Providence maintained full salaries for clinical staff the first several months of the pandemic, which cost around $600 million, Till said. The system also offered unlimited childcare reimbursement, an array of virtual mental health services and closely incorporated front-line workers into the decision-making process, Till added. For instance, Providence leaders worked closely with their clinical staff to design remote working models across the system, he said.
Providence is looking at the staffing mix rather than staffing reduction. It is ensuring that clinicians are practicing at the top of their license and using gig workers, advanced practice practitioners and predictive scheduling tools to fill in any holes, he said.
“AI will be worldview-changing over the next 10 years, especially for healthcare,” Till said. “Data and automation will help us deliver better outcomes and allow us to provide personalized benefits, engagement tactics and retention strategy for every caregiver.”
Organizations that were once an all-registered-nurse environment are using licensed practical nurses or medical assistants in a team-based nursing model, said Erin Shipley, a coach at consultancy Huron, who is also a licensed RN.
“That’s a workforce they can tap into, and naturally there is a shift in dollars,” she said.
Replacing an RN can cost around $65,000; if an organization has 12% RN turnover, that can add up, Shipley said. Organizations are beginning to break down first-year versus third-year turnover and what that means for their operations, she said.
“Most front-line leaders haven’t been trained in understanding what turnover means for the department,” Shipley said. “Organizations could get a lot of lift by innovating their onboarding.”
Providers are also using digital tools to keep in touch with their increasingly mobile workforce as more administrative employees are working from home than ever before. Telehealth has afforded a similar luxury for some clinicians.
Rather than losing an employee, managers are more willing to give them more flexible schedules, change departments or bump up pay, said Neil Faux, a managing director at consultancy Berkeley Resource Group.
“There is a lot of hesitation to reinstitute pre-pandemic productivity expectations, which could increase turnover,” he said, noting that it’s taking longer to fill positions as certain types of staff run short, which has increased job openings by 20% to 30% at many healthcare organizations. “They are moving people around instead.”
Still, healthcare workers are leaving the workforce, both young and old. Senior employees fast-tracked their retirement plans while younger workers are opting for less-stressful careers.
Westmoreland Manor, a long-term care facility in Greensburg, Pennsylvania, has tried to keep employees invested during the pandemic by offering lotteries, free meals, counseling sessions and other perks, said Nancy McCune, healthcare system administrator at Westmoreland.
“Management is more open to listening to employees and changing things to make their lives’ easier,” she said, adding that Westmoreland has changed reporting structures, offered them iPads and adjusted its time-off request process to ease workers’ burden. “That has made a big difference.”
Employers are more cognizant of employees who are working extra hours, and proactively checking in on them. Some providers have eliminated prerequisites for certain jobs, like education requirements, prioritizing cultural fit.
The knee-jerk reaction to staffing shortages is to double down on recruiting. But executives should rethink their value proposition so they can hang on to top talent, Rewers said.
“Executives need to make sure they are not overlooking their current workforce,” she said.
If healthcare providers don’t create internal opportunities to advance, employees will find other options, Faux said.
“If they do leave and want to return, they will likely be welcomed back. So there is not a lot of risk,” he said.
Whether it’s informal check-ins or wellness town halls, providers are expected to continue the dialogue.
Some health systems have created a diversity forum that allow employees to discuss social and racial unrest, said Neville Bilimoria, partner at law firm Duane Morris.
“Doing that on a regular basis throughout the pandemic went a long way and staff reported that attendance at these meetings by leadership was powerful, demonstrating a caring and concerted understanding by the employer of important issues the employees were facing on a daily basis,” Bilimoria said.
Many managers huddled with their teams multiple times a day during the pandemic to discuss the latest regulations, supply chain management or workloads. Proactive organizations will continue that daily practice, albeit less frequently, so employees feel heard, Shipley said.
Those check-ins could reveal that an employee wants to go to grad school or switch departments, which could help carve out workforce development programs and boost retention, she said.
“Employees need to feel that they are informed,” Shipley said. “That conversation is centered around trust.”