Behind every public health response are two make-or-break factors: the people doing the work and the systems that help them work together. First, Shirley Orr, Executive Director of the Association of Public Health Nurses discusses the Public Health Nursing Workforce Learning Lab Series Session 5 with insights from PHWINS, the nation’s only survey of the state and local public health workforce, which reached nearly 50,000 professionals. The data paints a detailed picture of who makes up today’s workforce, including an influx of younger staff, persistent leadership diversity gaps, and ongoing concerns about burnout and morale. Later, Dr. Lisa Villarroel, Chief Medical Officer for Public Health of the Arizona Department of Health Services shows us what happens when that workforce is connected in real time. Arizona’s Statewide Healthcare Collaborative Forum, a simple monthly virtual call during respiratory season, brings EMS, hospitals, post-acute care, and public health leaders together to review virus trends, hospital capacity, ED diversion, and emerging challenges. Born from pandemic lessons, the forum has led to tangible results: resolving EMS transport delays, sparking regional hospital alliances, rethinking masking policies, and aligning state data with frontline reality.
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This is Public Health Review
Morning Edition for Friday,
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February 13th, 2026.
I'm John Sheehan with news from
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the Association of State and
Territorial Health Officials.
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Today is all about sharing data
across the public health system
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and within a single state.
First, Shirley Orr, executive
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director of the Association of
Public Health Nurses, discusses
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the Public Health Nursing
Workforce Learning Lab Series,
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Session 5, with insights from pH
WINS, the nation's only survey
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of the state and local public
health workforce, which reaches
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nearly 50,000 professionals.
A little later, Doctor Lisa
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Villarreal, chief Medical
officer for Public Health of the
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Arizona Department of Health
Services, shows us what happens
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when that workforce is connected
in real time.
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Arizona's statewide Healthcare
Collaborative Forum, A simple
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monthly virtual call during
respiratory season, brings EMS,
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hospitals, post acute care and
public health leaders together
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to review virus trends, hospital
capacity, Ed diversion.
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And emerging challenges.
But let's start with Shirley Orr
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with what the upcoming Public
Health Nursing Workforce
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Learning Lab series session will
cover.
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To give a little bit of
background, pH Winds is the only
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survey that looks at the
educational needs as well as the
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demographics and trends in the
public health workforce.
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The Winds survey, the most
recent one, reached about 50,000
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workers in local and state
health departments.
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And it gives a good set of
comprehensive data for us to use
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as we think about the needs of
our workforce, in our case,
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public health nurses
specifically.
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The data includes areas like
age.
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It's important for us to be
aware of the age of our
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workforce.
Obviously to look at are we
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bringing in enough younger,
newer professionals as well as
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are we preparing for those
leaving the field due to
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retirement.
It looks at gender distribution.
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We know of course, that within
nursing it's largely female
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dominated.
And also we certainly want to
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try to diversify the field.
So it gives us some good
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guidance to base that action on.
It also looks at some really
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important things like what is
staff engagement look like?
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What about morale?
What about burnout in the
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workforce?
You know, we saw a lot of exodus
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during COVID and after that time
period I think things have
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become better.
But I think it's really
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important for us to continue to
be conscious of burnout in the
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workforce and look at strategies
that we can implement to help to
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promote recruitment and
retention.
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We know that nurses that come to
public health come here not for
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the salary.
You can certainly earn a higher
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salary in a clinical care
setting, but they come because
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they're really committed to the
mission and we want to try to do
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everything we can to encourage
them to continue to stay and
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practice in the field.
Yeah, absolutely.
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And it sounds like the survey is
pretty comprehensive.
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It has both qualitative and
quantitative, you know,
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demographic information as well
as that drill down information
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on what is the workforce looking
for, what are they experiencing?
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Are they burned out?
Yeah, that's true.
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Hopefully people will keep in
mind that it is indeed a survey,
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therefore it's based on a
representative sample of
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probably also a very good idea
for individual organizations to
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do a little bit of a deeper dive
on their own workforce and
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perhaps do some qualitative
follow up, maybe some focus
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groups with individuals who are
staff in their agencies to help
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them understand a little bit
more about the uniquenesses.
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We know that there's a lot of
commonality across the
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workforce, but there are also
some uniquenesses.
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So there is the opportunity to
do that at the individual
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organizational level.
Sure.
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And you touched on this a little
bit, noting that by and large
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the workforce skews female.
Can you talk a little bit more
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about sort of the demographic
makeup of the current?
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Workforce.
Yeah, sure.
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Some of the things that we know
about the workforce, we're
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getting better in terms of
younger people coming into the
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field.
I think right now around 25% of
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the workforce is underage, 35.
The majority of them are new in
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the past five years, which that
does represent a change from
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what we've seen in previous
years.
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People tended to come in and
stay quite a long time.
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Therefore, the workforce skewed
a lot.
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Older.
We do still have a number of
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individuals in that, that older
segment of the workforce that
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we're pleased to see that we're
bringing in new people to the
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field.
Another major issue that we
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continue to face, and this has
been an issue for many years, is
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to work toward a workforce that
better represents our
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population, the workforce that
looks like the people we serve.
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So that we have public health
nurses along with other public
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health workers who come from
diverse backgrounds.
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And I mean diverse in every way,
both racially and ethnically, in
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terms of age, geographically
representative.
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So really working on that is
important.
