Ryan Smith, MSN, MHA, RN, did not form his workforce philosophy in an executive office. He formed it at the bedside.
Before becoming president and COO of Tallahassee (Fla.) Memorial Hospital, Mr. Smith worked as a nurse, an experience that continues to shape how he thinks about supporting healthcare workers today.
As many health systems continue to prioritize recruitment and retention following pandemic-era staffing shortages, Mr. Smith said Tallahassee Memorial is taking a different approach. Instead, the system’s top priority this year is engagement.
“It’s a mindset change,” Mr. Smith said. “If we focus on engagement, in doing so, retention will improve and turnover will decline. I think that’s a more healthy approach.”
The strategy reflects a broader shift in how healthcare leaders are thinking about workforce stability. Rather than treating recruitment and retention as the primary solution to staffing challenges, Tallahassee Memorial leaders see engagement as the foundation that drives both.
Research supports that approach. Recent survey data suggest more engaged healthcare employees are less likely to leave their roles, while studies have also linked higher nurse engagement and involvement in decision-making to lower burnout.
At Tallahassee Memorial, the engagement push builds on several years of operational and quality improvements. The hospital has made significant progress improving its CMS star ratings and strengthening performance across key quality and experience metrics.
Now, Mr. Smith said leaders see an opportunity to build on that progress by focusing more intentionally on workforce culture. To strengthen workforce engagement, the health system is focusing on several areas, including expanding wellness resources, strengthening professional development opportunities and streamlining workflows to reduce friction in clinicians’ daily work.
Professional development is particularly important as younger generations of clinicians enter the workforce with different expectations around career advancement. Mr. Smith said many clinicians completing training today are more interested in advancing into leadership or advanced practice roles earlier in their careers than in the past. Health systems that recognize those goals and create opportunities for growth are more likely to keep clinicians engaged and improve long-term retention, he said.
As Tallahassee Memorial stabilizes its nursing workforce, leaders say the next priority is ensuring those clinicians feel supported, engaged and able to build long-term careers within the organization.
When Mr. Smith served as the hospital’s chief clinical officer in 2019, leaders closely analyzed local workforce data, including vacancy rates, turnover and the number of graduates entering the region’s healthcare workforce. The analysis showed that Tallahassee is not a major relocation destination for healthcare workers. To ensure the region had enough clinicians to meet demand, leaders realized the organization would need to invest in developing its own workforce.
At the time, Tallahassee Memorial began working closely with Tallahassee State College and Florida State University to expand training capacity.
“They both doubled their enrollment, and we’re now starting to see the fruit of that labor,” Mr. Smith said. “The amount of graduates coming through can fill the need of TMH as well as the community.”
While nursing pipelines have strengthened significantly in recent years, shortages persist in several allied health roles. Radiology, pharmacy, ultrasound and physical therapy are among the areas in which demand is beginning to outpace the number of graduates entering the workforce in the region.
Tallahassee Memorial is now working with academic partners to replicate its nursing pipeline strategy in those fields by expanding enrollment and aligning training programs with projected community demand.
For Mr. Smith, those workforce investments are closely tied to the system’s broader focus on engagement and creating an environment where clinicians feel supported and able to grow.
If organizations get that piece right, he believes recruitment and retention will take care of themselves.
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