'We can no longer simply increase wages': What health systems are doing instead for retention

The national healthcare staffing shortage has inflated wages and increased competition for talented nurses and clinical support staff. For a while, hospitals' main retention strategy was increased wages; that's changing as nurses feel more comfortable with their pay and have begun to value other qualities in a workplace.

Kristin Wolkart, RN, executive vice president and system chief nursing officer and operational integrity of Franciscan Missionaries of Our Lady Health System in East Baton Rouge Parish, La., said one of her top priorities is rebuilding team member engagement, focusing on culture and mission.

"In the post pandemic era, focusing on rebuilding a culture of accountability, joy in the workplace, and a focus on mission will continue to help us recruit and train staff, and rebuild our workforce," she said. "We can no longer simply increase wages. We need to articulate what makes us different so that we can become the employer of choice due to the way we treat our team members."

The health system is also offering more flexible staffing options to meet the needs of the modern nursing workforce.

"Gone are the days of everyone working a 12-hour shift," she said. "Our staff want better work-life balance, so we must find alternative staffing schedules to accommodate the needs and desires of the workforce. Introduction of a wide variety of flexible options to meet our patient care needs is a challenge we are embracing at the end of 2023."

Nancy Howell Agee, Roanoke, Va.-based Carilion Clinic's CEO, said the workforce, particularly recruiting and retaining nurses, will stay a top priority through the end of the year. She said the system has sharpened its focus on workforce development, expanded rewards for staff referrals, incentivized former and retired nurses to return, and established new scholarships and research opportunities.

"We'll never have enough people, so the question becomes: 'How do we redesign care using technology to reduce work burden so the incredible nurses and clinicians are doing the things they do best?'" Ms. Howell Agee told Becker's.

Daniel Simon, MD, president of academic and external affairs and chief scientific officer at University Hospitals in Cleveland, is also focused on creative ways to recruit and retain talented team mates.

"The COVID-19 pandemic reminded us why it's so important for health systems to have a talented workforce that thrives and stays engaged with their crucial work for our patients year after year," said Dr. Simon. "The evidence is clear; caregiver engagement is an essential ingredient in high-quality outcomes. To that end, top priorities for University Hospitals for the remainder of 2023 are to continue on our current positive trajectory for caregiver recruitment, retention and engagement."

University Hospitals has improved overall turnover rates for first-year caregivers and RNS in the last year and the year-to-date external job fills are up nearly 10 percent, with RNs up more than 28 percent, Dr. Simon said.

"The success stems from a variety of creative programs to attract caregivers and keep them engaged at UH, from a daily morning newsletter with self care tips, to recognition programs for exemplary work, to our novel program that allows caregivers to be paid for 'volunteer time off' they spend with service organizations in our community," Dr. Simon said.

University Hospitals executive leadership team also conducts extensive rounding visits to hospital and ambulatory locations to stay connected and has six new employee resource groups to promote diversity, equity and inclusion.

Thompson Health in Canandaigua, N.Y., has a recruitment and retention operations committee that meets weekly to establish targets for improving the hiring process and make improvements to retain associates longer. The system also established a healthcare education fund to assist CNAs in becoming LPNs, RNs and then NPs.

"The fund is covering tuition as well as stipends so our associates can work part time while they attend school part time but can still bring home a full time wage and pay their bills," said Michael Stapleton, president and CEO of Thompson Health.

Jeannine Nosko, vice president of patient care and CNO of Aspirus Wausau (Wis.) Hospital, is also focused on staffing models and innovation through the end of the year. Her health system is creating new positions to evolve the workforce.

"We are implementing new roles such as ambulatory aids to bolster our bedside workforce," she said. "We are expanding our patient visual monitoring system to maintain oversight and safety, while creating efficiency and time for our bedside nurses. In addition, our leadership team is planning efficiency studies to improve our workflows for the front line. I believe technology solutions and alternative models are the future of healthcare."


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