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One thing that I might point out
is that historically, nurses
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that rise to leadership roles in
and that group underrepresented
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minorities are even more
underrepresented.
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So creating career pathways to
provide a means for those people
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to move forward in their public
health careers and assume
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leadership roles is a really
important focus for the future.
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And another goal of the survey
is to provide direction and data
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towards training, what the
workforce needs in terms of
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training and.
How?
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How?
Agencies can improve.
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Can you talk a little bit more
about how the survey can be used
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in that capacity?
Yeah, sure.
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So understanding education and
training needs of the workforce
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helps us in a number of ways.
For one thing, in recent years,
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we have a relatively new process
for public health agency
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accreditation.
And one of the important
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components of that accreditation
is does the organization have a
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clearly defined process for
recruitment, retention and
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education of the workforce.
So having some data that enables
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agencies to look at that, to
plan quality improvement
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efforts, look at how they
allocate their budgets for
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training, that's really
important to to that.
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Certainly another important
aspect, along with
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accreditation, we've seen new
frameworks for public health
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practice come online, including
foundational public health
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services.
So it's really important for us
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to look at our workforce, their
educational needs particularly
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to assure that we have the
ability to meet those
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foundational services and to
provide those for our
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populations.
And hand in hand with that, can
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you talk a little bit about how
leadership could use the survey
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in tandem with or as opposed to
sort of an annual review process
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that looks only at their own
agency?
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The survey can bring in sort of
a whole picture look.
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Yeah, WINS gives us the ability
to have a broader database so we
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can benchmark our workforce at
local and state levels to the
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national workforce.
And I believe very importantly,
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it gives leaders the knowledge
and data to be able to advocate
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to policy makers for investments
in public health, particularly
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in terms of the workforce.
What are the needs?
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How can we be prepared for
emerging issues and trends in
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public health?
Do we have enough individuals
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who serve in various roles?
And if not, how can we begin to
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plan strategies to help both
improve the workforce we have
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through targeted training and
education, but also recruitment
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efforts?
And lastly, Shirley.
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You've you've.
Already sort of made some great
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cases for how the survey can be
used as a tool for advancing
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training recommendations for
setting benchmarks as you
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mentioned.
Can you make the case why
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someone should tune into this
webinar and listen to sort of
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the the pH Twins overview?
Yeah, sure.
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So as I mentioned, this is one
of the PHN recruitment and
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retention focused sessions in
the Public Health Nursing
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learning lab.
We know recruitment and
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retention is a very major issue
and certainly this is an
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important part of that.
Public Health Wins is a great
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tool and resource and sometimes
I think it may be not well
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enough understood across our
workforce widely.
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There have been many changes in
pH wins over the years.
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It has a lot more functionality
than it did even just a few
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years ago.
One of the new additions this
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year is something called
Insights to Action that contains
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somewhere around 40 practical
tools and resources for
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workforce development that can
be used within local agencies.
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And then importantly, we'll have
Maddie Papalis, who is with the
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de Beaumont Foundation, with us
to talk about WINS.
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She is the WINS expert.
Her professional role is 100%
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dedicated to WINS, so leaders
can certainly find out current
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information from the national
expert in Public health WINS.
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Shirley Orr is executive
director of the Association of
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Public Health Nurses.
You can learn.
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More about the upcoming Public
Health Nursing Workforce
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Learning Labs Series, Session 5
at the link in the show notes.
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Now let's hear from Doctor Lisa
Villarroel, chief medical
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officer for Public health of the
Arizona Department of Health
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Services, about Arizona's
statewide Healthcare
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Collaborative forum.
So for the past four years, the
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Arizona Department of Health
Services has hosted this
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statewide healthcare
collaborative forum, and it's a
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virtual statewide meeting that
invites everyone along the
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spectrum of healthcare.
So we're thinking, you know, EMS
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hospital post acute care setting
brings everyone together once a
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month for an hour during the
respiratory season.
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This season we started in
November and we're going to end
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either in February or March.
The way these meetings usually
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work is we start with a data
review from public health on
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circulating respiratory viruses,
on any new regulatory updates,
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any new EPI updates.
And then we move into a
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presentation from a local
partner on a particular topic
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around surge, around infection
control.
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And then we end with a full
partner report out and sometimes
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we're done in 35 minutes and
sometimes we're racing the clock
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at 59 minutes.
Yeah, that makes sense because
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you've got everyone in in the
virtual room from the on the
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ground practitioners to the
folks up making the policy and
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seeing where all of it sort of
shakes.
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Out.
Yeah, that's right.
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It's, it's like the one place
where you have on one call EMS,
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we have AZ REACH which is our
statewide inter hospital
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transfer system.
We have all, almost every acute
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care hospital represented and
the post acute care agencies and
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entities represented.
It's like the one place where
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the full spectrum is all there
at once.
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What was the sort of impetus for
it and why?
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Why was was the seasonal strain
just hitting so much that you
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were like, we, we need to figure
this out?
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Honestly, I think this came out
of COVID.
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You know, we were used at that
point for everyone coming
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together and meeting in one
place.
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And I think one of the lessons
we learned from the pandemic was
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the disproportionate impact just
bringing everyone together can
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have.
So it's a very simple concept to
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have one virtual phone call with
everyone.
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We all hear the same
information.
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If people have a particular
concern, it comes up.
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But we've been doing it for four
years now and we have incredible
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attendance still.
