North Carolina AHEC Program
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A Modern Day Application of Stone Soup: North Carolina Allied Health Regional Skills Partnerships

By Amy Vega, director of allied and interdisciplinary continuing education, Southern Regional AHEC

There’s an old Portuguese fable, “Stone Soup,” that begins with a kindly, old stranger who was passing through a village. As he entered, the suspicious villagers moved towards their homes, locking doors and windows. The stranger smiled and asked, “why are you all so frightened? I am a simple traveler, looking for a soft place to stay for the night and a warm place for a meal.”

“There's not a bite to eat in the whole province," he was told. "We are weak and our children are starving. Better keep moving on." Times were hard in the small community, but the stranger wasn’t convinced that things were as hopeless as the villagers claimed they were.

"Oh, I have everything I need," he said. "In fact, I was thinking of making some stone soup to share with all of you." He pulled an iron cauldron from his cloak, filled it with water, and began to build a fire under it. Then, with great ceremony, he drew an ordinary-looking stone from a silken bag and dropped it into the water. By now, hearing the rumor of food, most of the villagers had come out of their homes or were watching from their windows. As the stranger sniffed the "broth" and licked his lips in anticipation, hunger began to overcome their fear. "Ahh," the stranger said to himself rather loudly, "I do like a tasty stone soup. Of course, stone soup with cabbage -- that's hard to beat." Soon a villager approached hesitantly, holding a small cabbage he'd retrieved from its hiding place, and added it to the pot. "Wonderful!!" cried the stranger. "You know, I once had stone soup with cabbage and a bit of salt beef as well, and it was fit for a king." The village butcher managed to find some salt beef . . . and so it went, through potatoes, onions, carrots, mushrooms, and so on, until there was indeed a delicious meal for everyone in the village to share.

(Source: http://en.wikipedia.org/wiki/Stone_soup)

Allied Health Regional Skills PartnershipA couple of years ago, I was invited to take part in a modern-day Stone Soup exercise. In the summer of 2007, the North Carolina Department of Commerce issued a solicitation for grant proposals for the formation of what they called “Allied Health Regional Skills Partnerships,” which would create industry-specific “sector strategies” to strengthen the local workforce.

The push for the regional partnerships and sector strategies was driven by the need for a new way to solve workforce problems and a new way to do business. Due to the loss of hundreds of thousands of jobs in textiles and manufacturing over the past decade, North Carolina’s unemployment rate hit a historic high in recent years, leaving us in a state in an economic devastation. But in the wake of this crisis, the demand for health care professionals is steadily rising. Allied health is considered a particularly high-growth industry, with nearly one quarter of a million new jobs expected in NC over the coming decade. With this unique opportunity in mind, Southern Regional AHEC applied for and received a planning grant to form a Regional Skills Partnership (RSP), consisting of health care employers, schools, workforce and economic development boards, and other stakeholders in the community. The spirit of the partnership is to shift employer focus away from competition for a limited pool of qualified candidates for jobs, and work as a team to strengthen training pipelines that supply workers to the local region. With this new focus on collaboration, our RSP was charged with developing and implementing a region-specific sector strategy for moving dislocated and incumbent workers into livable wage allied health careers, and supporting their continued progression into higher-paying roles via defined career ladders and lattices.

Our journey began with a needs assessment of allied health workforce shortages. Looking at primary and secondary data, we determined that Physical Therapists (PTs) and Physical Therapy Assistants (PTAs) comprised more than half of all tracked allied health job vacancies in our region. We then considered that there is no training program in our region for PTs, and only one PTA program. As a largely rural region, it is extremely difficult to compete with metro areas of the state when recruiting PTs and PTAs from outside of our local area. All of the employers participating in our partnership were reporting long-term vacancies in PT and PTA positions, and all were in agreement that a new approach for filling those jobs was much needed.

We first considered that our one PTA program in the region at Fayetteville Technical Community College (FTCC) was our strongest resource, and would be our major point of intervention. Faculty in the program reported that the first-year dropout rate is a staggering one-third of the class. Our partners collaboratively developed a plan that involved academic and social supports to help more students make it through the first year of training. The second major component of the plan included expanding the reach of the program throughout the region through consortium agreements with two other community colleges in our region, Bladen and Sandhills. The agreements with these two schools allow students to complete their preparatory first year of training at either Bladen or Sandhills, and progress to the second year of training at FTCC’s campus, filling seats in the PTA program that had been vacated by students dropping out in the first year. Employers committed their support to hosting the students for shadowing, mentoring and clinical experiences, and workforce development agencies ramped up efforts to promote the PTA program and other allied health programs to displaced workers and other job seekers in the region.

Through the conversations that took place at our monthly partnership meetings, we learned that there was already an effort underway at UNC-Pembroke to bring a Doctor of Physical Therapy program to the area. We invited UNC-P to participate in our partnership, and joined forces to continue working toward the DPT program initiative together. A model for advancing PTAs to PTs through a non-traditional degree program is being explored as part of UNCP’s plan, and has gained significant attention and throughout the region and beyond as it is being considered at the state level.

Our efforts were rewarded by an implementation grant from the NC Department of Commerce after our planning period ended, and the funding has allowed us to begin making our strategies a reality. We are heavily documenting our accomplishments, challenges and wisdom gained along the way, as the Department of Commerce will be targeting other industries for regional partnerships and sector strategies based on lessons learned from work done in the allied health field.

Thinking back to the tale of Stone Soup, I realize that there’s a two-part moral of the story. The first part is about collaboration; that when we each throw an ingredient in the pot, the soup will be much more satisfying than what we come to table with on our own. In other words, the whole is greater than the sum of the parts. The second takeaway from this story is that even in hard times, we each still have something to give. When budgets have been tightened, resources have become even more constrained, and futures are uncertain, we’re much more likely to focus on our own survival and hold on tightly to whatever we have. But if we trust that throwing our last potato or carrot into the soup pot will reap rewards that outweigh having to make the sacrifice, we find that we invested smartly in the end. The same holds true with planning for the future of our health care workforce. We stand on the brink of a potential crisis, with a growing gap between the increasing number of individuals needing health care and the deepening shortage of health care professionals to deliver the services. If we stay in our silos and do nothing but hope that things will improve, we’re all destined to fail. But if we pull together – even in these difficult times – we stand a much greater chance of strengthening our health care workforce, healing our troubled economy, and making our state a healthier place to live. Partnerships truly are a powerful conduit for solving problems and creating positive change.

For more information about the Southern North Carolina Allied Health Regional Skills Partnership, led by SR-AHEC, visit http://sncahrsp.southernregionalahec.org. I encourage everyone at AHEC to study up on sector work as it is more than just a trend, but is a promising practice that is rapidly evolving into the preferred way to do business in workforce development. Another great primer in sector work is “Sector Strategies in Brief” © 2007 Aspen WSI. Take a look when you get a minute. It’s an interesting, easy read over a cup of coffee.

Or better yet, a bowl of soup.

Editor's Note: Amy Vega, the author of this article, also writes Nursing Novellas -- stories about the human side of health care. Is there romance? Yes! Conflict and fighting? Of course! Drama and intense situations? You bet! A happy ending that leaves you wanting more? Absolutely! Continuing education credit? Yes! Read about her novellas in this Fayetteville Observer article and visit Vega's Nursing Novellas blog for more.