Person-in-Environment: A Critical Framework in Health Care Workforce Development

COPE Health Solutions has been addressing the workforce needs of hospitals and health systems for over 16 years through our suite of educational programs, called COPE Health Scholars. The foundational purposes of the COPE Health Scholars programs are to 1) provide local talent with the training and patient engagement skills necessary to become the competent, culturally diverse future workforce, 2) provide our clients with a pipeline of best-fit candidates for recruitment and 3) provide clinical staff members with the support needed to work at the top of their licenses.

As demand increases for providers to coordinate patient care, reduce costs and improve access, it is critical to prepare the next generation workforce. Aspiring professionals need to be trained in holistic patient care, and exposed to emerging roles focused on care coordination and patient navigation. One approach to frame this training is the person-in-environment perspective. The person-in-environment approach is a guiding principle in the field of social work.

This principle asks social workers to understand an individual, and that individual’s behavior, in the context of their multifaceted environment. According to the National Association of Social Workers, “With the person-in-environment perspective, social workers look at all of the influences and aspects of a person’s life to complete a thorough assessment and treatment plan with the client, family, and other health care professionals.” ¹ This principle sets social work apart from other helping professions by focusing both on the individual and their wider environment. The individual influences, and is influenced by, social, political, familial, temporal, spiritual, economic and physical aspects of their environment. This principle can be applied at both an individual and systems level, and could be an incredibly helpful perspective to consider in patient-provider relationships.

The COPE Health Scholars programs are a step ahead in preparing the future workforce to meet these increasing demands because each program is rooted in the person-in-environment principle. Three ways in which we utilize the person-in-environment perspective are during program implementation, student recruitment and student training.

In the implementation process, COPE Health Solutions utilizes person-in-environment on a systematic level. When implementing, we fully imbed ourselves in to our partner health systems so as to integrate their culture, mission, values and priorities into their customized programs. We understand our partners in the context of the incredibly complex and quickly changing health care landscape. We build solutions tailored to the needs of our specific clients, while always understanding market drivers and future change. For example, we help our clients to identify department placements where our students will provide a needed boost in staff support and attention to patient needs, while offering high-value learning opportunities. We perform similar assessments throughout the implementation process to customize these solutions to our clients’ needs. Understanding our clients in the context of their environment is a pivotal part of the unparalleled success of the COPE Health Scholars programs.

Secondly, we demonstrate the person-in-environment principle in our student recruitment. One of the core advantages of the COPE Health Scholars programs is that they help home-grow our partner health systems’ future workforce. We specifically recruit students from local colleges, universities, trade schools and community groups so that the Scholars are representative of the patient population with which they work. We introduce local talent to our clients so that they can build a pipeline of culturally and linguistically competent future providers. By recruiting local talent and exposing them to health systems in their communities, we are preparing a workforce that already understands core components of their patients’ environments.

Lastly, person-in-environment is present throughout our training of all Scholars and the duration of their program experience. Our students are required to complete an intensive training (anywhere from 20-40 hours) prior to joining one of our programs. During that training, we expose our students to concepts of diversity, empathy and cultural competence. We also train them on the changing health care system and challenges regularly faced by payers, providers and consumers. This training provides our students the foundational knowledge necessary to understand key environmental forces. From there, our students are deployed to a variety of different clinical and administrative departments within the health system. In these departments, one of their main roles is to enhance patient experience. Students often do this by accompanying patients at their most vulnerable times, providing a listening ear and a compassionate touch. This is beneficial for the patient, and also exposes our students to empathy-building encounters. They have the opportunity to see first-hand how a person can be shaped by their environment and to witness the complex interplay between systems that regularly challenge so many patients. These types of experiences prepare our students to meet the increasing demands that the next generation of providers will need to address.

COPE Health Solutions uniquely prepares local talent to be the competent future health care workforce. Our educational programs expose students to the person-in-environment principle and engrains in them skillsets of compassion, empathy and complex problem solving. By introducing early careerists to the variety of factors that influence patients, providers and health systems— and by encouraging them to find linkages and connect themes— we are building a workforce that is ready and able to meet the changing landscape of the health care field.

¹ NASW Standards for Social Work Practice in Health Care Settings. National Association of Social Workers, 2005. Accessed May 24, 2016. <https://www.socialworkers.org/practice/standards/naswhealthcarestandards.pdf>.