What sorts of things have come
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up during these meetings that
you're like, oh, this is?
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Incredible.
We would have never otherwise
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seen this.
Yeah.
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So there's 4 main objectives of
this work group. 1 is to share
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situational awareness, 1 is to
share, you know, EPI or
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regulatory updates.
One is to present any kind of
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regional best practices going
on.
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And the last one is for the
health department to support any
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collaborative effort that all
the entities, you know, want to
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embark upon.
And so in the course of, you
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know, working with those 4
objectives, interesting things
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come up.
Recently, one of our healthcare
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systems presented on their
universal masking policy.
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One time an Arizona hospital
presented on a regional alliance
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they have with other hospitals,
where the smaller hospitals
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support each other with
consultations and diversion.
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One time a hospital leader
brought up the low flu
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vaccination rates that they were
seeing in their staff.
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So all these little pings really
inspire further conversations.
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And so, you know, a hospital
will think we'll do.
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Does our hospital need a
universal masking policy?
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Like should our hospital be part
of an alliance?
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Like, what is our staff
vaccination rate?
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I can tell you on the
vaccination rate part, when that
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00:12:57,440 --> 00:12:59,720
hospital brought it up, it
prompted the health department
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00:12:59,720 --> 00:13:02,800
to go back and look at our own
annual flu vaccination rate data
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00:13:02,800 --> 00:13:05,720
year over year to see if we were
tracking with what that
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particular hospital had been
seeing.
239
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Oh wow, so already getting these
tangible results from just
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sharing stories.
Yeah.
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00:13:13,720 --> 00:13:19,120
Another big example was when an
EMS agency brought up the fact
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that a new prior authorization
protocol was holding up their
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00:13:22,200 --> 00:13:24,480
transport.
We had not heard of this at the
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00:13:24,480 --> 00:13:27,880
health department and so we
ended up helping connect those
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00:13:27,920 --> 00:13:30,240
EMS agencies with the right
person at the pair.
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00:13:30,840 --> 00:13:33,600
It felt tangible.
It felt like there were there
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00:13:33,600 --> 00:13:35,560
was a result.
And I guess the question is
248
00:13:35,560 --> 00:13:37,080
where else should this have been
brought up?
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00:13:37,200 --> 00:13:40,240
Like where else do you have
everyone along the process of
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00:13:40,240 --> 00:13:43,080
healthcare and patient
throughput all together on one
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00:13:43,640 --> 00:13:45,160
call?
I mean, in this particular
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00:13:45,160 --> 00:13:48,360
circumstance, you have two of
the three components of the
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00:13:48,360 --> 00:13:52,320
healthcare system involved.
You have the facilities and you
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00:13:52,320 --> 00:13:55,240
have EMS, and in this call
they're all together.
255
00:13:55,720 --> 00:13:59,400
One of the big goals of the of
the program is collaboration
256
00:13:59,400 --> 00:14:01,440
through data.
Can you talk a little bit more
257
00:14:01,440 --> 00:14:04,000
about the kinds of data that
you're getting that you're
258
00:14:04,000 --> 00:14:06,760
collecting, maybe that you
didn't know that you needed?
259
00:14:07,640 --> 00:14:10,040
Yeah, Data is always how we
open.
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00:14:10,040 --> 00:14:13,080
Every meeting is to talk about
the data that that we have.
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00:14:13,160 --> 00:14:16,720
And I think it is critical for
the state health department to
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00:14:16,720 --> 00:14:21,600
be able to trust its own data.
And so every meeting we show the
263
00:14:21,600 --> 00:14:24,000
data that we have.
Yes, we show the EPI data on the
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00:14:24,000 --> 00:14:26,360
respiratory viruses that are
circulating, but we will always
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00:14:26,360 --> 00:14:28,880
show the bed capacity data that
we have.
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00:14:28,880 --> 00:14:32,640
We will show the Ede, you know,
diversion that we have and so
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00:14:32,640 --> 00:14:34,760
on.
And we asked specifically, does
268
00:14:34,760 --> 00:14:37,760
this match with what you all are
seeing on the ground?
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00:14:39,000 --> 00:14:42,320
Before we started, you made
clear that you want this to be
270
00:14:42,320 --> 00:14:44,280
known.
At it's heart, it's a phone
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00:14:44,280 --> 00:14:46,320
call.
It's getting everyone to talk to
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00:14:46,320 --> 00:14:47,960
each other.
Is that?
273
00:14:47,960 --> 00:14:51,520
How you would approach?
Other systems that are trying to
274
00:14:51,520 --> 00:14:53,720
think about like, well, how?
Do we just get everyone in a
275
00:14:53,720 --> 00:14:56,680
room to understand?
Make a phone call.
276
00:14:57,440 --> 00:14:59,400
No thanks.
That's, that's exactly the point
277
00:14:59,400 --> 00:15:01,920
that I'd like to make about the
Statewide Healthcare
278
00:15:01,920 --> 00:15:04,320
Collaborative forum is that
health departments could
279
00:15:04,320 --> 00:15:06,880
implement this next week if they
wanted.
280
00:15:06,880 --> 00:15:09,400
You don't need tech.
You don't need slides.
281
00:15:09,440 --> 00:15:11,680
We'll send you our slides if
that would be helpful, but you
282
00:15:11,680 --> 00:15:13,640
don't need a room.
You don't need written
283
00:15:13,640 --> 00:15:16,240
materials.
