Converting Workforce Challenges to Market Leadership through Innovation

The Problem

In 2000, Citrus Valley Health Partners (CVHP) – a network of three hospitals, a home health agency, hospice care and an ambulatory surgery center in the greater Los Angeles area – faced a critical shortage of registered nurses (RNs). CVHP regularly had over 100 vacant nursing positions and a 32% annual turnover rate for new graduate nurses. Struggling to find qualified, best-fit candidates to fill its high volume RN vacancies, they relied on high registry and agency use. These were short-term solutions that did not significantly contribute to their goal of sustainably recruiting and retaining a strong RN workforce.

The Solution

Together, CVHP and COPE implemented a Health Workforce Diversity Pipeline to address workforce challenges. Originating with a hands-on educational experience in 2001, known as the Clinical Care Extender Program, the Pipeline today consists of four core components: The Clinical Care Extender Program, Health Professions Training – Nurse Scholar Program, Mentorship & Professional Development, and PrepStep-RN.

  • Clinical Care Extender Program: This program pairs workforce needs with motivated college/university level students, graduates, and career transition individuals interested in health care careers from the local community. Client organizations gain valuable assistance from participants as they work alongside staff within the patient care setting.
  • Health Professions Training – Nurse Scholar Program: The second component of the pipeline provides comprehensive support, guidance, mentorship, and potential employment to local nursing students. RNs who were hired through this program committed to working for CVHP for two years, thus contributing to a significant decrease in new graduate RN turnover and the overall RN vacancy rate.
  • Mentorship and Professional Development Program (MAP): This is an extensive 12-week program for new graduates and new-hires in health care professions that provides the support and orientation needed to transition into and succeed in their new roles. Additionally, MAP provides preceptor training to the experienced RN staff.
  • PrepStep-RN: This program cultivates a reserve of future nurse candidates best-fit to CVHP’s culture of patient care to be readily drawn upon to fill vacancies. Through this structured 24-week program, new graduate RNs attend weekly shadowing sessions with experienced RNs in clinical areas while also attending Professional Skills Development Workshops.


  • Clinical Care Extenders provided significant patient care support by helping with non-licensed/certified tasks, increasing response time to patient needs, and enhancing the patient experience. Over 100 Clinical Care Extenders ultimately chose CVHP as their place of employment.
  • Since 2004, the Nurse Scholar Program has assisted and supported 94 nursing students with obtaining their RN licensure. Of that, 88 (94%) were offered and accepted full-time employment with CVHP.
  • In 2006, the MAP Program received the Excellence Award at the Showcase of Excellence Luncheon during the Chapter Leader Academy of Sigma Theta Tau, International, Inc., the Honor Society of Nursing.
  • CVHP experienced a decrease in new graduate RN turnover from 32% pre-Pipeline implementation to 5% post-implementation.