The Best ‘Stay" Strategy for Healthcare’s Workforce

More than ever, hospital CEOs seek solutions to keep and care for existing talent and attract new employees to the organization. They believe growth and sustainability depend on new approaches to recruitment and retention—and they have tasked HR leaders with identifying ways to reimagine the employee experience.¹

Given pervasive staffing challenges, HR teams recognize the need to move from the “firefighting mode” of the past few years toward more innovative, differentiated, and inclusive approaches that attract high-quality candidates and retain and care for current employees.

Solving for these workforce challenges is foundational to hospitals and health systems in accomplishing their strategies for growth, efficiency, quality, and experience.²

Redesigning Recruitment and Retention

While there are no easy answers to recruitment and retention improvement, HR leaders recognize that innovation requires tight collaboration between the HR function and leaders at every level in the organization. Key to this effort is involvement of clinical and nonclinical staff in understanding and redesigning the end-to-end employee experience.

In spring 2022, a large health system in the south sought to redesign its approach to retention and recruitment. Top priorities included keeping and caring for its associates using the right ‘stay’ strategies—with a strong focus on decreasing first year turnover; redesigning its recruitment process to reduce time to fill measures while offering a welcoming experience that would attract the best people; and redesigning its care team model to unburden associates and improve efficiency.

To accomplish this, leaders used a blended approach leveraging design thinking and LEAN to develop a path forward, organized around key dimensions of the employee journey, as noted in the graphic below.

Central to this approach were these four steps:

1. Deepen listening to understand employee “pains and gains.

At a time when burnout has reached crisis levels in healthcare, relying on old techniques for gathering employee feedback is no longer enough. Instead, healthcare organizations need a fresh approach to listening that ensures employees at every level feel seen and heard - meaning the solutions adopted by the organization must be created with their feedback in mind.³

At the southern health system, enterprise and HR leaders worked with Guidehouse to convene “listening sessions” where employees and leaders from key segments documented their joys, stressors, and aspirations through creation of “personas”. They articulated what drew them to the organization and what keeps them there. During the listening sessions, they also created “empathy maps” that helped leaders and HR understand gains and pains surrounding every aspect of the employee experience. Report outs helped leaders and HR deepen their understanding of what employees value and which obstacles they face.

2. Design the future and the path to get there.

This health system invited employees and leaders from throughout the organization to attend a “design think” session where they would propose new approaches to hiring, onboarding, involvement, development, appreciation, and well-being based on feedback from the listening sessions. During the one-day design session, employee personas were shared along with national trends and key HR metrics like time-to-fill, engagement, turnover, vacancy rates, and other performance data.

Being part of the redesign effort inspired employees to bring invaluable perspectives that are vital to creating an environment where they authentically feel seen and valued as contributors to the organization’s outcomes. They also helped address some of the organization’s top recruitment and retention challenges by answering questions such as, “What needs to happen during an associate’s first year of employment for them to stay at our organization?” and “Which forms of appreciation matter most to our associates, clinicians, and leaders?

For example, certain care teams found it challenging to meet top-of-license expectations for their work. Workforce shortages had stretched capacity, while lack of access to supplies and resources challenged their ability to deliver care efficiently and effectively. During the design session, team members recommended that the health system leverage key associates and leaders in designing new staffing models that would account for top of license across all roles. They also advocated for increased support from ancillary staff that could extend the reach of direct caregivers.

During the session, teams generated more than 100 recommendations, which were prioritized for impact and effort. This resulted in a comprehensive workplan noting short-term wins, mid-term recommendations, and longer-term solutions that require more resources, including technology improvements. The recommendations were presented to C-suite and facility executives at the end of the session, and all attendees participated in a closing commitment ceremony.⁴

3. Act on design session recommendations.

Following the design session, HR stakeholders integrated recommendations into existing work, defined measures and decision rights, and established a governance structure to oversee the work, keeping in mind the processes and resources, including technology, needed to put the plan in motion. They also developed a communications plan for securing employee buy-in and established quarterly check-ins to review progress and assure a high level of accountability.

At the HR level, the design-think process resulted in recommendations to refine the structure of HR, identifying emerging roles—such as an HR navigator and an employee experience specialist—to help prepare the organization for the future of work. HR leadership also prioritized the need to collaborate with marketing to build a distinctive employer brand to enable recruiters and leaders to tell a consistent story of why a candidate should work for the organization. This type of storytelling would help candidates better understand and trust the organization while differentiating the system from its competitors in the search for talent.

4. Establish a plan for leaders related to recruitment and retention.

The data analysis, interviews, and listening sessions revealed a high degree of variability in how recruitment and retention processes were carried out among hospitals and leaders. To lay out the imperative for change, the organization convened a leadership symposium to share the organizational strategic plan and specifically highlight workforce as the No. 1 strategic priority. Leaders had an opportunity to learn about the listening and design work and weigh in on the individual roles they could play to reduce variability, incorporate experience principles, and standardize processes.

Inspiring Hope Among Employees and New Recruits

It’s no secret that the healthcare industry is experiencing the most unusual circumstances it has ever faced.⁵ Taking a fresh approach to employee retention and recruitment will resonate with current and future employees by demonstrating that the organization empathizes with the challenges they face and desires to elevate the their experience. And by more effectively caring for their employees, hospitals and health systems can strengthen their value in the communities they serve.

Co-authored by Martha Davis and John C. McLean III

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¹https://guidehouse.com/news/healthcare/2022/cu-denver-guidehouse-survey
²https://guidehouse.com/insights/healthcare/2022/5-prescriptions-for-physician-burnout
³https://www.hhs.gov/about/news/2022/05/23/new-surgeon-general-advisory-sounds-alarm-on-health-worker-burnout-and-resignation.html
⁴https://www.hhs.gov/about/news/2022/05/23/new-surgeon-general-advisory-sounds-alarm-on-health-worker-burnout-and-resignation.html
⁵https://guidehouse.com/insights/healthcare/2022/webinars/transforming-risks-into-growth-opportunities