University Hospitals

Cleveland, Ohio

Key strategies employed

  • Designate geographic focus in high-poverty neighborhoods
  • Set aside positions for pipeline cohort graduates
  • Offer job coaching for new hires and map out potential career pathways
  • Partner with local educational institutions and community organizations
  • Provide tuition assistance for trainings accessible to frontline employees

University Hospitals Cleveland Medical Center

1032-bed tertiary medical center


8,000 (24,000 system wide)

Mission of Workforce Development Programs

“Enable people to develop careers in which they can meet their potential, aspirations, and earning power and help University Hospitals meet its workforce needs.”


University Hospitals (UH) of Cleveland, Ohio focuses their workforce development initiatives on connecting community residents to jobs, and then to career ladders within the institution. The external programs focus specifically on six high poverty neighborhoods that surround UH’s main campus, called the Greater University Circle (GUC). The GUC has a population of about 50,000. A local nonprofit organization, Towards Employment, provides participants with skills training focused on specific open positions at UH. UH sets aside position spots outside of the normal candidate pool and hires directly from cohort graduates. UH also has an internal worker-training program for current staff, which provides encouragement and support for internal advancement. UH offers a robust set of literacy building and skills training initiatives, with supports such as release time built in, and partners with education and training entities that can provide targeted skills development. In addition, employees can apply for job-specific training programs where they will receive paid training to move into a more advanced position on the career ladder.


Initial workforce development efforts at UH began as part of a grant-funded literacy-building program for employees. Debbi Perkul, now senior workforce development professional, was hired to run the program. The success of the program led to an extension of the grant funding, and, eventually, to the institutionalization of Perkul’s position and workforce development. At the same time, efforts around community outreach accelerated. Interest in local hiring began as part of the Greater University Circle Initiative, a multi-anchor partnership focused on economic revitalization. Perkul’s involvement in the Hire Local committee led to the idea of increasing local hiring into entry-level positions in the hospital. A major barrier to increasing local hiring was the number of applications received by UH—over 17,000 candidates apply each month. At the same time, turnover rates for specific positions were high, necessitating a different recruitment approach. Kim Shelnick, UH’s vice president of talent acquisition, recognized that the way to connect the talent in the surrounding neighborhoods to jobs at UH would be to create a “funnel within the funnel,” in which UH community partners would do the initial screening and training of neighborhood applicants, who would then apply to job openings in target departments as a part of a separate pool.  With these strategies in place, Step Up to UH launched in 2013.

Possible Career Ladder: Patient Care
Possible Career Ladder: Patient Care

As both the human resources and community efforts gained traction, the two areas became further integrated. In 2013, UH launched the Pathway to Patient Care Assistant and a career coaching program. Building off the success of these programs, UH launched Step Up to Patient Care Assistant in 2015, which connects community residents directly to PCA jobs. In December 2014, Human Resources and System Leadership began a strategic planning process for workforce development, through which they assessed existing programming and launched additional pilots.

Program set-up

UH’s workforce development approach includes two types of initiatives. Step Up programs are external facing and target specific, high-poverty neighborhoods. Pathways programs are for current UH workers and are tied into career development and advancement. The goal of Step Up to UH is to support economic development in high poverty neighborhoods surrounding UH by training residents for open positions at the institution. The initial program focused on environmental services and nutrition services, and in 2015, Step Up to PCA was launched which focuses specifically on the patient care assistant position. Towards Employment is UH’s external workforce development partner, providing recruitment and screening, job readiness, coaching, and soft skills training. Another local community-based organization, Neighborhood Connections, provides community outreach. In 2013, twenty-eight people were hired from Step Up to UH, with a 75 percent retention rate after the first year. In 2014-2015, an additional sixty-four people were hired through Step Up to Environmental and Nutrition Services and twenty-nine patient care assistants were hired from Step Up to PCA.

