The 'boomerang' strategy: 2 health systems tap former employees to fill empty roles

Hospitals and health systems across the U.S. continue to face exacerbated staffing shortages, forcing them to tap into even more creative and intentional approaches with recruitment and retention. At Little Rock-based University of Arkansas for Medical Sciences — which expects a 30 percent turnover rate this year, a record high — this includes implementing a "boomerang" strategy.

This is "basically working with our leaders and saying, 'Who's left us that we want to try to get back?'" said Danielle Lombard-Sims, PhD, vice chancellor for human resources and chief human resources officer at UAMS, an academic health center with about 11,100 employees. "And we've done outreach where we've called them. We've sent them postcards saying, 'Hey, here's what's going on right now at UAMS. It's an exciting time to be a part of us.'" 

She said the "boomerang" campaign for nursing has been especially successful. UAMS has hired back 30 nurses who left their jobs during the pandemic. 

This initiative comes as organizations in healthcare and other industries eye reemployment of former employees. Data from LinkedIn's Economic Graph team — published March 30 and based on a study of about 32 million LinkedIn members' job histories — showed 4.3 percent of job switches last year in the U.S. across all industries were employees who "boomeranged," or returned to work for a former employer. That compares to less than 2 percent in 2010. LinkedIn found the average time it took employees to return to an old employer was 17.3 months.

Within hospitals and healthcare, 4.3 percent of job switches last year also were "boomerang hires," according to LinkedIn. The average time for hospital and healthcare workers to return to an old employer was 16.5 months.

Here, Ekta Vyas, PhD, chief human resources officer of Los Angeles-based Keck Medicine of USC, and Dr. Lombard-Sims discuss how healthcare organizations can win back former employees and the factors to be aware of when it comes to rehiring.

Winning back workers, and keeping them there 

Health systems have been increasingly focused on attracting new staff and keeping existing staff to address worker shortages. Last year, an estimated 333,942 healthcare providers dropped out of the workforce. 

Dr. Vyas took on her role this year and has played a key role in integrating the workforces of Keck Medicine with Methodist Hospital of Southern California in Arcadia, which joined Keck Medicine as USC Arcadia Hospital in July. 

At the beginning of the pandemic, Keck Medicine, which has about 9,000 employees, saw an increase of about 59 percent in monthly hours worked by contractors, Dr. Vyas said. However, the health system has more recently gradually started to decrease reliance on those workers and increase the number of direct hires.

The result has been a lower vacancy rate. 

"Contingent staffing is always dependent on how good you're doing on direct hiring. The more you bring down your vacancy rate, and you're able to successfully fill positions, the less contingent staff you're going to need," said Dr. Vyas. 

This year, "we increased the average number of external hires per month by 33 percent. That's 70 hires per month, [compared to] 104 hires per month in 2020," she said. 

Keck Medicine has also focused on maintaining the overall turnover rate during the pandemic through staff engagement strategies and receiving feedback from employees during exit interviews. Overall, Dr. Vyas said she is encouraged by how the health system has weathered the effects of recent years when it comes to hiring.   

"We weren't untouched by what's happening in the industry and what the pandemic brought to us," she said. "But we were able to manage the situation because of our better retention rate."

She added that she was particularly reassured by the fact Keck Medicine rehired 224 employees who previously worked at the health system and had left. 

To achieve goals regarding rehiring, Drs. Vyas and Lombard-Sims agreed offers must be comprehensive and attractive. 

Nurses represented by the California Nurses Association have their own contract provisions in play. However, Keck Medicine can offer a non-unionized nurse employee who has been away from the organization for more than a year a sign-on bonus. Per the union contract, the health system can offer a sign-on bonus to a union nurse if they have been away from the organization for more than two years.

Keck Medicine and UAMS also boosted pay to win back former workers. 

Keck Medicine increased the base wage structure for USC Arcadia Hospital nurses, so their pay was on par with other community hospital base rates, according to Dr. Vyas. 

"You have system strategies, but for a growing system like us where you're acquiring a new facility, certainly there's a focused effort to see, 'What are some of the things that now we can look at, from the perspective of parity?'" she said.  

At UAMS, the minimum wage jumped from $14 per hour to $15 per hour to be more competitive. 

"In doing so, we've been able to get back some of our workers who were at $14 an hour and left to go to companies for $15," Dr. Lombard-Sims said. "They've been able to come back because now we're on par with" competitors in healthcare and other industries. 

Don't just solicit feedback — use it

While health systems have used compensation as part of recruitment and retention strategies, they are also focusing on other areas and incentives to address workforce challenges.

Dr. Vyas said Keck Medicine is looking at revisiting its employee value proposition and employer branding approach to continue to ensure feedback from exit interviews and engagement surveys are adequately factored into retention and recruitment. Additionally, the health system is focused on eliciting feedback from those who are rehired for insights into why it made sense for them to rejoin the organization at this time. 

UAMS is focusing on efforts such as parental leave, tuition reimbursement and scholarships. Dr. Lombard-Sims said the organization has implemented a tuition reimbursement program and is working with its foundation and donors to fund a nursing scholarship program. She said UAMS also is considering a broader parental leave program for next fiscal year.

Some turnover can be healthy

No matter the incentives or approaches with bolstering the workforce, Drs. Vyas and Lombard-Sims agreed that rehiring may not always be the answer. 

Dr. Vyas acknowledged that "not everybody who's left the organization should be rehired."

"What we fail to realize, which creates a pitfall for us, is we get into a one-sided conversation on retention and rehire, and we fail to acknowledge that a certain extent of voluntary turnover is healthy for an organization," she said. 

Dr. Lombard-Sims expressed similar sentiments. She said, "some turnover is good turnover," which is why a "boomerang" strategy must be purposeful.

She recommended that health systems considering a "boomerang" strategy to ensure that the strategy is targeted and that "you don't just cast the net and hope that everybody comes back."

"If you understand why people left, then you can go back and say, 'Hey, we heard you. Here are some things we're doing differently,'" Dr. Lombard-Sims said. "Without that understanding, it would be very hard to drive a 'boomerang' strategy."

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