Like many essential health systems, East Alabama Health (EAH), in Opelika, Ala., struggled with staff turnover and vacancy challenges after the COVID-19 pandemic.

Susan Johnston, the health system's chief human resources officer, knew that closing these critical industry gaps started right at home.

"Our current employees need to be our future employees," says Johnston. "We realized there was a big desire amongst the employees to advance."

However, many staff were unable to pursue higher education and step into advanced roles because they could not afford to step away from full-time work.

"Some of these employees cannot financially scale back," Johnston says. "They cannot not have health insurance, or they can't afford health insurance [working] part-time."

The health system found the solution in partnerships with local colleges and universities. Together, they remove barriers to entry and create sustainable career pathways in nursing, medical coding, radiology, emergency services, and other fields while allowing staff to maintain their current roles.

In 2024, EAH partnered with Chattahoochee Valley Community College (CVCC) to launch an on-site Licensed Practical Nurse (LPN) school. After finishing their degree and achieving licensure, students can step into their new jobs as LPNs at EAH.

"We've figured out a way to have structured school time," says Johnston. "They're paid their hourly rate to go to school. Then they have a part-time role that they maintain. They're still having a full-time paycheck, full-time benefits, but they're going to school."

EAH also sponsors 10 spots each semester for employees to enroll in Southern Union State Community College's (SUSCC's) nursing program. Additionally, the health system's Registered Apprenticeship Program allows nursing students at Auburn University, Central Alabama Community College, CVCC, SUSCC, and Troy University at Montgomery to earn a wage while gaining clinical hour credit toward their nursing classes.

"This is a way to invest in our current staff and rebirth that loyalty that was there," says Johnston. "They feel safe here knowing that they can grow and try something new. [Some are] the first college student ever in their family."

On-site Learning Key to Success

For Katie Reaves, LPN, the career programs at EAH were life-changing.

Reaves started her career in health care working as an activities assistant at EAMC-Lanier Nursing Home.

"One day, I just said, 'You know what? I'm going to believe in myself, and we'll see where it takes me,"' she says.

Reaves first applied to the Pathways to Advancement Program, a 10-month, on-site learning program designed for employees seeking to strengthen foundational education and technology skills.

Upon completing this program, Reaves felt empowered to keep going. She joined the inaugural cohort for the on-site LPN school, where she gained invaluable skills to take the next step in her career.

"Our instructors were very open to hearing our encounters [from] our different roles," she explains. "It became very personal sharing our stories and experiences, which helped to retain the information we were learning about because we got to hear real one-on-one."

Reaves, who helps raise her niece, says the on-site integration was extremely helpful in managing her busy schedule.

"I didn't have to worry about either losing work hours or having to work extra hard outside of class to meet those hours," she explains. "It all just kind of flowed together and made it a little bit easier and less stressful."

At the end of her first semester in the LPN program, Reaves learned about EAH'S nurse apprenticeship program.

"I said, 'Well, I took a shot on myself once. Let me throw my name in the hat again,'" says Reaves.

She was selected for the apprenticeship program in her second semester.

"It really gave me an appreciation of how the hospital flows as a whole, getting to see it from all different angles and not just one day here or with a group of other nursing students," says Reaves. "It astronomically changed my grades being able to tie the hands-on to the paper."

Reaves has since graduated from the LPN program and currently works in East Alabama Medical Center's psychiatric unit.

"It never hurts to try. It never hurts to learn," Reaves says. "Sign up for the classes, do the program, take the chance . . . no one's going to believe in you better than you."

Workforce Investment Pays Off

Beyond developing employees, investing in a well-staffed workforce is also critical for ensuring access to care in rural areas like Opelika.

"We're a desert for ultrasounds," Johnston says. "We're a desert for nuclear medicine. We're a desert for whatever it happens to be. We really need to be putting programs where the needs are."

This investment mutually benefits both staff and EAH as an employer. Staff can access higher-paying jobs while EAH saves both time and money that otherwise would have been spent on recruitment.

"Now [I] no longer have to go through the entire hiring process and vetting the people. That is a job in itself," explains Johnston. "I'm showing my CFO [the ROI] in [reduced] turnover costs [and] reduced orientation costs, especially with nursing."

At any given time, 250 EAH employees are actively enrolled in education or training programs, says Johnston, who hopes other struggling essential hospitals use EAH's workforce strategy as a blueprint for community sustainability.

"It is changing people's lives for sure,' says Johnston. "Two [employees] told me this week, 'I'm going to prove to my children that I can do this and show them so that they can do it.'"