4 Ways CEOs Address Workforce Challenges

Innovation is a must when addressing evolving healthcare workforce needs.

Between the labor shortages, diminished margins, accelerating competition, and even leadership vacancies, there’s a perfect storm of workforce factors pressing healthcare CEOs. CEOs need to employ meticulous strategies to rein in costs while creatively thinking about building a sustainable workforce.

Innovation is key for CEOs while they continue to work closely with their executive team to address these seemingly endless challenges, because if they don't, they will only fall behind the competition.

Here are four ways CEOs successfully address workforce challenges at their organizations.

1. Creating a Pipeline

Roxanna Gapstur, PhD, RN, president and CEO of WellSpan Health, a nonprofit integrated health system serving central Pennsylvania and northern Maryland, shared with Healthleaders earlier this year the reality of workforce shortages that have swept across the country.

"In Pennsylvania, we lost about 230,000 [workers] during the pandemic," she said. This, coupled with women returning at a lower rate than men to the workforce, has resulted in a million women missing from the labor force, Gapstur said.

"It's not just nursing that we're seeing shortages in—we're seeing shortages across job categories. Part of it [also] accelerated retirements. We've seen our retirements nearly double here at WellSpan."

"Like many health systems, we've been challenged to ensure that we have the right skillset with the right role throughout our system," she added. "We offer a full continuum of care, and we have had times where we've had to downsize or close a location periodically throughout the pandemic because of staffing."

When it comes to solving workforce challenges, hospitals and health systems must be even more creative in the current competitive landscape.

"It's definitely a multi-pronged approach," Gapstur said.

"We've partnered with [more than 20 high schools, colleges, and universities] across our geography. We have specific health sciences programs that we underwrite and support both financially and with clinical preceptors and with faculty. We use several different venues and vehicles for those partnerships, as well as having our own medical education program here at WellSpan, where we have more than 180 in residency who are training with us."

They've even brought education in-house.

"We've also started our own educational programs here at WellSpan," she adds. "This fall, we're starting a surgical technologist program in addition to the multiple programs we already had, which was medical assistant, CRNA, respiratory therapy. We already had those programs in place when the pandemic began; we're now adding additional ones and we're expanding the slots in the ones that we already have."

These initiatives will help to fill needed roles and successfully train the workforce.

2. Engaging and Innovating with Frontline Staff

Eric Dickson, MD, MHCM, president and CEO of UMass Memorial Health, a $3.3 billion nonprofit health system in central Massachusetts, recently shared an initiative that has enabled him to learn the wants and needs directly from his organization's frontline staff.

"One of the things that I established as CEO on day one was an idea system that engaged our frontline workforce and asked them how we can improve," he said.

"Over the 10 years that I've been CEO, we've implemented over 100,000 ideas from the frontline workforce. These are things to make care safer for our patients, caregiving safer for our caregivers, ways to enhance the patient experience, [and] ways to enhance the caregiver experience here."

By taking these ideas and putting them into action, it shows the organizations embraces innovation, and that it continues to find better ways to support clinical workers. This can help with staff retention and recruitment and create a culture of innovation across the organization.

3. Creating Care Teams to Enable Work at Top of License

Michael A. Slubowski, president and CEO of Trinity Health, spoke with HealthLeaders earlier this year about the future of healthcare delivery and payer models.

To stay ahead, the system implemented an internal staffing agency.

"Before the pandemic, we created our own internal staffing agency called First Choice, so that colleagues who decide to leave the profession full-time or part-time have an option to work on their terms and what works for them," he said. "Creating flexibility for people and providing an opportunity for them to earn some income has been an important vehicle for us."

This saves the business money, as staffing agencies have recently bled hospitals and health systems dry. It also helped with staff retention.

The organization also created a specialized triad care team to better serve patients and the organization's clinical workforce, which was starting to be rolled out earlier this year.

"It's a three-person care team; it includes a floor nurse, it includes either a CNA or LPN, and then the third member of the team is a nurse that is in a hub that can [virtually] support the patient's care needs," he said.

"Those three people function together as one team for a set of patients. The floor nurses, who are generally new grads, feel supported because there's an experienced nurse at the health hub that is supporting the care and working as part of their team. We've been able to keep nurses who otherwise would have left the profession, either because the work is too much for them given physical demands, or flexibility, who still want to provide care."

Virtual nurses work in hubs across the organization's campuses. They can "beam" into any room, they have full access to the patient's medical record, and they can even observe the patients through a camera.

"The nurse assistant or LPN can practice at the top of their license as well," he said. "It's helping us with the retention of new nurses and keeping experienced nurses in the workforce."

And the patients and families love it as well, he said. When they push a call light, someone immediately comes on screen and can attend to the patient, help coordinate care, and do discharge planning, saving the patient and the nurse valuable time.

"Patient satisfaction is very high with this model. It's one of those transformational things that can help us with staffing as well as patient satisfaction," he said.

4. Defining Workplace Culture and Purpose

Tiffany Miller, DBA, MHA, is the CEO of Yoakum Community Hospital in Yoakum, Texas. The 100-year-old, 23-bed critical access hospital faces additional challenges in recruitment, being in a rural part of the state.

The biggest pain point for the hospital is competitors’ extremely high salary rates. High rates make it hard to compete with larger institutions that are in closer proximity or contract travel jobs.

"One of the biggest focus areas for Yoakum is the recruitment and retention of qualified staff," Miller said. "That starts with the culture of our hospital, especially given the current environment of higher labor costs. It's about creating an environment where people not only want to be, but they also want to stay."

Leaders can drive this environment shift and create a culture that not only retains staff but keeps them happy in a role they are passionate about.

"As a leader, I believe it's important to be transparent with your team and being able to make that connection—that purpose—and help bridge that gap between action and the why behind it," Miller said. "I've [had] those conversations with team members to help make the connection that underscores that importance of fiscal stewardship and being able to get creative on [creating] an environment where people want to work and that they want to stay."