Step Up class 2016

Step Up to UH’s 2016 Class 

UH Pathway to PCA is a program built to support UH employees in frontline service positions to advance into direct patient care. Employees apply to the program, and, if accepted, are hired as clinical technical assistants and then receive paid training. In 2013, ten PCAs were hired through this program with a retention rate of 80 percent after year one. Between 2014 and 2016, an additional eighteen PCAs were hired, most of whom are still employed after one year.

UH Bridge to Your Future is an incumbent worker-training program administered by Tri-C, a local community college that prepares employees for college education. The program focuses specifically on math and reading skills. Employees enrolled in the program receive one hour of release time a week to study, are given access to an online learning platform, and get additional forms of support, such as: coaching, budgeting and financial education, and stress management. 257 employees have enrolled to date, with a completion rate of 79 percent.

Internal career coaching and education programs are open to all employees, help to bolster the existing programs and increase the internal hiring rate. After the implementation of the coaching program in 2013, the internal hiring rate rose from 32 percent to 39 percent. Career coaches help employees navigate their various options for advancement within the institution and the training opportunities offered.

Staffing and budget

Staffing for the Step Up and Pathway programs involves both organizational development and learning and talent acquisition. Integrating these two areas helped to make the efforts more holistic and far reaching. Kim Shelnick spearheads the local hire effort, which illustrates leadership’s commitment to these efforts. Debbi Perkul, senior workforce development professional, is responsible for coordinating training opportunities and seeking out opportunities to add programs and grow partnerships, both inside and outside the institution. “Having a point person who connects human resources hiring and the community-based organizations is really important… There are so many different systems in place, so somebody who [can] help navigate the systems is the key to success,” highlights Perkul. Participation of the hiring managers at the departmental level is also important. As Perkul emphasizes, “Whether it’s a Step Up program or a Pathway program, we’ll be hiring people who will need continued coaching from the job coach, and the managers have to be willing to give the person the leeway and time to transition into that kind of employment.”


The funding for programs comes primarily from philanthropic sources. Many of the incumbent worker programs began as grants. Other costs, such as training and outreach for the Step Up programs, are funded by braiding internal resources with community partners’ funding.

Key strategies employed

Geographic focus on high-poverty neighborhoods

According to Perkul, the focus of Step Up to UH is to “prioritize specific neighborhoods and specific people who might not be able to successfully apply to these jobs through the regular recruitment process.” Step Up to UH focuses on the high poverty zip codes prioritized in the Greater University Circle Initiative, a large place-based revitalization initiative with many anchor, philanthropic, and community partners. This geographic focus ensures alignment of investments across the institution, so that efforts to build and stabilize wealth have the greatest impact. For example, these are the same neighborhoods where employees can participate in the employer-assisted housing program and receive a subsidy to purchase a house. By focusing on neighborhoods with high unemployment, the Step Up program seeks to create measurable impact in the local economy.

Set aside positions for pipeline cohort graduates

Although there is not a guarantee to program graduates that they will be hired, human resources sets aside a percentage of positions for cohort participants, ensuring that their applications will be considered. This process ensures that the Step Up candidates do not get lost in the large volume of applications for open position. The rest of the job openings in the target departments are posted to the regular career website, and follow the usual recruitment process. Step Up and Pathways applicants compete against each other for the designated positions, but not with the general applicant pool. 

Offer job coaching for new-hires and map out potential career pathways

A key feature of UH’s workforce development strategy is to connect the local hire pipeline to pathways for advancement within the institution. UH has outlined clear pathways for frontline employees to advance to higher-wage positions by mapping out training opportunities that will allow employees to learn new skills. Their approach also includes creating pathways for employees to move laterally in cases where this will offer opportunities for further advancement. For example, an employee in environmental services can transition to patient care assistance, which, over time, will offer greater opportunities for career growth.


