital department rotation.


Hands-on Training
Once the initial training is complete, CCE students begin their rotations through the hospital’s departments where they are able to work alongside clinicians. For example, in the intensive care unit (ICU), CCEs often help manage the flow of the department by ensuring there are only a certain number of visitors in the ICU at one time. CCEs also assist with repositioning and bathing patients. Additionally, they are able to observe light procedures such as inserting a peripherally inserted central catheter line.

In addition, CCEs learn about industry initiatives such as the Centers for Medicare & Medicaid Services electronic health record (EHR) incentive programs and meaningful use guidelines. For instance, CCEs learn how they can help St. John’s meet its meaningful use patient engagement goals for its online patient portal. St. John’s began implementing its EHR system in June 2014, and its goal is to have 5% patient engagement with the patient portal. While visiting patients, CCEs are tasked with helping patients register for the online portal or showing them how to log in or navigate through the website. To date, St. John’s has surpassed its goal with 8% patient engagement on the portal.

Throughout the program, CCEs attend two meetings every three months for team building and continuing education. There is also a CCE leadership team that is responsible for managing CCE schedules for the different hospital units and gathering feedback from nurses and the staff to see how the CCEs are performing. This leadership team is an opportunity for CCE participants to learn more about health care leadership. Hospital staff members provide educational materials to ensure CCEs are aware of important hospital initiatives and developments as well. For example, St. John’s, a member of Dignity Health, once promoted the message of “Hello Humankindness.” This is part of its branding and part of its culture to encourage employees, CCEs, patients, visitors, and the world to share stories of human kindness- moments that are big or small and extend care and compassion to those we encounter each and every day. CCEs are encouraged to contribute to the organization’s project and to share stories. CCEs are also eligible for hospital awards, such as the Sacred Work Award, which recognizes individuals who go above and beyond to make a positive impact on a patient or staff member. Taking part in the hospital’s cultural activities prepares the CCEs to be well-rounded employees who would be a good fit for the organization after completing their clinical training.


Future Health Care Leaders
There are numerous hospital staff stories about how helpful the CCEs are, what a wonderful attitude they display while working on the units, and how thankful the staff is to have the CCEs as partners in care delivery. For instance, Grace Ibe, former Senior Director of Service Excellence and Culture Development at St. John’s Hospitals and currently Vice President, Patient Experience at Good Samaritan Hospital in San Jose shared the following sentiment:

“The Clinical Care Extender program was very instrumental in supporting the healing ministry of the culture at St. John’s Hospitals. The partnership between the CCEs and the staff transformed the CCEs to become care partners and engage them in a collaborative process to help optimize the patient care experience. This collaboration contributed to our measures of success, which I highlighted in presentations to other healthcare leaders. We welcomed the opportunity to engage college students to open their hearts, to be compassionate, and help them enhance their future in a changing healthcare industry.”

During the past ten years, the CCE program participants transitioned from being simply a volunteer position to being an integral part of the St. John’s family. There is more collaboration between the CCEs and hospital staff now than when the program first started. Hospital staff members are also taking more of an interest in the CCEs themselves and are starting to ask questions like “How can I help you grow and reach your goals?”

For more information about the Health Care Talent Innovations Clinical Care Extender program, please contact:

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