Roxanna Gapstur, PhD, RN, shares strategies WellSpan Health uses to combat workforce challenges in the current competitive climate.
Hospital CEO participants in the annual American College of Healthcare Executives survey confirmed—not surprisingly— that workforce challenges were their top concern in 2022.
Roxanna Gapstur, PhD, RN, president and CEO of WellSpan Health, a nonprofit integrated health system serving central Pennsylvania and northern Maryland, reflects on the reality of this issue for healthcare organizations in Pennsylvania and across the country.
A competitive Pennsylvania market became fiercer after the fallout of the pandemic. Organizations like WellSpan are no longer just competing with other organizations in the state for patients, such as the University of Pittsburgh Medical Center and Highmark Health, the parent company of Allegheny Health Network, they are also competing with staffing agencies and remote work opportunities across the country for potential staff.
Gapstur says, "In Pennsylvania, we lost about 230,000 [workers] during the pandemic. Nationally, women are returning at a lower rate than men to the workforce; the number is … a million women missing from the labor force. It's also created an issue with service workers and others. It's not just nursing that we're seeing shortages in—we're seeing shortages across job categories. Part of it is [also] accelerated retirements. We've seen our retirements nearly double here at WellSpan.”
"We've also seen a significant amount of inflation with staffing agencies and salaries increasing somewhere between 6% and 12% each year, which is a hefty number for most health systems to absorb," she adds.
"Like many health systems, we've been challenged to ensure that we have the right skillset with the right role throughout our system. 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."
In a recent HealthLeaders interview, Gapstur shares five steps that WellSpan has taken to combat workforce challenges and become more competitive in the healthcare workforce climate.
Combatting workforce challenges with a multi-pronged approach
When it comes to solving workforce challenges, hospitals and health systems must be creative in this competitive market. "It's definitely a multi-pronged approach," Gapstur said. "We have several strategies that we are currently employing."
1. Become a preferred employer
"We want to be a preferred employer in south-central Pennsylvania and nationally. Many of us now are recruiting and hiring people for remote positions from across the United States. Things like our diversity and inclusion wards, best workplace for women, being on the Forbes list for best workplaces, those are important things that we work to uphold a culture where people want to work."
2. Streamline recruitment
"Recruitment is part of our goal. We are recruiting and hiring by far more people than we've ever hired before. We've got more streamlined processes, and in a competitive market like this, we have to make sure that we're offering a value proposition that employees want."
3. Create a pipeline
"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.
"We've also started our own educational programs here at WellSpan. 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."
4. Enact more efficient processes
"[The] challenge that remains is the redesign of work. We all know that work has changed significantly since the pandemic, and remote and hybrid working conditions are common in most organizations.
For those individuals who need to be on-site or providing face-to-face patient care, we are working [on] piloting innovative workforce solutions around people, process, and technology. Combining those three things in making more efficient processes, decreasing administrative burden, and leveraging AI and other technologies to make sure that we have the most efficient process, [and] we're offloading our clinical teams from administrative work.
There's a lot of talk about this around the country. We are heavily involved right now with virtual nursing approaches. Same with credentialing and HR functions; how would we use chatbots? We've done some of that during the pandemic because we have a small employee health team; we used chatbots to interview and get our folks back to work. Those are the kinds of things that we think are going to be the future in healthcare is this people, process, technology triad and how you put that together to support your workforce and ensure that you have the right kind of skills at the right place."
Like other health systems' top leaders surveyed by the ACHE, solving financial and behavioral health issues is top of mind for WellSpan Health's CEO.
"Financial challenges are absolutely always something that we need to pay attention to. We have done a significant amount of work in the last two-and-a-half years to pull cost out of our infrastructure, mostly in our back-end areas, like our business services areas. That's been tremendously helpful for us, because we want to make sure that clinical-facing components are the face of WellSpan. But where can we be efficient using AI and other technologies on the back end?"
"We have recently expanded our inpatient bed capacity at WellSpan to accommodate the growing needs in our communities [surrounding behavioral health]. We have one of the largest behavioral health organizations in the United States, about 60% of the behavioral healthcare in south central Pennsylvania is provided by us. Our work is split 60/40: 60% adults, 40% kids. We're one of the few providers that [works with] children and adolescents. We want to be sure that we're keeping a pulse on how things are going in the behavioral health arena and that we're meeting as many of the needs as we can in our communities. The expansion of our inpatient bed capacity and some of the work that we're doing in our behavioral health area with telehealth has been helpful."
"Burnout is another focus for us here and well-being. We recently [conducted] our physician and advanced practice provider engagement survey, and it turned out one of our strengths of our system is that they feel supported, that they feel there's a lot of well-being efforts here at WellSpan. We're looking at that same thing with our middle management levels, so our nurse managers and our operational managers and all managers, to make sure that their work is efficient [and] that they feel supported."
“Like many health systems, we've been challenged to ensure that we have the right skillset with the right role throughout our system.”
— Roxanna Gapstur, PhD, RN, President and CEO, WellSpan Health
Melanie Blackman is a contributing editor for strategy, marketing, and human resources at HealthLeaders, an HCPro brand.