From flexible scheduling and virtual nursing to strategic workforce partnerships, how health systems are saying goodbye to staffing models of the past
Healthcare organizations are increasingly adopting holistic workforce models and partnerships to proactively respond to changing needs posed by the nursing shortage, a multigenerational workforce, and the growing emphasis on mental health. According to Patti Artley, DNP, RN, CPN, NEA-BC, CNO of Medical Solutions, “The old way of doing things is no longer feasible. Success requires a deep understanding of our staff at a micro level and the strategic application of flexible scheduling and staffing resources. We must also work harder to build cultures that take care of the well-being of individuals,” she says. Here, Artley shares insights into how organizations can prepare for the future through workforce partnership, staffing, culture, and technology innovations.
Q: What should organizations seek in a workforce partnership?
Artley: Hospitals and health systems must strongly consider what comprises a true partnership. Workforce partnerships have moved beyond filling requests for travelers. While travelers are important in meeting recruiting requirements, one of the most significant opportunities lies in collaborating with a company that can help decrease your dependency on contingent labor. They should provide guidance in critical areas such as flexible scheduling, crisis staffing, mental health, culture, and technology.
Q: What strategies can organizations use to meet all their current and future workforce needs?
Artley: A significant barrier for organizations is trying to accomplish many different goals. It’s most important to understand the challenges in front of them, which is the growing nursing shortage for many. By 2030, the nurse workforce is projected to experience a deficit of 1.2 million registered nurses nationwide, with 4.7 million nurses planning to retire in the next decade. Additionally, programs deny admissions to 80,000 qualified nursing students each year. Assessing the impact of these trends on your organization, region, and state is essential.
Health systems must also move away from a one-size-fits-all approach to workforce management, think creatively, and develop effective staffing plans that cater to the unique needs of their staff. Understanding their staff’s diverse professional and personal needs is crucial, especially for the younger generations. For example, Millennials and Gen Zs desire to stay with organizations that will help them grow professionally and enable them to practice at the top of their license. Mentorship and guidance in areas such as clinical ladders are key for their career development and long-term retention. Residency programs for new graduates are also vital for a successful transition to nursing practice.
Organizations should also prioritize flexible scheduling to retain nurses who can’t or don’t wish to work 12-hour shifts, including retiring individuals, parents with schooling challenges, and those coming off maternity leave. Empowering frontline managers with a manageable span of control is equally essential for success. A holistic workforce solutions partner will help you address all of these factors. Those organizations more willing to try new models and tactics and who are unafraid of failure are more likely to close the nursing gap.
Q: What creative staffing models are emerging, and what should organizations consider?
Artley: The more innovative staffing models integrate flexibility to retain existing staff. For example, some organizations leverage the volume of PRN staff during slower periods and while experiencing their largest churn. This approach allows a hospital to build in breaks and lunch coverage. It also enables them to hire nurses who can only work shorter shifts while offering Millennials, for example, the flexibility to pick up extra hours when they want. The result is less reliance on traditional 12-hour shifts for coverage.
Additionally, providers continue to implement a range of flexible solutions, including internal and external float pools that deploy resources to where they are needed most to support nurses and address their team’s mental and physical exhaustion. We have also seen an increase in international staffing. These highly skilled nurses are loyal to the hiring organization and can help fill gaps or balance staffing pools with experienced nurses, especially in regions with high graduate nurses. Additionally, Code Lavender provides crisis intervention to nurses during stressful situations.
Technology is critical in supporting new staffing models, creating efficiencies such as reducing documentation, and enabling virtual nurse platforms. We see virtual nurses as an integral part of clinical teams moving forward. Virtual nurse roles range from discharge nurses to resource nurses for recent graduates. We also predict an explosion in AI and robotics for delivering care, medications, and supplies. These technologies will allow people to get back to caring for patients.
Q: How can healthcare organizations build staffing pipelines beyond recruitment and travelers?
