Staffing shortages and other workforce challenges continue to test healthcare organizations’ operating models and ability to deliver high-quality care. To address these challenges, hospitals and health systems are increasingly exploring novel workforce solutions.
This was the main theme of a roundtable discussion at Becker’s Hospital Review 15th Annual Meeting, sponsored by CareRev and moderated by Larry Adams, chief nurse executive and senior vice president for strategy at CareRev. The panel discussion featured three healthcare executives who were joined by clinical, human resources, operational and administrative leaders from across the country. Panelists were:
- Jenny Cinquemani, assistant vice president and chief nursing officer, Bristol Health (Bristol, Conn.)
- Adriana Velasco, senior vice president and chief nursing officer, Valley Presbyterian Hospital (Van Nuys, Calif.)
- Deborah Visconi, president and chief executive officer, Bergen New Bridge Medical Center (Paramus, N.J.)
Three key insights:
- Nursing shortages are expected to worsen, exacerbated by many organizations’ inflexible approach. According to a recent study by the National Council of State Boards of Nursing, healthcare organizations have lost more than 138,000 nurses since 2022. These losses follow the loss of 100,00 nurses who left the profession during the first two years of the COVID-19 pandemic. And the outlook is worrisome, as nearly 40% of registered nurses intend to leave the profession in the next five years.
The shortage of nurses is merely the end result of the systemic approach that organizations use in hiring, employing and retaining nurses, which is driving many nurses away. “Maybe the problem is how nurses want to work with greater flexibility and how we’re [resisting providing this flexibility] by using restrictive traditional models,” Mr. Adams said.
Ms. Visconi concurred. “What we’re seeing with our workforce is that people are looking for greater flexibility to create their own schedules and their own workflow,” she said.
Offering greater flexibility is essential in countering these trends. When Bristol Health allowed nurses from its float pool to choose weekend-only shifts, that reduced the weekend burden for full-time staff — making it a win-win. “Working through that [flexibility demand] helped improve our retention rates,” Ms. Cinquemani said.
- Effective solutions enable healthcare professionals to pick shifts that work for them. The key is offering a level of autonomy and flexibility that is extended to internal full-time staff as well as to internal and external float pool members. “We want you to use your full-time staff first, then go to your internal float pool and [only then] start stepping into ‘premium labor,'” Mr. Adams said, describing the philosophy of CareRev’s solution.
The CareRev app is designed to facilitate that step-wise approach to staffing. It offers two modalities — CareRev IRP+ for internal full-time and pro re nata (PRN) staff and CareRev Marketplace for external float pool members.
At Bergen New Bridge Medical Center, “We launched CareRev IRP+ in February and we have already seen a tremendous shift in terms of more of our own staff picking up shifts,” Ms. Visconi said. “About 90% of our staff have onboarded into the internal resource pool, so when they see a shift open, they now have first dibs on that shift.”
Giving nurses more control over their work schedules ties into broader cultural shifts. “The workforce has evolved and it’s no longer about just filling out a staffing position, but more about looking at work-life balance, burnout and wellness programs,” Ms. Velasco said.
A roundtable participant whose organization has adopted a similar view agreed. “We’re listening to what our nurses’ needs are and are taking these needs into consideration because happier nurses result in happier patients.”
Other elements of the new social contract between provider organizations and team members include heightened expectations for professional development and growth opportunities. “People are starving for a career ladder,” Mr. Adams said. In response to that yearning, Bergen New Bridge is embarking on a career ladder program and a student loan repayment program for its nurses.
- Workforce strategy must be aligned with broader organizational goals. Care quality, patient safety and financial health are non-negotiable requirements for hospitals and health systems. This means that any rethinking of workforce strategy should be closely aligned with and support those non-negotiable goals.
“In our organization, we have a nurse executive council in charge of shared decision-making. We are leveraging that knowledge to inform what our strategic plan is going to look like four or five years out,” Ms. Cinquemani said. “You have to leverage the voices of those who are doing the front-line work every day and give them the space to give you feedback.”
Another way to align workforce strategy with strategic goals is by tying performance initiatives to quality metrics and communicating that connection clearly and frequently. “Bring it into your everyday huddles and make everyone aware that quality initiatives are not just the chief nursing officer’s responsibility — they are everyone’s responsibility,” Ms. Velasco said.
