Four ways for health systems to get ahead in the race for talent

As the health care staffing crisis surges, health systems are still experiencing significant challenges in filling vital clinical roles. While the much-discussed burnout and financial concerns are still a major driving force in health care staffing, they raise important issues around workforce planning and culture. Members of our People Advisory Services (PAS), Health Care Analytics and Care Delivery Transformation practices recently conducted an interactive virtual roundtable with a group of health care executives to learn more about how they’re navigating these headwinds.

Current conditions in health care staffing

Amid the peak of the Delta variant last fall, a survey of nurses revealed that more than one-third had considered leaving their jobs during the pandemic¹ As such, we began our roundtable with a quick pulse check of our attendees to gauge attrition conditions today. Seventy-one percent of respondents said that turnover continues to be an “extremely significant” problem for their organizations (see Figure 1).

Roselyn Feinsod, a principal in our PAS practice noted that, “this response rate tracks with the fact that 4.4 million Americans quit their jobs in February 2022, signaling that the Great Resignation is likely to continue for the foreseeable future. It also mirrors our recent findings in the EY 2022 Work Reimagined survey  of over 17,000 employees (including over 1,000 health care workers in the US) and 1,500 employers. For example, 43% of respondents are thinking about leaving their jobs in the next year, and 69% of companies have experienced higher turnover.” Ballooning inflation, which is impacting the costs of food, energy and other vital commodities, is no doubt also a factor here. In addition, some health systems are even seeing attrition outside of traditional caregiver roles. As one attendee stated, “Now we’re starting to see the management side of the impact, which is creating a very big shortfall in us meeting all the standards and requirements that are out there.”

With four generations now occupying the workforce, building consistent and engaging employee experiences for all is a major hurdle. As Chris Cooper, RN, a managing director in our Care Delivery Transformation practice, stated, “We have generations that are in very different points of view as far as what really what motivates them; what invigorates them; how they feel about change; how they feel about training and technology.” We also know that younger generations are much more likely to “jump ship” due to less-than-satisfactory working conditions in health care.² What’s more, 1 million nurses are expected to retire in the next 10 to 15 years,³ and this looming nursing shortage is exacerbated by deficits in available nursing instructors across the country.⁴

Pain points

Asked about the key drivers they’re seeing on the ground, roundtable participants noted several now-familiar pain points, including compensation (see Figure 2). Responses such as “lack of advancement,” “childcare” and “dislike manager,” however, echo EY research and analysis indicating that nonmonetary factors are also driving current conditions. These factors include the onboarding experience, which sets the tone for the entire employee journey within the organization, as well as communication and collaboration capabilities, caregiver impact on care delivery models and opportunities for career growth and continuing education. Feinsod also noted that these responses are consistent with our findings in the EY 2022 Work Reimagined study, where employee participants stated that career progression is the number two reason for leaving their jobs. One executive described a stark landscape around their company’s employee retention efforts: “There’s only so many levers we’ve been able to pull. At what point does the whole system turn upside down? We’re looking at 15% to 18% labor increases.”

Culture insights

For many of the health care leaders we speak with every day, measuring and truly comprehending diverse employee sentiments on workplace culture issues can be daunting. For example, when asked about what culture and analytics focus areas they’re looking to address, many roundtable participants cited an overall need to derive better insights from the data they’re gathering and the culture-change initiatives they’ve introduced. Collecting and strategically analyzing information on even basic metrics, such as promotions and transfers, vacation and sick days used, and percentage of acuity and patient load, can help health system executives begin to drive better retention, culture and productivity among their ranks.

Many health systems are also going a step further by developing an integrated, end-to-end experience management ecosystem that gives leadership visibility into every phase of the employee lifecycle. Leading approaches include gathering operational interaction data around performance, taking explicit measures through tools such as surveys and feedback, tracking implicit metrics through social media and other channels, and performing deep-dive analyses and testing to uncover correlations between all of these data points.

Gail Babes, a managing director in our Health Care Analytics practice, described the complexities at play in developing a better understanding of the health care workforce: “How do we combine this information and actually start to engage in thinking about how are we listening to all the personas? How can we collect that information together, especially in the era of value-based care, when actually we’re going to have to start threading outcomes to employees and how that impacts their financials?”

These efforts drive growth and expand the business, boost employee productivity and good will, stem attrition, and foster a deeper sense of belonging among employees. Solving staffing challenges often simply begins with listening more intently to employees’ grievances, while also managing key operational insights with leading technology. Defining the organization’s culture needs in terms of key behaviors is often the best place to start. Feinsod summed up these culture concerns with a simple question:

Roundtable participants also discussed some of the underlying causes around the general sense of burnout that has fueled so much of the workplace exodus we’re seeing. “Sometimes, part of the burnout is that we are asking people to do things outside of what they typically had done in their job role or it’s not really the best use of their time,” Babes noted. This is where more clearly delineated career frameworks and job families developed through the use of analytics can make a tremendous difference.

Total rewards

While compensation and benefits certainly aren’t the only factors at play during the health care staffing crisis, health systems that overhaul their incentives even minimally will be best positioned to retain satisfied staff. For example, one roundtable executive stated that, “the one that has probably had the biggest short-term impact is more flexible scheduling — a big driver for folks.” Amid tough conversations around revenue, however, compensation and other fiscal adjustments are often easier said than done.

However, instituting the above-referenced operational efficiencies is one of the best ways to leverage compensation and other benefits without breaking the proverbial bank. “Are there more things that we can focus on that are maybe time-intensive but not fund-intensive related to culture enhancement? That might be also kind of a bigger, more feasible journey,” Cooper continued. Still, even these measures aren’t easily implemented in the current environment. “We’re constantly at the table reassessing,” said one participant. “Where can we take these finite dollars and get the best momentum? It’s not easy,” they explained.

As they explore the right mix of benefits and rewards, health care leaders should consider that incentives such as sign-on bonuses, base pay increases, schedule flexibility, additional paid time off, and childcare and meal reimbursements aren’t a one-size-fits-all proposition. Providing simple package choices that offer one or a combination of these features can go a long way toward stemming attrition. However, when we polled our roundtable participants on what changes they’ve made to address staffing concerns, two of the top three responses involved financial incentives (see Figure 3).

Comprehensive strategies

Through a holistic approach to tackling the staffing crisis, health system leaders can blunt the Great Resignation and build more enterprise value in the process. Below are four key strategies to achieve these results: