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Reinventing the partnership between workforce service providers and healthcare systems for the healthcare workforce of tomorrow.
Despite the tumultuous landscape caused by the COVID-19 pandemic, the need for collaboration between healthcare systems and workforce service providers has become more pressing than ever. “It’s time for both parties to shift their mindset from providers and vendors to partners to develop enterprise-level solutions that meet the current needs of the industry,” says Steven Endsley, national vice president of strategic talent solutions for AMN Healthcare. In the conclusion of a three-part series on enhancing workforce partnerships, Endsley shares his powerful insights into the crucial elements of a successful partnership that will help drive the industry toward a more sustainable future for its workforce.
Q: The pandemic added a lot of friction between workforce service providers and healthcare systems. How can workforce service providers help re-establish that trust?
Endsley: Unfortunately, the pandemic led to increased tension between the two groups as contract labor prices surged. One key to mending this vital relationship is having greater transparency and better data. We need to help provide more industry and workforce service provider information on inflation, costs, and pricing to forge ahead. Workforce service providers and hospitals must now form innovative partnerships beyond contractual arrangements. The future of the workforce depends on a symbiotic relationship where providers can continue to rely on flexible, contract labor arrangements to meet organizational goals, manage staffing shortages, support permanent staff, and reduce clinician burnout while also achieving Quadruple Aim objectives.
Q: How do healthcare workforce service providers need to rethink how they support their healthcare partners?
Endsley: To meet the evolving needs of hospitals and health systems, workforce service providers must re-evaluate their value proposition, prioritizing the Quadruple Aim center of excellence. As a partner, we must sit with providers in the center and understand their pain points. Healthcare organizations require a comprehensive talent partner who can diagnose their needs and offer services encompassing multiple service lines. This is our strategy at AMN Healthcare — we provide support in key areas such as contract labor, permanent recruitment, and virtual care. We leverage data analytics to help our customers make critical workforce decisions, including how to integrate more flexible workforce models. Without the correct data and analytics, it is challenging to understand the necessary core solutions and flexibility layers needed to make informed workforce decisions.
Q: What should healthcare systems consider as they evaluate their partnerships for their workforce management goals in the future?
Endsley: Healthcare systems must seek workforce service providers who will innovate with them while embracing their mission, vision, and values. A potential partner should challenge the organization’s thinking and elevate their performance to the next level to help them adapt to the workforce of the future. They should also serve as strategic connectors to other health systems, sharing best practices and solutions for overcoming top challenges. Identifying partners that go beyond single solutions to offer customized services that match the organization’s needs and support their center of excellence is crucial. Single solutions, often enabled by a siloed approach, are no longer enough to differentiate healthcare providers in the market. Overall, embracing partners who share your values, offer multi-faceted solutions, and support peer best practices are critical to thriving in the modern workforce era.
Q: How can workforce service providers and healthcare systems work together in unity to achieve optimal results for the future of the industry's workforce?
Endsley: Ultimately, we must prioritize the patient before everything else to attain the best outcomes. Workforce service providers, hospitals and other healthcare organizations must advance to a place where they can support one another to fulfill this requirement. Furthermore, partnerships can be strengthened by a mutual commitment to the Quadruple Aim, helping healthcare providers balance patient-centered care with financial sustainability. Strong collaborations also require keeping effective workforce practices from pre-pandemic times and being willing to push the status quo. It is essential to rethink how care is delivered and ask critical questions, including ‘Do we have the right positions?’, ‘Are we executing job functions correctly?’ and ‘Can we automate more functions?’ By working together, we can find ways to support each other and reach an optimal state for the future workforce.
Today’s healthcare workforce is undergoing a transformative period with an unprecedented potential for flexibility as more healthcare professionals challenge traditional job roles and schedules.
The pandemic and digital transformation have amplified this shift, with healthcare talent seeking more personalized ways of working. “We need to reengage people with more flexibility and new opportunities to shape their work experiences,” says Steven Endsley, national vice president of strategic talent solutions for AMN Healthcare.