You need an hour once a month
284
00:15:16,240 --> 00:15:18,520
during the respiratory season
for a virtual meeting.
285
00:15:19,200 --> 00:15:22,040
And I think, you know, we keep
our program really standard.
286
00:15:22,200 --> 00:15:24,200
We tweak it a little bit, you
know, year over year.
287
00:15:24,200 --> 00:15:27,920
One year, I remember we tried to
highlight the major published
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00:15:27,920 --> 00:15:30,920
articles on surge that were
coming out this year.
289
00:15:30,920 --> 00:15:34,200
For example, we had to add a
section on measles because
290
00:15:34,200 --> 00:15:36,280
that's something that we're
experiencing here in Arizona.
291
00:15:36,640 --> 00:15:41,200
Honestly, the opening content
can change, but the invitees and
292
00:15:41,200 --> 00:15:45,080
the concept of inviting everyone
to the table for folks to come,
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00:15:45,080 --> 00:15:46,880
you know that is what doesn't
change.
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00:15:47,440 --> 00:15:51,800
And this is our fourth year
running this and attendance
295
00:15:51,800 --> 00:15:54,560
remains high.
Nearly every acute care hospital
296
00:15:54,560 --> 00:15:58,000
is represented, all EMS
agencies, several local health
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00:15:58,000 --> 00:16:01,040
departments and then the
agencies representing post acute
298
00:16:01,040 --> 00:16:03,160
care as well.
And I just think it's a
299
00:16:03,160 --> 00:16:06,360
wonderful baseline structure to
have.
300
00:16:06,920 --> 00:16:09,960
And I remember one year there
were conversations internally
301
00:16:09,960 --> 00:16:13,960
like, should we reconvene this
group before our next meeting
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00:16:13,960 --> 00:16:18,480
because things are escalating
with with hospital surges and we
303
00:16:18,480 --> 00:16:23,000
didn't at the time, but that's a
lever that can be pulled at any
304
00:16:23,000 --> 00:16:25,640
time.
This is a known entity.
305
00:16:25,920 --> 00:16:30,480
This is a known work group.
And it's so nice to have that.
306
00:16:32,080 --> 00:16:35,000
Doctor Lisa Villarroel is chief
medical officer for public
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00:16:35,000 --> 00:16:37,600
health of the Arizona Department
of Health Services.
308
00:16:38,280 --> 00:16:41,240
Earlier we heard from Shirley
Orr, executive director of the
309
00:16:41,240 --> 00:16:43,280
Association of Public Health
Nurses.
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00:16:44,680 --> 00:16:47,760
Leading Change is a new ASTA
workshop designed for
311
00:16:47,760 --> 00:16:50,600
professionals and clinical and
non clinical public health
312
00:16:50,600 --> 00:16:53,280
roles.
The workshop equips participants
313
00:16:53,280 --> 00:16:56,560
with strategies and skills to
navigate change and uncertainty
314
00:16:56,560 --> 00:17:00,200
as individuals, team members and
organization wide leaders,
315
00:17:00,880 --> 00:17:03,280
emphasizing actionable
instruction and resources.
316
00:17:03,280 --> 00:17:06,760
It enables leaders to create and
implement real world initiatives
317
00:17:06,760 --> 00:17:09,560
in their agencies for 2026 and
beyond.
318
00:17:10,319 --> 00:17:13,720
Participants will gain tools to
design targeted initiatives and
319
00:17:13,720 --> 00:17:16,079
foster tangible organizational
change.
320
00:17:16,680 --> 00:17:19,680
This experience prepares them to
drive meaningful impact in their
321
00:17:19,680 --> 00:17:22,000
workplaces.
Find more at the link in the
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00:17:22,000 --> 00:17:24,920
show notes.
This has been public health
323
00:17:24,920 --> 00:17:27,280
review morning edition.
I'm John Sheehan for the
324
00:17:27,280 --> 00:17:30,320
Association of State and
Territorial Health Officials.
00:00:00,920 --> 00:00:03,440
This is Public Health Review
Morning Edition for Friday,
2
00:00:03,440 --> 00:00:07,080
February 13th, 2026.
I'm John Sheehan with news from
3
00:00:07,080 --> 00:00:10,000
the Association of State and
Territorial Health Officials.
4
00:00:10,680 --> 00:00:14,280
Today is all about sharing data
across the public health system
5
00:00:14,280 --> 00:00:18,400
and within a single state.
First, Shirley Orr, executive
6
00:00:18,400 --> 00:00:21,760
director of the Association of
Public Health Nurses, discusses
7
00:00:21,760 --> 00:00:25,080
the Public Health Nursing
Workforce Learning Lab Series,
8
00:00:25,080 --> 00:00:29,880
Session 5, with insights from pH
WINS, the nation's only survey
9
00:00:29,880 --> 00:00:32,920
of the state and local public
health workforce, which reaches
10
00:00:32,920 --> 00:00:37,000
nearly 50,000 professionals.
A little later, Doctor Lisa
11
00:00:37,000 --> 00:00:40,320
Villarreal, chief Medical
officer for Public Health of the
12
00:00:40,320 --> 00:00:43,480
Arizona Department of Health
Services, shows us what happens
13
00:00:43,480 --> 00:00:46,200
when that workforce is connected
in real time.
