One of the many “side effects” of the COVID-19 pandemic is a labor shortage pervasive throughout all geographic regions, organizational types, and job sectors. Understandably so, healthcare continues to be uniquely affected. A range of circumstances, including, but not limited to, burnout, safety concerns, workload, stress, and vaccine mandates, has intensified the staffing crisis within the healthcare industry. Healthcare workers have also experienced significant loss, firsthand, throughout the global health crisis.
In an effort to better assist healthcare organizations with these challenges, PYA interviewed several healthcare executives to learn more about what they are experiencing, and to find out about any successes in their pursuit of innovative staffing and retention solutions. Our discussions emphasized the labor shortage and illuminated two key issues: The Great Resignation and Filling the Pipeline. While employers have always strained to recruit and retain talent, these challenges are now amplified.
The Labor Shortage
There have been mass employee exits from the healthcare industry as a whole since the onset of the COVID-19 pandemic, and this trend shows no signs of slowing. Per the United States Department of Health and Human Services (HHS), nearly 1,200 out of 5,000 hospitals experienced critical staffing shortages in early January 2022.[1] Hospitals continue to report critical staffing shortages as recently as early March 2022.[2] Labor costs continue to rise as well, compounding the concern. Specifically, clinical labor costs are up an average of 8% per patient day compared to 2019, equaling approximately $17,000,000 in additional labor expenses for an average 500-bed facility.[3] Further, healthcare employers expect their costs to rise more than 5% in 2022.[4] Shrinking margins have made it more difficult for employers to retain skilled workers. The shortage has also been exacerbated by population shifts, as people have moved away from large metropolitan areas to suburbs across the United States.[5] The combination of these factors has led to chronic understaffing, which contributes to burnout of the remaining, seasoned employees.
Other American industries are raising the minimum wage in response to economic and societal pressures resulting from the pandemic, causing many workers to leave the healthcare industry to find financially comparable jobs in other industries, including retail or food service. Increased use of telehealth has also created a new division of remote workers who are unwilling to return to traditional in-person work settings. In addition, PYA has identified trends in nurses leaving the bedside to pursue non-direct patient care roles or to further their education.
Moreover, the United States’ healthcare system is projected to face a shortage of up to 139,000 physicians by 2033. If underserved populations are given equal access to healthcare over the next 10 years, as is the national goal, these shortages could increase demand by an additional 74,000 to 145,000 physicians.[6] One driving force behind the physician shortage is limited training opportunities for medical school graduates. Internship and residency programs have a limited amount of teaching faculty, space, and equipment available, resulting in smaller class sizes. The reduced applicant pool has made succession planning even more difficult. Additionally, the nation’s healthcare system needs more than 200,000 new registered nurses per year to meet the increasing need and fill vacancies left by retiring nurses.[7] All of this amounts to chronic staffing shortages that are raising increasing concerns for patient safety.
Reversing the Great Resignation – Focus on Retention
It is critical for employers to promote effective employee engagement. The most successful strategies were in place long before the COVID-19 crisis occurred. However, it is never too late to re-engage staff. Effective leaders recognize the importance of facilitating open, honest discussions with current employees regarding their preferences related to schedules, benefits, and working locations. Several healthcare organizations are offering enhanced engagement through additional support services, such as childcare, tutoring services, mental health resources, and other benefits. These efforts have been met with positive staff feedback.
Employers should be racing to offer maximum, customizable benefit options to allow employees autonomy with plans that work best for them. Some organizations are offering a menu-like variety of benefit options, allowing employees to choose their benefits according to their personal needs and season of life. Such options can also differentiate an organization among others in the hiring market, since anticipating employees’ needs and concerns builds trust and loyalty across an organization.
Some employees may be interested in flexible schedules or remote working locations, which may allow for additional clinical coverage hours, while improving employee satisfaction. Patients can also benefit from extended clinic hours, thereby a win-win-win for employer, employee, and patient. Other employees may be interested in cross-training, allowing for the use of cross-functional teams.
Organizations must also continue to practice good “compensation hygiene” (i.e., if it stinks, people will talk about it).[8] Compensation practices should be equitable and aligned with market comparisons to avoid conflict and mistrust within the organization. Compensation hygiene is equally important for both talent retention and recruitment.