Artley: A holistic approach to workforce management is needed, prioritizing retention as the most critical factor in stabilizing the workforce. The game-changers have figured out how to decrease turnover while adding on and layering into the workforce, making it a net add versus a constant churn. Assessing and determining staff needs in the individual work area is also crucial as a culture is defined in that microsystem. And when we reward and recognize our teams meaningfully while addressing burnout, that helps keep them there. I don’t think you can say “thank you” enough.
How has the pandemic reshaped healthcare staffing? What sort of challenges are hospitals and health systems facing now? The key to success is understanding these critical issues and formulating a plan to address them.
Healthcare staffing shortages can make it harder to find skilled talent, and facilities face higher bill rates too. Compounding this is the burnout associated with factors such as unsafe staffing levels and lack of professional development, felt mostly by early to mid-career clinicians.
“We continue to see a significant clinician shortage that existed well before the pandemic,” said Medical Solutions Sr. Director of Client Growth Scott Armstrong. “Over the past two years, COVID further exasperated the issue and really placed it under a microscope and at the forefront of all of our conversations.”
Health systems must look for a workforce partner who has made adjustments due to how factors have changed since the pandemic. It’s time to shift business strategies!
Business Strategy Shifts
Staffing is no longer transactional. To be successful, you need a strategic workforce solutions partner who will provide consultative insight and guidance with real-time data to help you make decisions that go beyond simply filling jobs. This partner will help you drive decision-making, find opportunities to cut costs, and stop overpaying in situations where clinicians are in abundance due to a common specialty or the popularity of the location.
Utilize Data Analytics
The right workforce solutions partner provides you with real-time analytics to help inform staffing decisions, understand current market trends, and make more strategic, data-driven choices. They also help you understand job volumes, supply and demand, program efficiency, and many other performance and trend indicator metrics.
“What you do today, even if you’re doing it really well, might not be what is needed in the future,” said Medical Solutions Vice President of Client Success Kevin Walsh.
Predict Healthcare Staffing Supply and Demand
Effective healthcare leaders are embracing the use of predictive modeling through machine learning to more accurately determine anticipated workforce needs in the future. Predictive modeling helps facilities resolve a number of issues such as ensuring they have enough labor supply to fill their demand, without overpaying or underpaying.
It’s no longer enough to use traditional forecasting methods like basic spreadsheets or now outdated acuity tracking tools. You need machine learning technologies to analyze and process data differently, to give you a comprehensive predictive model to determine your needs now and in the future.
Pay Attention to How Clinicians Want to Work
Another pandemic-fueled strategy shift for you to consider is how younger generations think about their job and overall careers—they are always looking for advancement that can oftentimes be achieved by changing jobs multiple times to gain experience.
Also, regardless of which generation they come from, your staff is looking for flexibility. This is why it’s so important that when choosing your workforce solutions partner, you work with one that offers access to multiple supply channels— permanent, per diem, travelers, interim leadership—and one that can help you manage your internal traveler program.
Provide Quality Care
Quality patient care is always the focus. Your workforce solutions partner should understand this and have proven methodologies in place to ensure clinicians have the right experience, skill set, and commitment to supporting the values of putting patients first. It’s also good to work with a partner who knows the importance of putting technology platforms at the forefront of your needs while ensuring that human interaction remains a vital component.
Evaluating Your Workforce Solutions Partner
Observations over the last few years have revealed how the pandemic has exacerbated staffing challenges, how health systems need more comprehensive support, and how machine learning and data analytics continue to grow in importance as well as applicability.
Here’s what to ask when evaluating your workforce solutions partner:
Does your workforce partner have a deep understanding of the market ecosystem, both where it’s been and where it’s going?
Is your partner agile enough to quickly adapt to the changing market conditions?
Does your partner prioritize your success and evolve with you by investing in technology and people?
Does your partner have access to machine learning and data analytics to validate all its recommendations?
Armstrong and Walsh both acknowledge how clear it is that leaders cannot get by with the solutions, resources, or approaches that were seen prior to the pandemic. It's important that hospitals and health systems are mindful of making necessary adjustments to ensure they are set up for success, so their clinicians feel supported, and they have better patient outcomes.
Total healthcare workforce partners combine human efficiency and innovative technology, driving greater flexibility, predictability, and cost containment
Healthcare staffing needs have evolved rapidly in recent years, leading to increasing labor shortages and escalating expenses—all of which drive health systems to seek staffing partners with more marketplace insights and a strong focus on efficiency, quality, and cost control. “Health systems want a total healthcare workforce partner capable of solving diverse staffing challenges more efficiently and with a sharp eye on their unique future needs,” says Joel Tremblay, chief operating officer of Medical Solutions. Below, he explores the benefits of a total healthcare workforce partnership and shares how the powerful combination of quality human interaction and efficient technologies can offer clinicians a more tailored experience and health systems a better way to predict staffing demand accurately.
Q: What unique technology offerings does Medical Solutions have that benefit its clients?
Tremblay: During the past few years, we were all working in a staffing crisis situation, where everyone had to react quickly. This reactionary approach to staffing drove up prices. Our goal is to help our clients transition to a more stable environment with appropriate pricing as we move out of crisis staffing. Through technology, we can help our health system partners control costs by being more forward-looking while also ensuring their shifts are filled, their needs are met, and the quality of care remains high. For example, we’re working on a new client app that will offer an overall better user experience for all aspects of the staffing cycle, including billing, invoicing, credentialing, and predictability. We’re also leveraging machine learning to predict staffing demand more accurately with enough notice to be impactful.
The accuracy of predictions is more impactful the further out you can predict, and we’re closing in on the data to make this happen. We’re also in the early stages of using machine learning to forecast pricing, which will make staffing more cost-effective for our clients. The earlier we know of a staffing need or gap, the more time we have to find the right clinician with the right experience at the right time to assign at a fair market value—well ahead of when they start their position.
Q: How do these unique technologies benefit travelers?
Tremblay: We look carefully at the data, including preferences and behaviors, to ensure our technology offers clinicians a more refined and customized experience. This experience means clinicians have to input less information, are matched to jobs instead of searching for them, and better understand available opportunities to create the careers they desire.
Also, exciting developments are in the works to create an even better clinician experience. We are making significant strides to develop a clinician loyalty program, including a new web app experience. This new technology is focused on presenting clinicians with the right jobs and can filter our available openings by more than just location, specialty, and pay. With more than 20,000 current job openings, which can be overwhelming for any clinician to sort through, our new technology uses multiple factors and filters to ensure the clinicians have access to the jobs that work best for their wants and needs. Ultimately, we want them to know as much as possible about the position before starting it to set them up for a successful assignment and a great experience in their travel career.
Q: What strategic changes have you made over the last year that differentiates Medical Solutions from others in the industry?
Tremblay: We recognize the pandemic brought major staffing changes, and we are answering the call to support hospitals with more flexibility for their own staff or through permanent or temporary staff. We’re more than just a contingent staffing agency—we’re a total healthcare workforce solution focused on providing different supply channels that work together to solve a myriad of staffing problems and challenges for our clients. Instead of working in silos, our total healthcare workforce functions as an ecosystem to optimize the workforce to fit our clients’ needs. We are a strategic partner and consultant, helping clients find the most cost-effective way to provide the highest quality of care for our clinicians and their patients.
Tremblay adds that Medical Solutions, with its size and scale, including a large number of clinicians and an array of partnerships and contracts, has a broader market view and can help health systems create more predictive staffing models. Medical Solutions is investing in the solutions facilities need while helping build a unique program that works for each partner.
The ability to predict healthcare staffing supply and demand changed dramatically for hospitals and health systems during the pandemic, when forecasting algorithms based on historical trends failed.
Now, facilities are turning to predictive modeling through machine learning for more accurate predictions as they anticipate future workforce needs. “Our industry is becoming more advanced, and there is a greater desire to make data-driven decisions rather than rely only on what happened in the past,” said Scott Armstrong, senior director of client growth, and Jason Lander, EVP of product and service innovation at Medical Solutions. Below, the two discuss why predictive staffing models, in partnership with a total healthcare workforce ecosystem, are more timely, efficient, and cost-effective.
