Health system human resources leaders are retooling paid time off policies in pursuit of stronger retention and engagement. Yet, for some, the most important changes have less to do with how many hours employees earn than with whether they can actually use them.
The conversation has been building. HR leaders at organizations including Oklahoma City-based Integris Health and Louisville, Ky.-based UofL Health told Becker’s in January they were rethinking paid time off as a proactive burnout tool — moving away from accrual models that can encourage stockpiling toward structures designed to make utilization easier and more expected.
At Children’s Hospital Colorado in Aurora, Chief Human Resources Officer Duane McFadden said the hours employees have accumulated are rarely the central barrier.
“At Children’s Hospital Colorado, the biggest barrier isn’t whether team members have enough PTO. It’s creating an environment where they can actually use it,” Mr. McFadden told Becker’s. “In healthcare, staffing challenges combined with a deep sense of responsibility to patients and colleagues can make taking time away difficult, even when that time has been earned.”
Addressing that requires structural investment, he said, not encouragement alone.
“Organizations have to create the operational capacity that makes taking time off possible,” he said. “For us, that means continuing to strengthen staffing and coverage, exploring more flexible scheduling approaches, and encouraging earlier conversations between managers and team members before PTO balances become difficult to manage.”
There is also, Mr. McFadden said, a cultural message that needs to be rewritten.
“In healthcare, dedication can sometimes become synonymous with always being available,” he said. “We want to reinforce a different message: Taking time to recharge isn’t stepping away from our mission. It’s part of sustaining the people who make our mission possible.”
Other health systems have focused on the structural side of that equation: giving employees more control over how their earned time is built and accessed. At Kalamazoo, Mich.-based Bronson Healthcare, those changes have been concrete and wide-ranging. Senior Vice President of Human Resources and Chief People Officer Cheryl Johnson told Becker’s the system has moved to give employees more direct control over the structure of their earned time, with a five-generation workforce in mind.
“We have combined vacation and holiday time into a single PTO bank and a PTO sell option, giving employees greater discretion over how they use their earned time,” Ms. Johnson said. “We have also benchmarked a holiday exchange, where employees may work with their leaders to exchange a fixed holiday for another meaningful day or tradition.”
At major life moments, Bronson has also worked to reduce friction. Ms. Johnson said the system extended paid parental leave to four weeks and provides adoption leave separate from earned PTO, acknowledging “the unique needs of employees who are growing their families.”
Underlying those changes is a foundational belief about what retention actually requires.
“Our philosophy is that workforce retention is strengthened when employees feel valued as individuals, not simply as members of the workforce,” she said, “and we see these updates as part of a broader effort to support our employee well-being and retention.”
At Cleveland Clinic, leadership has expanded the ways caregivers can convert accumulated time into tangible value. Executive Vice President, Chief Caregiver Officer and Chief Administrative Officer Kelly Hancock, DNP, said enhancements to two existing programs gave employees more choices for how to use what they have already earned.
“This year, we enhanced our ‘PTO cash in’ and ‘PTO trade for benefits’ programs to give eligible caregivers greater flexibility and choice in how they use their earned time off,” Dr. Hancock said. “These changes include more opportunities to convert PTO to cash and the ability to manage PTO trade for benefits throughout the year, rather than all at once.”
The focus on making PTO more usable echoes what Becker’s reported in January, when HR leaders at organizations such as Oklahoma City-based Integris Health and Louisville, Ky.-based UofL Health described rethinking paid time off as a proactive burnout tool — moving away from accrual models that can encourage stockpiling toward structures designed to make utilization easier and more expected.
West Burlington, Iowa-based Great River Health System CHRO Michael Yost made a similar argument about the limits of expanding accrual alone. Healthcare employers sometimes assume that simply adding more PTO will improve retention, he told Becker’s.
“In our experience, a key issue is whether employees feel they can actually use their time off without creating additional stress for themselves or their coworkers,” Mr. Yost said. “PTO becomes more valuable when leaders actively support time away, staffing models provide reasonable coverage, and employees feel comfortable disconnecting.”
For Mr. Yost, what surrounds the benefit matters as much as the benefit itself.
“The culture around PTO often matters as much as the number of hours employees earn,” he said.
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