Solving Workforce Shortages is Not an Individual Sport: What Healthcare Needs to Do Differently

We all know how deep and severe the demand for nurses and allied health workers grew over the course of the pandemic. We still live it. From the skyrocketing cost of traveling nurses to retaining those who are burnt out and frustrated, from sourcing diverse hires for better health outcomes to reskilling current employees for technology changes, to addressing how telework impacts culture and employment tenure, these challenges facing the healthcare workforce keep CEOs up at night. Many of you share in their struggle and seek to find solutions.?

How do we fill vital allied health roles in a reliable and inclusive way? Allied health roles comprise an estimated 60% of the care workforce. They run the gamut of occupations including medical assistants, phlebotomists, vocational/practical nurses, sterile processing techs, surgical techs, health IT and data analysts, peer support specialists, community health workers, and so on.?

According to pre-pandemic numbers, the United States will need an additional 2.3 million allied healthcare workers by 2025, and California alone will need 500,000 of them by 2024. Numbers this large mean the challenge is structural, and no one organization can realistically take on the challenge alone.?

One proven solution is through industry collaboration: working together to source, support, and train a diverse talent pool so they have the right skills at the right time. It’s often tempting for healthcare employers to try and build their own workforce solution. Forming a consortia can feel like an anathema for healthcare systems that normally compete. However, reaching out to partners and forging a path of collaboration can make a stronger workforce pool and one infused with more diverse talent.?

Employer consortia is a best practice in workforce development.

Grouping employers into a consortia is a workforce best practice. Bringing together peers, suppliers, adjacent industries, and even competitors in order to bring forth solutions at a level of scale to mirror the size of the issue can have outstanding results. Once employers form into a consortia within a region, education and public sector resources can more efficiently liaison and braid to meet the labor market needs.

This playbook comes road tested. The nation’s electric, gas, and nuclear sectors (for short, we’ll call it the energy sector) went through a similar metamorphosis in the early 2000s when it foresaw 25-50% of workers on the verge of retirement. Like the aging of seasoned nurses in healthcare, energy employers foresaw the exodus and ushered in a whole set of strategies based on collaboration. State-by-state, employers within the industry coalesced to form consortia to take on workforce challenges they had in common.

These consortia infused vibrancy into outdated curriculum, retrained faculty at participating colleges in the latest skill sets, added seat capacity to previously atrophied programs, and stood alongside certificate and degree offerings to signal their intent to hire students. They exchanged tools and practices for their regionalized and localized needs.

Healthcare can rally in a similar way. Solving workforce shortages is better done as a team, not as an individual sport. Additionally, the Governor’s proposed 2023 California state budget offers $1.7B in new healthcare workforce incentive funds that can be more readily tapped when employers collaborate.

No one size fits all when it comes to the intervention.

Top of mind for all healthcare executives are nurses. Paying 2-3 times more for traveling nurses is financially unsustainable and bad for employee morale. To determine the fix, remember to evaluate where the workforce pipeline is broken.?

Are colleges graduating enough nurses? According to a University of California, San Francisco presentation of data hosted by the California Department of Labor, the anticipated shortage of RNs in the state will dissipate as new graduates enter the labor market over the next five years. Total enrollments were down from 2018-2019 to 2020-2021, but projected enrollments for 2022-2023 trend higher than the two previous academic years. However, attrition remains high for both new and seasoned RNs, and not all new graduates are getting hired – and those that do are not staying on the job. Base in point, the same UCSF presentation noted that between 2018 and 2020 nearly 1,000 new, younger RN graduates did not persist.??

While employers prefer to hire seasoned workers, there’s not enough of them, and they are commanding high wages as traveling nurses.?To grow and retain the talent pool, new graduates need to get hired, and industry should invest in a first-year nursing retention and preceptor program to prepare them to persist. Common Spirit just?announced? an innovative nurse residency program for their 45,000-person nursing workforce across 21 states.?

Meanwhile, specific nursing specialties in California are in limited supply. More nurses are required in the emergency department, operating room, and psychiatric settings. Rather than starting from scratch, the prescription here is to develop more advanced skills in the existing workforce through upskilling existing RNs and BSNs to these specialty areas.?

Employers need to go a step further and adopt best practices in tuition support programs – shifting from tuition reimbursement to disbursement in order to help workers address cashflow. If you want to know how employers are changing their thinking about educating workers in the wake of COVID, Jaime Fall is in a great position to tell you. As director of the Aspen Institute ’s workforce development initiative Upskill America, Jaime is constantly in touch with some of the 5,000 businesses in the program’s network. He shared ideas and best practices with me on a recent?episode of the WorkforceRx podcast .?

Another significant challenge at hand are “bottlenecks” in the workforce pipeline, wherein more students are trying to fulfill their required clinical hours—which are as high as 1,850 hours, depending on the program—than there are clinical hours available. Last year, California Competes, in partnership with Futuro Health,?conducted a study ?to measure the extent of the allied healthcare worker shortage, forecast the increased demand of clinical placements, and identify policy solutions to address the bottleneck caused by the lack of availability of and access to clinical training hours. We offered three categories of solutions to address the bottleneck issue:?

1. Changes in collective stakeholder efforts: Strengthening regional consortia composed of educational institutions, employers, and community organizations who are committed to addressing the bottleneck problem.
2. Changes in education programs: Increasing the use of various simulation modalities, implementing credit for prior learning and competency-based education, and incorporating the use of telehealth are all ways to help students achieve minimum competencies.
3. Changes in employers: Incentivizing clinical training sites to increase clinical training opportunities, identifying currently untapped physical facilities, and expanding the use of Federally Qualified Health Centers can help with not having enough clinical placements for students.?

Download the study ?for a more complete examination of each category.?

You don’t have to do this work alone. Futuro Health is here to help.

Kaiser Permanente invested to create?Futuro Health? (as a nonprofit) to bring forth innovative solutions for the whole healthcare industry. In just two years since launch, over 5,000 diverse adults have gone on to pursue healthcare credentials thanks to the education and support ecosystem developed by Futuro Health. Futuro Health’s design of the student journey and generous scholarship opportunities create a diverse talent pool employers can draw from. Eighty percent of our adult students are ethnically diverse, 51% are bilingual (an essential skill in any healthcare setting), 73% are female, and the average age of our participants is 30. With the right employer and consortia of healthcare partners, we can bring our best practices to share.?

About Van Ton-Quinlivan :? Ton-Quinlivan is CEO of Futuro Health and the Vice Chair of the California Healthcare Workforce Education and Training Council, established to coordinate the State’s healthcare workforce needs. She served previously as Executive Vice Chancellor of the California Community Colleges and was named a White House Champion of Change.?

About Jeff Weiss :?Weiss founded CCI, Inc. in 1986. He is also an Adjunct Assistant Professor of Medicine at UCLA, where he co-leads the Leadership Program for UCLA/Rand National Clinician Scholars Program (Formerly Robert Wood Johnson Clinical Scholars) and is a Trustee and was a Founding Director of Thrive Scholars, which provides mentoring and scholarships to gifted minorities nationally. Jeff is also on the Board of AltaMed Foundation and RAND Health.?

About the Center for Corporation Innovation :?CCI, Inc. runs exclusive ongoing forums where CEOs and senior executives from Global 1000 firms and large healthcare systems can explore strategies and growth. CCI is partnered with major global consulting firms.?