14
00:00:47,080 --> 00:00:50,840
Arizona's statewide Healthcare
Collaborative Forum, A simple
15
00:00:50,920 --> 00:00:54,960
monthly virtual call during
respiratory season, brings EMS,
16
00:00:55,120 --> 00:00:59,080
hospitals, post acute care and
public health leaders together
17
00:00:59,080 --> 00:01:02,880
to review virus trends, hospital
capacity, Ed diversion.
18
00:01:03,160 --> 00:01:06,960
And emerging challenges.
But let's start with Shirley Orr
19
00:01:07,000 --> 00:01:09,640
with what the upcoming Public
Health Nursing Workforce
20
00:01:09,640 --> 00:01:12,040
Learning Lab series session will
cover.
21
00:01:12,880 --> 00:01:17,320
To give a little bit of
background, pH Winds is the only
22
00:01:17,840 --> 00:01:21,440
survey that looks at the
educational needs as well as the
23
00:01:21,440 --> 00:01:25,280
demographics and trends in the
public health workforce.
24
00:01:25,480 --> 00:01:29,360
The Winds survey, the most
recent one, reached about 50,000
25
00:01:29,360 --> 00:01:32,120
workers in local and state
health departments.
26
00:01:32,440 --> 00:01:36,480
And it gives a good set of
comprehensive data for us to use
27
00:01:36,480 --> 00:01:39,480
as we think about the needs of
our workforce, in our case,
28
00:01:39,480 --> 00:01:41,360
public health nurses
specifically.
29
00:01:41,640 --> 00:01:44,560
The data includes areas like
age.
30
00:01:44,560 --> 00:01:46,880
It's important for us to be
aware of the age of our
31
00:01:46,880 --> 00:01:49,120
workforce.
Obviously to look at are we
32
00:01:49,120 --> 00:01:52,880
bringing in enough younger,
newer professionals as well as
33
00:01:52,880 --> 00:01:55,880
are we preparing for those
leaving the field due to
34
00:01:55,880 --> 00:01:59,040
retirement.
It looks at gender distribution.
35
00:01:59,040 --> 00:02:02,480
We know of course, that within
nursing it's largely female
36
00:02:02,480 --> 00:02:05,080
dominated.
And also we certainly want to
37
00:02:05,080 --> 00:02:07,640
try to diversify the field.
So it gives us some good
38
00:02:07,640 --> 00:02:11,640
guidance to base that action on.
It also looks at some really
39
00:02:11,640 --> 00:02:15,680
important things like what is
staff engagement look like?
40
00:02:15,920 --> 00:02:19,160
What about morale?
What about burnout in the
41
00:02:19,160 --> 00:02:22,240
workforce?
You know, we saw a lot of exodus
42
00:02:22,240 --> 00:02:26,120
during COVID and after that time
period I think things have
43
00:02:26,120 --> 00:02:28,040
become better.
But I think it's really
44
00:02:28,040 --> 00:02:31,880
important for us to continue to
be conscious of burnout in the
45
00:02:31,880 --> 00:02:36,400
workforce and look at strategies
that we can implement to help to
46
00:02:36,400 --> 00:02:38,600
promote recruitment and
retention.
47
00:02:39,080 --> 00:02:42,440
We know that nurses that come to
public health come here not for
48
00:02:42,440 --> 00:02:44,520
the salary.
You can certainly earn a higher
49
00:02:44,520 --> 00:02:48,040
salary in a clinical care
setting, but they come because
50
00:02:48,040 --> 00:02:51,360
they're really committed to the
mission and we want to try to do
51
00:02:51,360 --> 00:02:55,680
everything we can to encourage
them to continue to stay and
52
00:02:55,680 --> 00:02:58,040
practice in the field.
Yeah, absolutely.
53
00:02:58,040 --> 00:03:00,480
And it sounds like the survey is
pretty comprehensive.
54
00:03:00,480 --> 00:03:03,440
It has both qualitative and
quantitative, you know,
55
00:03:03,440 --> 00:03:06,800
demographic information as well
as that drill down information
56
00:03:06,800 --> 00:03:10,280
on what is the workforce looking
for, what are they experiencing?
57
00:03:10,280 --> 00:03:12,560
Are they burned out?
Yeah, that's true.
58
00:03:13,240 --> 00:03:16,440
Hopefully people will keep in
mind that it is indeed a survey,
59
00:03:16,440 --> 00:03:19,240
therefore it's based on a
representative sample of
60
00:03:20,160 --> 00:03:24,040
probably also a very good idea
for individual organizations to
61
00:03:24,040 --> 00:03:26,960
do a little bit of a deeper dive
on their own workforce and
62
00:03:26,960 --> 00:03:29,760
perhaps do some qualitative
follow up, maybe some focus
63
00:03:29,760 --> 00:03:33,800
groups with individuals who are
staff in their agencies to help
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00:03:33,800 --> 00:03:37,160
them understand a little bit
more about the uniquenesses.
65
00:03:37,160 --> 00:03:39,320
We know that there's a lot of
commonality across the
66
00:03:39,320 --> 00:03:41,680
workforce, but there are also
some uniquenesses.
67
00:03:41,960 --> 00:03:45,800
So there is the opportunity to
do that at the individual
68
00:03:45,800 --> 00:03:47,800
organizational level.
Sure.
69
00:03:48,760 --> 00:03:52,240
And you touched on this a little
bit, noting that by and large
70
00:03:52,240 --> 00:03:55,560
the workforce skews female.
