The complaints are all too common: Students can't get a job without experience, and they can't get experience without a job. Employers need skilled workers to boost efficiency, but constant training takes too much time. They're the pitfalls in the output-focused field of HIM.

Professional practice experiences (PPEs) can fill those gaps, giving students the chance to get hands-on experience and employers the opportunity to cull new talent. Some facilities are reluctant to sign up, but according to Bryon Pickard, MBA, RHIA, director of operations, Vanderbilt Medical Group Business Office, Nashville, TN: "As a profession, that's one of the things absolutely all of us should be doing."

Got your excuse ready? Our experts will give you the real story.

You're too busy to take on students.
Electronic health record (EHR) implementations, new legislation and regular updates--it's a lot for HIM departments to juggle. Throwing a student into the mix would only leave less time for other duties.

On the contrary, according to Pickard, who helped develop the American Health Information Management Association (AHIMA) PPE Guide. "If you're involved in a computer conversion, you're moving your department or you've got deadlines...that is absolutely without question the best time for a student to be there," he said.

Pickard worked with students for years, enlisting their help on Joint Commission surveys and even assigning one management student to do office planning in advance of a large move. Time after time, students have offered inventive solutions and fresh perspectives that helped, not hindered, the department.

Dwan Thomas-Flowers, MBA, RHIA, CCS, who welcomes students to revenue cycle services at Mayo Clinic, Jacksonville, FL, agreed. "Generally [facilities] say, 'We're going through a transition to an EHR and don't have time to take a student.'" she said, "Do you know how much of a benefit a new HIM student could be for that? This is probably the best time to accept the right kind of student, offering a mutual benefit to both parties."

If you're worried about completing other tasks while keeping an eye on students, delegate a few assignments to other supervisors or employees. "If you do it in an organized manner, [being a PPE site] is not a hardship whatsoever, even during the busiest times," Pickard said.

Students pose too great a risk.
Privacy and security requirements keep growing, and some facilities don't want to be held liable for a student's mistake.

By the time students reach their practicum requirement, they've already been well-versed in privacy and security issues, the experts noted. And as newbies, they may be even more cautious than seasoned employees. "As far as HIPAA requirements, that's one of the benefits of having a student because they're right up to par on the most recent information," Pickard said.

Both experts said their facilities require students to sign confidentiality agreements, just like any other employee. If a breach occurs, the facility will be held responsible, but the student will also share in accountability.

Before you start accepting students, make sure your privacy and security policies are clear. Define confidentiality expectations with the program director, and run any contracts or agreements by legal counsel before signing.

When students arrive on site, spend the first few days orienting them to the department, policies and reporting structure, so they know when to report a mistake and who to tell.

Maintain open communication with students and the program director, the experts added. That way, any problems with performance, attendance or even dress code can be immediately addressed.

You wouldn't know what to assign.
"The student comes with a set of instructions, and sometimes they're very generic, high-level," Thomas-Flowers said regarding school PPE requirements. But that just means you have to get creative.

Most educational programs only require a certain number of hours; how much time the student spends on a particular competency is up to you. Contact other PPE sites for suggestions of successful student projects and ideas for other tasks that give students a valuable experience. Thomas-Flowers brings management affiliation students along to meetings, then debriefs them on what was discussed. When students show a particular interest in a subject, she'll assign a project that lets them dig deeper.

Let students explore non-traditional areas, Thomas-Flowers added. At the Mayo Clinic in Rochester, the research building is a popular tour stop among HIM students; they get to see animals and learn how health information plays a role in clinical studies, she said.

Pickard also invites students to shadow him during their management affiliation hours. "If they're here when we're meeting with a vendor for some reason, they'll go to that meeting," he said.

Before the start of each PPE, Pickard sets a schedule so the student has a general idea of what to expect. But he always cautions that, more often than not, meetings will pop up and the schedule will change.

Most importantly, Pickard gets the student's input. "I want to understand what their own objectives are...what they want to accomplish out of their PPE," he said.

Still stuck for ideas? Consider these suggestions from the experts.

Short-term assignments:

• Code 10 outpatient charts, then code 10 inpatient charts.
• Critique the privacy and security policies posted on the facility's Web site.
• Scan and index explanation of benefits forms.

Long-term projects:

• Conduct a cost-benefit analysis for new equipment.
• Evaluate four coding contracts and determine which is best for the facility.
• Complete a needs assessment for telecommuting.

It's a lot of work, with little payoff.
Hosting students takes time and effort, but it's not as hard as it sounds. The amount of labor needed will depend on your facility. If you're a small organization, setting up the program may be as simple as drafting a letter of agreement; larger organizations may require lawyers and more elaborate contracts. Once a relationship is established, it's a matter of maintaining communication to keep it going.

PPEs are designed for the student's benefit, but HIM departments may be surprised to find how much they can reap from the program, too. Pickard uses PPEs to screen for potential employees, and having long-standing relationships means he gets the top students. "I tell [the schools] I want their best and brightest," he said.

Rather than irk staff members, the students have brought Pickard's office closer together. Employees have embraced their roles as mentors and are eager to answer questions. "I think it gives them a feeling of satisfaction to share their knowledge and what they know with the student," Pickard explained.

At the same time, staff can learn a thing or two from students, according to Thomas-Flowers. "Sometimes they share some of the newest practices or their textbook knowledge," she noted. "Maybe the manager can get some ideas from reading the textbook."

There aren't any educational programs in your area.
Haven't been approached by any schools? That may soon change. "A lot of the student populations are growing because HIM and HIT are becoming so popular," so schools may be on the hunt for more sites, Pickard said.

Online programs also open new opportunities to host PPEs. Pickard was recently contacted to accept a student who lives in Nashville, where Pickard's office is located, but takes courses online through the University of Chicago.

And of course, contact your state and local associations, Pickard said. They can point to educational programs in your area and get your name out as a potential PPE site. Join forces with other PPE sites and speak at colleges and universities. It's a way to share your experiences and network with students, Pickard said.

For additional guidance on hosting students at your facility, read AHIMA's PPE Guide, the experts advised. And seriously consider giving PPEs a try. It's not just about helping your organization, Thomas-Flowers said, "It's the only way to ensure our future is viable."

Cheryl McEvoy is an assistant editor with ADVANCE.