Rationale

A capable and diverse health care workforce is necessary to improve the health and health care of all Americans. The Robert Wood Johnson Foundation makes investments to build specific fields within health and health care to help ensure that our nation has a well-trained workforce providing high-quality care and services. As the nation’s population ages and grows more diverse, as demand for public health services increases and as new technologies require new skills, stronger systems of human resource development and innovative approaches to learning are needed.

The Jobs to Careers initiative was established to meet the needs of the workers delivering direct health care and services—a diverse group in positions such as medical assistants, health educators, laboratory technicians, substance abuse counselors, or home health aides—and their employers, who require a skilled and stable frontline workforce. These workers practice in settings such as acute care hospitals, long-term care institutions, behavioral and community health clinics, and public and community health organizations. They provide their patients and clients with preventive and early intervention services, chronic illness management strategies, and long-term and post-hospitalization rehabilitative care.

These workers—4.7 million of them in the United States—earn less than $40,000 per year on average, have less than a Bachelor’s level education, and lack credentials that allow independent practice. (For further description of frontline workforce occupations, see Defining the Frontline Workforce.)

Frontline workers often receive limited formal training and learn from peers and through "trial and error" experience, which may compromise service and care delivery. Jobs also lack clear standards and competencies, with limited focus by supervisors on employee skill development and advancement. These factors, combined with workers’ perceptions of being unrecognized for their contributions to the workplace, are associated with high turnover, increased costs, and compromised quality.

Supported by research that shows a connection between reduced turnover and increased quality of care and service delivery, employers seeking to train and retain workers more effectively have begun to implement strategies to:

• Improve supervision, mentoring, wages and benefits;
• Support training and career ladders; and
• Bolster human resource policies that support skill and career development.

Jobs to Careers seeks to learn from, advance and build on these approaches.