Endsley notes that organizations can manage their employees more efficiently and empower a more dynamic workforce with virtual care, remote, part-time, and gig work opportunities, thanks to advancing technologies such as telemedicine, artificial intelligence (AI), and predictive analytics. In part two of this three-part series, he delves into the importance of greater adaptability in the healthcare workforce and how providers can navigate this evolving landscape.
Q: What does “flexibility” mean to healthcare workers today?
Endsley: Flexibility is more than just a buzzword. It means providing a customized work experience that caters to individual needs such as job responsibilities, work hours, and scheduling. Employees want a better balance between their personal and professional lives, with some asking for non-traditional roles and schedules. For example, some workers may prefer to work the same hours as their children’s school schedules, while others may opt for a two-month on two-month off plan so they can travel.
It is becoming increasingly clear that provider organizations must revamp traditional roles, tailor positions to individual needs, and continue to layer in contingent caregivers to support staff and patient needs as workforce needs evolve and new generations enter. To keep pace with the changing times, healthcare providers must proactively reimagine job responsibilities and potentially restructure job roles to accommodate the various macro factors at play. For instance, some nurses may not wish to work at the bedside but can still practice nursing in other areas, such as triage and virtual care roles.
Q: Where can we create new forms of flexibility for this workforce?
Endsley: An area being explored is leveraging a large number of nurses who are about to retire or those seeking part-time work assignments where they can self-schedule across multiple provider organizations as a PRN or 1099 to meet their work-life balance preferences, rather than working a full-time commitment to one single provider organization. Additionally, virtual work options are on the rise, providing more flexibility, and there are emerging opportunities for primary and preventive care roles in retail settings. Industry giants such as Amazon and Walgreens are already setting a precedent with flexible day-shift jobs. Furthermore, gig work is an expanding field of interest, and advanced platforms like AMN’s Passport app enable individuals to pick up contract opportunities and part-time work shift-based work or search new full-time jobs, giving them the freedom to choose how much they work and in what level of engagement they want to work with a single or multiple provider organizations.
Q: What infrastructure is necessary for health systems to adapt to the dynamic nature of the modern, flexible workforce?
Endsley: When adapting to a more flexible workforce, providers need a center of excellence that connects the four spokes of the Quadruple Aim. This center should enable health systems to collect, analyze, and act on key organizational decisions, resulting in more effective workforce management. Access to data, analysis, and knowledge supported by AI and machine learning technologies is also critical for greater workforce flexibility. Ultimately, the shift from siloed to strategic workforce decision-making requires a center of excellence driven by data analytics. Data-driven decision-making is a primary goal for AMN as we collaborate with our provider partners to introduce flexibility into the future workforce through a multi-channel approach to support the delivery of care: full-time staff, internal float pools, international clinicians, gig workers, internal agencies, virtual care, and external agency. Better integration of these workforce areas is necessary to drive efficiency and meet budget goals consistently.
Q: How can we retain quality care while embracing a more flexible workforce?
Endsley: It is crucial to prioritize quality as workforce flexibility increases. While some worry that the growing flexible labor pool is a risk to patient care continuity, our experience suggests it is possible to maintain high-quality patient care while introducing more flexibility to the workforce. Advanced technology tools, real-time patient care data, strategic care handoffs, and training can achieve this. One comprehensive study of travel nurses and staff nurses at five hospitals over three years found that patient care quality and experience remained consistent between the two groups. It is important to acknowledge that our workforce structure is changing, and we must embrace this. Forcing a traditional structure on staff may result in more people leaving the profession and unsafe staffing ratios. We can ensure that care quality remains high by prioritizing a happier and more engaged workforce with a more flexible work-life balance.
Part three of our Q+A series uncovers strategies and tactics for building a stronger relationship based on trust and transparency between healthcare systems and workforce service providers.
Prior to the pandemic, working in hospitals meant 8- or 12-hour shifts, every other weekend plus a minimum number of holidays.