Can you talk a little bit more
71
00:03:55,560 --> 00:03:57,480
about sort of the demographic
makeup of the current?
72
00:03:57,480 --> 00:03:59,880
Workforce.
Yeah, sure.
73
00:04:00,200 --> 00:04:02,960
Some of the things that we know
about the workforce, we're
74
00:04:02,960 --> 00:04:06,160
getting better in terms of
younger people coming into the
75
00:04:06,160 --> 00:04:09,480
field.
I think right now around 25% of
76
00:04:09,480 --> 00:04:14,440
the workforce is underage, 35.
The majority of them are new in
77
00:04:14,440 --> 00:04:17,839
the past five years, which that
does represent a change from
78
00:04:17,839 --> 00:04:19,720
what we've seen in previous
years.
79
00:04:20,120 --> 00:04:22,600
People tended to come in and
stay quite a long time.
80
00:04:22,600 --> 00:04:24,680
Therefore, the workforce skewed
a lot.
81
00:04:24,680 --> 00:04:27,680
Older.
We do still have a number of
82
00:04:27,680 --> 00:04:31,520
individuals in that, that older
segment of the workforce that
83
00:04:31,520 --> 00:04:34,360
we're pleased to see that we're
bringing in new people to the
84
00:04:34,360 --> 00:04:37,200
field.
Another major issue that we
85
00:04:37,200 --> 00:04:42,160
continue to face, and this has
been an issue for many years, is
86
00:04:42,160 --> 00:04:45,240
to work toward a workforce that
better represents our
87
00:04:45,240 --> 00:04:49,280
population, the workforce that
looks like the people we serve.
88
00:04:49,280 --> 00:04:52,440
So that we have public health
nurses along with other public
89
00:04:52,440 --> 00:04:55,520
health workers who come from
diverse backgrounds.
90
00:04:55,520 --> 00:04:59,200
And I mean diverse in every way,
both racially and ethnically, in
91
00:04:59,200 --> 00:05:02,800
terms of age, geographically
representative.
92
00:05:02,800 --> 00:05:04,760
So really working on that is
important.
93
00:05:05,120 --> 00:05:08,800
One thing that I might point out
is that historically, nurses
94
00:05:08,800 --> 00:05:13,440
that rise to leadership roles in
and that group underrepresented
95
00:05:13,440 --> 00:05:16,080
minorities are even more
underrepresented.
96
00:05:16,360 --> 00:05:21,320
So creating career pathways to
provide a means for those people
97
00:05:21,520 --> 00:05:25,960
to move forward in their public
health careers and assume
98
00:05:25,960 --> 00:05:29,120
leadership roles is a really
important focus for the future.
99
00:05:30,080 --> 00:05:35,240
And another goal of the survey
is to provide direction and data
100
00:05:35,240 --> 00:05:37,680
towards training, what the
workforce needs in terms of
101
00:05:37,680 --> 00:05:38,720
training and.
How?
102
00:05:38,960 --> 00:05:40,480
How?
Agencies can improve.
103
00:05:40,480 --> 00:05:43,680
Can you talk a little bit more
about how the survey can be used
104
00:05:43,680 --> 00:05:45,800
in that capacity?
Yeah, sure.
105
00:05:45,800 --> 00:05:50,040
So understanding education and
training needs of the workforce
106
00:05:50,520 --> 00:05:54,360
helps us in a number of ways.
For one thing, in recent years,
107
00:05:54,800 --> 00:05:58,680
we have a relatively new process
for public health agency
108
00:05:58,680 --> 00:06:00,840
accreditation.
And one of the important
109
00:06:00,840 --> 00:06:05,760
components of that accreditation
is does the organization have a
110
00:06:05,760 --> 00:06:08,960
clearly defined process for
recruitment, retention and
111
00:06:08,960 --> 00:06:13,240
education of the workforce.
So having some data that enables
112
00:06:13,240 --> 00:06:16,640
agencies to look at that, to
plan quality improvement
113
00:06:16,640 --> 00:06:19,360
efforts, look at how they
allocate their budgets for
114
00:06:19,360 --> 00:06:22,800
training, that's really
important to to that.
115
00:06:22,800 --> 00:06:26,120
Certainly another important
aspect, along with
116
00:06:26,120 --> 00:06:30,880
accreditation, we've seen new
frameworks for public health
117
00:06:30,960 --> 00:06:34,360
practice come online, including
foundational public health
118
00:06:34,360 --> 00:06:36,920
services.
So it's really important for us
119
00:06:36,920 --> 00:06:41,560
to look at our workforce, their
educational needs particularly
120
00:06:41,560 --> 00:06:45,240
to assure that we have the
ability to meet those
121
00:06:45,240 --> 00:06:47,800
foundational services and to
provide those for our
122
00:06:47,800 --> 00:06:50,960
populations.
And hand in hand with that, can
123
00:06:50,960 --> 00:06:55,480
you talk a little bit about how
leadership could use the survey
124
00:06:55,640 --> 00:07:00,040
in tandem with or as opposed to
sort of an annual review process
125
00:07:00,040 --> 00:07:01,840
that looks only at their own
agency?
126
00:07:02,160 --> 00:07:05,120
The survey can bring in sort of
a whole picture look.