Q: What are the benefits of predictive modeling?
Armstrong and Lander: The main advantage is the ability to make better decisions faster and with more confidence, which will lead to a more predictive state of future needs and less looking back at past data to forecast. Our clients are starved for data and information in all forms because they operate in a more dynamic environment today than before the pandemic, when the standard or contracted bill rate was flat 99% of the time. As facilities move to a new normal, predictive modeling based upon machine learning can help them manage through the change by providing analytics and information on everything from rehire rates and supply and demand metrics to completion rates, quality metrics, and costs. Predictive modeling helps solve key problems, such as ensuring facilities have enough labor supply to fill their demand without overpaying or underpaying. It also provides healthcare professionals with the right information to make better choices around patient outcomes and their own careers.
Q: Why Medical Solutions?
Armstrong: We are a total healthcare workforce ecosystem with a national perspective on staffing needs and pricing. We are attuned to our client staffing needs and challenges at every possible level, which have changed through the seasons with the Affordable Care Act and, most recently, the COVID-19 pandemic. For example, we equip our clients with the proper data and analytics to make informed decisions in crucial areas like bill rates. We show them expected outcomes of different bill rates so they can set the correct bill rate to drive appropriate labor supplies to their facilities. The data our team manages represents 90% of the industry. It’s meaningful and accurate because of our size, scale, and commitment to partnership, predictability, and transparency.
Lander: It’s also important to add that many facilities still use traditional methods to look at data and make forecasts, including spreadsheets and outdated acuity tracking tools. Medical Solutions implements machine learning technologies that analyze and process data differently, resulting in a predictive model. We also partner with facilities and our internal teams, including client success teams, data scientists, and product teams, to look at market, competitive, and client data, helping facilities understand their unique needs, the broader market lens, and how to use the data properly. For instance, we can provide clients with timely information on indicators that may lead to nurse attrition and burnout, two critical challenges that cause an enormous burden and expense.
Q: How does supply and demand influence predictive modeling in the healthcare industry?
Lander: Supply and demand changes very quickly, with various market conditions and other factors affecting regions differently. Facilities need a macro view of relevant data, including things such as customers, resource supply, competition, geography, seasonality, and attrition, to make better, timely, cost-effective staffing decisions. For instance, facilities can hire staff at more favorable bill rates if they can predict their needs and secure supplies ahead of predicted spikes in demand, which are still occurring even as markets become more stable.
Armstrong: We’ve also seen our industry's purchasing process for contingent labor become more dynamic and sophisticated. It is a group purchasing effort that, in addition to clinicians, often includes supply chain, purchasing, and financial teams. This interdepartmental group wants specific data on current trends and information that supports pricing and staffing model strategies for more than just travelers. For example, facilities also need data that drives decisions on the percentage of annual new hires who will be local versus travel staff.
Q: What are the risks for those who do not adopt predictive modeling?
Armstrong and Lander: This is truly the direction in which the industry is going. It’s also what our nationwide clients need to effectively manage and run the business of healthcare staffing, given the impacts of the pandemic, the gig economy, the great resignation, and other trends. It’s putting more pressure on our industry to provide more information and be a higher quality, more sophisticated partner that creates value beyond filling travel needs. If your staffing partner doesn’t offer machine learning-based technologies that produce predictive outcomes, you are not as equipped as you could be to make the best decisions.
Armstrong and Lander agree that COVID-19 and other healthcare workforce disruptors signal an increasing need for predictive modeling. Facilities that use machine learning and predictive modeling in situations like a pandemic can learn, adjust, and get back on their feet sooner by adding data to their staffing model to create accurate predictions they can trust faster.
Scott Armstrong is the Senior Director of Client Growth and Jason Lander is the EVP of Product and Services Innovation at Medical Solutions