Options included full-time, part-time, and limited per diem. Today, according to Steven Endsley, regional vice president of strategic talent solutions for AMN Healthcare, the COVID-19 pandemic has challenged provider organizations to reevaluate long held beliefs on how to ensure the delivery of care to their communities.
Endsley notes that significant trends projected to unfold in the next ten years are already occurring, such as the demand for healthcare and healthcare providers, and the shift in how healthcare is delivered. Hospitals and health systems must expedite their future workforce strategies, remaining focused on delivering quality patient care while reducing clinician burnout and costs.
In this three-part series, Endsley explores fundamental steps to optimizing the workforce of today while creating the workforce of tomorrow through stronger internal and external partnerships.
Q: How does healthcare’s workforce management structure align with the Institute for Healthcare Improvement’s Quadruple Aim?
Endsley: As hospitals and health systems establish strategies and operating plans to align with the Quadruple Aim, the current environment has escalating workforce costs and high vacancy rates limiting access to care for many and creating stressful work environments. There is increasing polarity between the four aims, impacting workforce management. The pandemic played a contributory role as it has further complicated workforce dynamics. For instance, healthcare organizations today face a greater risk of misalignment when balancing the need to reduce costs while ensuring a positive experience for clinicians and patients. At the same time, provider organizations tend to make decisions across multiple, siloed departments that lack a holistic understanding of the impact these choices may have on each area of the Quadruple Aim.
Q: Why must healthcare organizations consider an alternative workforce management model in the current state?
Endsley: The answer lies in the rapidly changing workforce. According to Forbes, Millennials are on the verge of becoming an overwhelming majority in the workforce (75 percent by 2025). 1
As noted in the AMN Healthcare 2021 Survey of Registered Nurses, nearly one-quarter of nurses, or 23% of nurses surveyed said they likely will quit their job because of burnout and a high-stress working environment as a result of the COVID-19 pandemic. Approximately one million registered nurses will retire by 2030.2
These shifts indicate it is time to adopt a new workforce management model prioritizing flexibility, retention, clinician satisfaction, continuity of care, and financial stability. Throughout one’s career lifecycle, there are different priorities; stability and structure, flexibility to meet family needs, or variety to use skills in new ways and in new settings. To retain employees, these options must be available and attractive. New workforce models must also be financially sustainable for healthcare organizations. Today, hospitals are facing daunting financial challenges. One of the components leading to those challenges is the cost of the workforce. By building more layers to your workforce, at different costs, and utilizing a technology to predict staffing needs, hospitals can ensure they have the right staff, at the right time at the right cost.
Q: Which areas of the healthcare organization need to align more closely to ensure the future success of workforce management?
Endsley: To ensure a coordinated approach to workforce management, clinical, finance, HR and IT must align and work in unison. Often finance, clinical and HR are working from different technology systems that provide data through a different lens, leading to frustration when one department reports they are understaffed, yet another model shows they have the staff needed. IT has become a critical component, but they too have workforce challenges and have limited capacity to integrate new technologies that could lead to greater access to care or process efficiencies. It is imperative that the departments have a shared vision and work together within a center of excellence to understand how their decisions impact other areas and align with the bigger picture. Our ultimate goal in working with our clients is to create a more collaborative approach and provide the tools that support the vision.
Q: What best-practice models have been deployed in health systems nationwide?
Endsley: We’ve witnessed some of our health system partners, who are leaders in the industry, offer innovative workforce opportunities that improve the employee experience, leading to better patient outcomes. These organizations have even created internal contract labor functions to engage their workforce more strategically, especially in the wake of the high turnover from the pandemic. They are adding flexible labor programs beyond the traditional float pool model, including gig-economy-inspired flexible scheduling, internal agencies, virtual care delivery and international clinicians. To build a successful workforce for the future, we believe organizations must adopt this type of flexibility.
Part Two of our Q+A series explores how hospitals and health systems can meet the evolving needs of healthcare by promoting greater workforce flexibility.