Step Up to UH

  • 111 hires in two and a half years
  • Reduced interview to hire ratio for recruiters
  • One-year retention rate at 80 percent for pipeline graduates, compared with 66 percent overall

Pathway/Step Up to PCA

  • 55 total hires
  • 80 percent retention

Positions graduates are hired into

  • Environmental services
  • Nutrition services
  • Patient care assistant
  • Operating room assistant
  • Medical assistant

Creating pathways within the institution also serves to make diversity goals more impactful, which is a top UH priority. “The trick is that over time we want to continue to push people up once they’re here. The further up we can push people, the more it will add to the institution’s diversity,” Perkul notes.

Job coaching is also an essential component of this pathways approach. Step Up employees receive six months of job coaching from Towards Employment after their hire. And, thanks to a large philanthropic gift received in 2016, all entry-level employees have access to career coaching. In addition to helping employees navigate their training and advancement options, their leadership has been trained to better support frontline employees. Shelnick explained, “[We’re] training our leaders on how to be more understanding of the everyday problems that this level of employee is experiencing from social and economic standpoints…If they’re having a babysitter problem, or just having other day-to-day problems as single moms or dads, we can give training to our leaders to know how to work through those issues.”

Tuition assistance for frontline employee accessible training

In order to make these pathways a reality, human resources connects employees to tuition assistance, which is not just available for degree granting programs, but for skill building and certificate programs as well. For a number of programs, employees can get release time and be compensated for training. For example, in the Pathway to PCA program, participants are hired as PCAs upon acceptance to the program, and are paid for their training time.

Partnerships with local educational institutions and community organizations

Partnerships, particularly with Neighborhood Connections and Towards Employment, are key to the success of the UH programs. Not just because they help deliver quality services and connect to neighborhood-based expertise and resources, but because they make financial sense as well.  Shelnick explained that one of UH’s first priorities was to establish strong partnerships, since they did not have the human resources to have members of the team perform all of the roles. Partnering is also critical to outreach. Neighborhood Connections is successful in its outreach efforts for the Step Up programs because it is embedded in the community and has a wide grassroots network. Because Neighborhood Connections offers a variety of services, including a small grants program, community members engage with the organization even if they are not participants in the Step Up programs. Moreover, Neighborhood Connections has credibility in the community because of the success of their other programs, allowing Step Up to build off of their existing reputation.

For more information

For additional tools and templates, see More Resources


Debbi Perkul, interview by David Zuckerman and Katie Parker, November 3, 2015, transcript.

Debbi Perkul and Danielle Price, interview by David Zuckerman and Katie Parker, Cleveland, OH, January 11, 2016, transcript

Kim Shelnick, interview by Ted Howard, Cleveland, OH, October 15, 2015, transcript.

CareerStat, National Fund for Workforce Solutions and Jobs for the Future, “University Hospitals,”

More Workforce Case Studies

West Philadelphia Skills Initiative

In Philadelphia, Pennsylvania, the West Philadelphia Skills Initiative is building the local workforce capacity to meet anchor institutions’ (including health systems’) hiring needs, and connecting diverse residents from high- poverty neighborhoods to ...

Emergency Medical Services Corps

In Alameda County, California, EMS Corps is increasing the number of underrepresented emergency medical technicians by connecting young men of color to mentorship and job training opportunities.

Partners HealthCare

In Boston, Massachusetts, Partners HealthCare is offering paid internship programs with pathways to hire and providing coaching and tuition assistance for internal advancement for frontline employees.

University of Colorado Anschutz Medical Campus

In Aurora, Colorado, University of Colorado Anschutz Medical Campus is prioritizing community engagement and partnering with local workforce intermediaries to provide training to diverse, local residents for high-need, high-turnover jobs.

Johns Hopkins University & Health System

In Baltimore, Maryland, Johns Hopkins University & Health System is connecting forecasting, training, and hiring departments to create a workforce strategy that prioritizes hiring diverse, local residents, and then providing intentional internal career...