Health systems focused on long-term sustainability and growth are using workforce development initiatives and analytic tools to ensure new and current positions are filled strategically, based on organizational need and data-driven insight.
At Lee Health, a Fort Myers, Fla.-based health system with more than 17,000 employees, this involves two levels of teams that help review position requests using extensive analytics tools.
Leaders of hospitals, clinics or service lines look at job requests first, Lee Health Chief People Officer Mike Wukitsch, PhD, told Becker’s. If the entity team approves a request based on analytics, then the request goes to the system-level labor management council. The council, chartered in 2023, includes more than a dozen system operational and support leaders, with Mr. Wukitsch and Chief Nursing Officer Jennifer Higgins, DNP, RN, serving as executive sponsors.
“While they do review entity-level requests, their primary focus is system requests — especially leadership positions, since operations ultimately pay for those,” Mr. Wukitsch said, referring to the council. “They review labor results, including year-to-date salary and wages, full-time equivalents, adjusted patient days, FTEs per adjusted occupied bed, average hourly rate, and variances. This determines whether the analytics and financials support staffing the position.”
Recently, the council reviewed a sterile-product compliance pharmacist position.
Mr. Wukitsch said the council acknowledged the outpatient role was not initially in the budget, but still approved it because of its importance.
“We needed support for our cancer center, and from a quality standpoint, we had to prioritize sterile-product compliance,” he added.
In another example, an environmental services team requested two housekeepers, but the request was denied due to the productivity at the entity submitting the request, Mr. Wukitsch said.
He also noted that some requests come back to the council with a revised business case, while others may be deferred to the next year’s budget cycle.
For instance, the child life development centers submitted a request for a behavioral specialist. The request was initially denied, but later approved after the council reviewed more rigorous data.
“This process goes beyond just metrics,” he explained. “It gives operating and system function leaders exposure to what’s happening across the organization. It builds awareness around requests and strategic considerations — whether it’s compliance, a shift in strategy or a budgeting oversight. Sometimes a person leaves the organization and their budget is reallocated to another need.
“This visibility is incredibly valuable. When my team or I request a position, we have to justify it, because it’s ultimately paid for through operational revenue. If the request is supported, that leader knows exactly what they’re getting for their investment.”
This transparency is among the largest benefits of the council, according to Mr. Wukitsch, to ensure the system is not overstaffing leadership roles and can afford new positions through the budget or contingency funds.
“There’s rigor involved — productivity metrics, overtime, premium pay and productive hour variance,” he said. “They look at fixed versus variable departments to determine productivity and justify if a position is truly needed.
“It’s a very open, candid process. As a sponsor, I really appreciate the dialogue. It’s a well-functioning system.”
Lee Health is also using this approach in a time when margins are tight at many health systems. With labor costs representing approximately 50% of Lee Health’s expenses, the organization aims to ensure positions are needed, openly discussed and backed with a strong rationale.
This doesn’t mean the health system is reducing hiring, Mr. Wukitsch added, “but we’re trying to be smarter, more disciplined and rigorous about the roles we add — especially non-revenue-producing roles. We want to see a return on our labor investments, whether that’s through cost avoidance, compliance or future growth.”
Still, he noted that there’s no perfect algorithm to determine the roles that should be replaced or added. As he sees it, the process involves art as well as science.
“The data helps guide us, but it’s also about thinking critically about when and how to add fixed costs,” he said. “That’s a fascinating part of this process.”
Mr. Wukitsch said building trust is also crucial.
“One challenge is that these committees can become political — ‘you scratch my back, I’ll scratch yours.’ People might hesitate to challenge each other,” he said.
“We’ve broken that. It started with role modeling early on. We set expectations and encouraged real dialogue. Leaders are stewards of the system — not just their own entity — [and] that culture has taken hold. It’s a safe space now, with honest conversation and no retaliation. That’s hard to build but very valuable.”