127
00:07:05,920 --> 00:07:10,640
Yeah, WINS gives us the ability
to have a broader database so we
128
00:07:10,640 --> 00:07:15,120
can benchmark our workforce at
local and state levels to the
129
00:07:15,120 --> 00:07:18,680
national workforce.
And I believe very importantly,
130
00:07:18,960 --> 00:07:24,440
it gives leaders the knowledge
and data to be able to advocate
131
00:07:24,480 --> 00:07:28,840
to policy makers for investments
in public health, particularly
132
00:07:28,840 --> 00:07:31,160
in terms of the workforce.
What are the needs?
133
00:07:31,160 --> 00:07:34,760
How can we be prepared for
emerging issues and trends in
134
00:07:34,760 --> 00:07:37,520
public health?
Do we have enough individuals
135
00:07:37,520 --> 00:07:40,480
who serve in various roles?
And if not, how can we begin to
136
00:07:40,480 --> 00:07:44,480
plan strategies to help both
improve the workforce we have
137
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through targeted training and
education, but also recruitment
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efforts?
And lastly, Shirley.
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You've you've.
Already sort of made some great
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cases for how the survey can be
used as a tool for advancing
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training recommendations for
setting benchmarks as you
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mentioned.
Can you make the case why
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someone should tune into this
webinar and listen to sort of
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the the pH Twins overview?
Yeah, sure.
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So as I mentioned, this is one
of the PHN recruitment and
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retention focused sessions in
the Public Health Nursing
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learning lab.
We know recruitment and
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retention is a very major issue
and certainly this is an
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important part of that.
Public Health Wins is a great
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tool and resource and sometimes
I think it may be not well
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enough understood across our
workforce widely.
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There have been many changes in
pH wins over the years.
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It has a lot more functionality
than it did even just a few
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years ago.
One of the new additions this
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year is something called
Insights to Action that contains
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somewhere around 40 practical
tools and resources for
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workforce development that can
be used within local agencies.
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And then importantly, we'll have
Maddie Papalis, who is with the
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de Beaumont Foundation, with us
to talk about WINS.
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She is the WINS expert.
Her professional role is 100%
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dedicated to WINS, so leaders
can certainly find out current
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information from the national
expert in Public health WINS.
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Shirley Orr is executive
director of the Association of
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Public Health Nurses.
You can learn.
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More about the upcoming Public
Health Nursing Workforce
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Learning Labs Series, Session 5
at the link in the show notes.
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Now let's hear from Doctor Lisa
Villarroel, chief medical
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officer for Public health of the
Arizona Department of Health
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Services, about Arizona's
statewide Healthcare
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Collaborative forum.
So for the past four years, the
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Arizona Department of Health
Services has hosted this
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statewide healthcare
collaborative forum, and it's a
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virtual statewide meeting that
invites everyone along the
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spectrum of healthcare.
So we're thinking, you know, EMS
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hospital post acute care setting
brings everyone together once a
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month for an hour during the
respiratory season.
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This season we started in
November and we're going to end
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either in February or March.
The way these meetings usually
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work is we start with a data
review from public health on
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circulating respiratory viruses,
on any new regulatory updates,
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any new EPI updates.
And then we move into a
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presentation from a local
partner on a particular topic
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around surge, around infection
control.
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And then we end with a full
partner report out and sometimes
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we're done in 35 minutes and
sometimes we're racing the clock
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at 59 minutes.
Yeah, that makes sense because
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you've got everyone in in the
virtual room from the on the
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ground practitioners to the
folks up making the policy and
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seeing where all of it sort of
shakes.
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Out.
Yeah, that's right.
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It's, it's like the one place
where you have on one call EMS,
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we have AZ REACH which is our
statewide inter hospital
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transfer system.
We have all, almost every acute
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care hospital represented and
the post acute care agencies and
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entities represented.
It's like the one place where
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the full spectrum is all there
at once.
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What was the sort of impetus for
it and why?
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Why was was the seasonal strain
just hitting so much that you
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were like, we, we need to figure
this out?
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Honestly, I think this came out
of COVID.
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You know, we were used at that
point for everyone coming
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together and meeting in one
place.
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And I think one of the lessons
we learned from the pandemic was
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the disproportionate impact just
bringing everyone together can
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have.
So it's a very simple concept to
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have one virtual phone call with
everyone.
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We all hear the same
information.
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If people have a particular
concern, it comes up.
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But we've been doing it for four
years now and we have incredible
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attendance still.
What sorts of things have come
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up during these meetings that
you're like, oh, this is?
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Incredible.
We would have never otherwise
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seen this.
Yeah.
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So there's 4 main objectives of
this work group. 1 is to share
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situational awareness, 1 is to
share, you know, EPI or
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regulatory updates.
One is to present any kind of
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regional best practices going
on.
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And the last one is for the
health department to support any
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collaborative effort that all
the entities, you know, want to
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embark upon.
And so in the course of, you
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know, working with those 4
objectives, interesting things
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come up.
Recently, one of our healthcare
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systems presented on their
universal masking policy.
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One time an Arizona hospital
presented on a regional alliance
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they have with other hospitals,
where the smaller hospitals
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support each other with
consultations and diversion.
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One time a hospital leader
brought up the low flu
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vaccination rates that they were
seeing in their staff.
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So all these little pings really
inspire further conversations.
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And so, you know, a hospital
will think we'll do.
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Does our hospital need a
universal masking policy?
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Like should our hospital be part
of an alliance?
