How Duke Health is bolstering its 'talentforce'

Stabilizing and growing Duke University Health System's workforce, or "talentforce," is the primary objective of Craig Albanese, MD, who took over as CEO of the Durham, N.C.-based system in March.

The cost of turnover and contract labor is an ongoing challenge for hospitals and health systems. Many healthcare workers, particularly nurses, continue to bear the brunt of lingering pandemic and Great Resignation effects, "and they have more options —- inside and out of healthcare —- than ever before," Dr. Albanese told Becker's.

Healthcare's formerly-robust pipeline for new talent is shrinking, and it's no surprise that workforce challenges consistently rank as the No. 1 issue keeping healthcare executives up at night. 

To make matters worse, around 800,000 nurses say they intend to leave the workforce by 2027, according to a recent study published by the National Council of State Boards of Nursing and National Forum of State Nursing Workforce Centers. 

North Carolina has a projected shortfall of about 12,500 RNs —- 9 percent of the current RN workforce — by 2033, concentrated in Duke's Raleigh-Durham-Chapel Hill home market, according to Dr. Albanese, who is hellbent on bending this curve. 

"We are tackling this problem head-on and have responded by investing in our team members through salary increases, market adjustments, enhanced workplace safety programs, professional development and academic progression support," Dr. Albanese told Becker's. "And renewing our culture so everyone feels valued, empowered, respected, and that they belong."

These actions are already yielding results; Duke has reduced its turnover in recent months and applications have increased 15 percent year over year, Dr. Albanese said. Part of this is due to local programs promoting careers in healthcare, building a pipeline of future providers, research scientists and staff. 

For example, Duke has partnered with Durham Technical Community College to help train its nursing students and provide a pathway to employment at Duke after graduation. Duke nurses will teach advanced classes and provide mentorship and support for students. Duke believes this will improve retention by granting nurses more opportunities to instruct at the bedside and recruit more nursing students to the health system. 

"As a result we have significantly reduced our reliance on contract labor and have line of sight to the high-reliability internal talentforce that we want," Dr. Albanese said.

While Duke has made significant investments in salaries over the last two years, Dr. Albanese believes that engaging the health system's skilled, dedicated staff is the key to success.

"I have asked everyone at Duke to add 'chief retention officer' to their list of responsibilities — and I know our leaders have heard the call as our turnover has decreased by over 25 percent from the last fiscal year," Dr. Albanese said. "We must all do our part to decrease attrition and bring joy back to work by tending to the varied stresses —- short-staffing, workplace violence and burnout — of our talentforce."

Duke Health has also pinpointed artificial intelligence and process improvement tools as key ways to support its workforce redesign, which Dr. Albanese believes will benefit the health system's staff and bottom line equally. 

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