Prepping the Pipeline – Focus on Education and Recruitment
It is essential for healthcare organizations to develop and maintain relationships with recruiting agencies and teaching programs, including high school programs. Some systems may even be able to cultivate resources for their training programs. For example, Griffin Health, a health system in Derby, Connecticut, has created the School of Allied Health Careers training program, intended to help the system with recruiting for difficult-to-fill entry-level positions. This hospital-based program began as a training program specific to phlebotomists, but has since expanded to offer education for a range of careers, including certified nursing assistant, patient care technician, and certified clinical medical assistant. The School of Allied Health Careers is partnered with the local high school and school district to prepare students for these programs. Students can partner with the program as early as their junior year of high school. This innovative pathway from high school to entry-level healthcare careers allows students the opportunity to pursue advanced training at reduced tuition rates. Griffin Health President & CEO Patrick Charmel shared, “The School of Allied Health Careers has created an abundance of qualified entry-level healthcare professionals, which not only benefits the students and our healthcare system, but the local community as well.”
Healthcare employers should consider non-traditional recruiting sources, such as LinkedIn or other digital platforms, as well as out-of-the-box staffing solutions, such as employing administrative and clerical workers in other time zones. International nursing and physician recruiting should also be considered. Though the COVID-19 pandemic has caused some delays and restrictions for work visas, international staffing is still a viable option worth exploring. Former employees and retirees may also be a potential staffing source. Though these individuals have left the organization or the workforce, they may be interested in becoming “boomerang” employees, returning in a modified capacity, such as part-timers or flex workers. In addition, recruiting from industries external to healthcare, such as the service industry, could be fruitful for non-clinical roles. Healthcare employers need to embrace schedule flexibility to recruit and preserve high-quality talent.
Recruiters are a critical resource in today’s hiring market. Hiring and onboarding processes must be clean and efficient, as this is a candidate’s first impression of the organization. Many candidates may also have competing offers, so recruiters must be timely and responsive to preserve applicants’ interest. Ultimately, employers must ensure staffing models are consistent with the organization’s mission, vision, and values. Ensuring all staff, especially recruiters and talent acquisition, are aware of these values and future goals is key. Potential candidates should be interviewed with these values in mind. Healthcare entities cannot afford to compromise long-term goals and values for short-term gains.
Likewise, both in recruitment and retention, it is vital to create a genuine feeling of safety for staff. This is especially true as some employees have experienced significant loss, both in personal and professional settings, during the public health crisis.
Forging Ahead
As the healthcare industry continues to face a multitude of challenges in the wake of the COVID-19 pandemic, healthcare organizations must face the labor shortage head-on to continue to provide the best possible patient care for the communities they serve. While specific strategies for addressing the staffing crisis should be tailored to an organization’s values and strategic plan, the aforementioned retention and recruitment innovations can serve as solid starting points to ensure continued success.
For further information or assistance with staffing strategies, contact a PYA executive below at (800) 270-9629.
[1] “A Quarter of U.S. Hospitals Have Critical Staffing Shortages,” https://www.theintelligencer.com/news/article/A-quarter-of-U-S-hospitals-have-critical-16769889.php, accessed March 13, 2022.
[2] “Hospital Data Coverage Report,” https://protect-public.hhs.gov/datasets/HHSGOV::hospital-data-coverage-report-1/explore?location=38.534353%2C-88.972322%2C4.30, accessed March 13, 2022.
[3] “Hospitals paying $24 billion more for labor during the COVID-19 pandemic,” https://www.healthcarefinancenews.com/news/hospitals-paying-24-billion-more-labor-during-covid-19-pandemic, accessed March 13, 2022.
[4] “Employers Anticipate Health Costs Rising 5% in 2022,” https://www.healthcarefinancenews.com/news/employers-anticipate-health-costs-rising-5-2022, accessed March 13, 2022.
[5] “United States Migration Patterns and COVID-19,” https://www.unacast.com/post/united-states-migration-patterns-covid-19, accessed March 13, 2022.
[6] “Physician Shortages in Medical Specialties in 2021: An Inside Look,” https://www.merritthawkins.com/news-and-insights/blog/healthcare-news-and-trends/physician-shortages-in-medical-specialties-in-2021-an-inside-look/, accessed March 13, 2022.
[7] “Fact Sheet: Strengthening the Health Care Workforce,” https://www.aha.org/fact-sheets/2021-05-26-fact-sheet-strengthening-health-care-workforce, accessed March 13, 2022.
[8] PYA did not coin this phrase, but we wish we had. Special thanks to one of our interviewees for sharing this important perspective.