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Like, what is our staff
vaccination rate?
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I can tell you on the
vaccination rate part, when that
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hospital brought it up, it
prompted the health department
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to go back and look at our own
annual flu vaccination rate data
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year over year to see if we were
tracking with what that
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particular hospital had been
seeing.
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Oh wow, so already getting these
tangible results from just
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sharing stories.
Yeah.
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Another big example was when an
EMS agency brought up the fact
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that a new prior authorization
protocol was holding up their
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transport.
We had not heard of this at the
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health department and so we
ended up helping connect those
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EMS agencies with the right
person at the pair.
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It felt tangible.
It felt like there were there
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was a result.
And I guess the question is
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where else should this have been
brought up?
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Like where else do you have
everyone along the process of
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healthcare and patient
throughput all together on one
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call?
I mean, in this particular
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circumstance, you have two of
the three components of the
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healthcare system involved.
You have the facilities and you
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have EMS, and in this call
they're all together.
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One of the big goals of the of
the program is collaboration
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through data.
Can you talk a little bit more
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about the kinds of data that
you're getting that you're
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collecting, maybe that you
didn't know that you needed?
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Yeah, Data is always how we
open.
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Every meeting is to talk about
the data that that we have.
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And I think it is critical for
the state health department to
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be able to trust its own data.
And so every meeting we show the
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data that we have.
Yes, we show the EPI data on the
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respiratory viruses that are
circulating, but we will always
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show the bed capacity data that
we have.
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We will show the Ede, you know,
diversion that we have and so
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on.
And we asked specifically, does
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this match with what you all are
seeing on the ground?
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Before we started, you made
clear that you want this to be
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known.
At it's heart, it's a phone
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call.
It's getting everyone to talk to
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each other.
Is that?
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How you would approach?
Other systems that are trying to
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think about like, well, how?
Do we just get everyone in a
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room to understand?
Make a phone call.
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No thanks.
That's, that's exactly the point
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that I'd like to make about the
Statewide Healthcare
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00:15:01,920 --> 00:15:04,320
Collaborative forum is that
health departments could
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00:15:04,320 --> 00:15:06,880
implement this next week if they
wanted.
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You don't need tech.
You don't need slides.
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00:15:09,440 --> 00:15:11,680
We'll send you our slides if
that would be helpful, but you
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00:15:11,680 --> 00:15:13,640
don't need a room.
You don't need written
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00:15:13,640 --> 00:15:16,240
materials.
You need an hour once a month
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during the respiratory season
for a virtual meeting.
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00:15:19,200 --> 00:15:22,040
And I think, you know, we keep
our program really standard.
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We tweak it a little bit, you
know, year over year.
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One year, I remember we tried to
highlight the major published
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articles on surge that were
coming out this year.
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00:15:30,920 --> 00:15:34,200
For example, we had to add a
section on measles because
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that's something that we're
experiencing here in Arizona.
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Honestly, the opening content
can change, but the invitees and
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the concept of inviting everyone
to the table for folks to come,
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you know that is what doesn't
change.
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And this is our fourth year
running this and attendance
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remains high.
Nearly every acute care hospital
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is represented, all EMS
agencies, several local health
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00:15:58,000 --> 00:16:01,040
departments and then the
agencies representing post acute
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care as well.
And I just think it's a
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wonderful baseline structure to
have.
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And I remember one year there
were conversations internally
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like, should we reconvene this
group before our next meeting
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because things are escalating
with with hospital surges and we
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didn't at the time, but that's a
lever that can be pulled at any
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time.
This is a known entity.
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This is a known work group.
And it's so nice to have that.
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00:16:32,080 --> 00:16:35,000
Doctor Lisa Villarroel is chief
medical officer for public
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00:16:35,000 --> 00:16:37,600
health of the Arizona Department
of Health Services.
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00:16:38,280 --> 00:16:41,240
Earlier we heard from Shirley
Orr, executive director of the
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00:16:41,240 --> 00:16:43,280
Association of Public Health
Nurses.
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00:16:44,680 --> 00:16:47,760
Leading Change is a new ASTA
workshop designed for
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00:16:47,760 --> 00:16:50,600
professionals and clinical and
non clinical public health
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00:16:50,600 --> 00:16:53,280
roles.
The workshop equips participants
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00:16:53,280 --> 00:16:56,560
with strategies and skills to
navigate change and uncertainty
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00:16:56,560 --> 00:17:00,200
as individuals, team members and
organization wide leaders,
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00:17:00,880 --> 00:17:03,280
emphasizing actionable
instruction and resources.
316
00:17:03,280 --> 00:17:06,760
It enables leaders to create and
implement real world initiatives
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00:17:06,760 --> 00:17:09,560
in their agencies for 2026 and
beyond.
318
00:17:10,319 --> 00:17:13,720
Participants will gain tools to
design targeted initiatives and
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00:17:13,720 --> 00:17:16,079
foster tangible organizational
change.
320
00:17:16,680 --> 00:17:19,680
This experience prepares them to
drive meaningful impact in their
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00:17:19,680 --> 00:17:22,000
workplaces.
Find more at the link in the
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00:17:22,000 --> 00:17:24,920
show notes.
This has been public health
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00:17:24,920 --> 00:17:27,280
review morning edition.
I'm John Sheehan for the
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00:17:27,280 --> 00:17:30,320
Association of State and
Territorial Health Officials.