While health systems have always struggled to manage – let alone optimize– their staffing spend, COVID took staffing shortages to an entirely new level. As hospitals struggled to achieve safe staffing levels, contract labor budgets skyrocketed, and with more FTE nurses having to work overtime in highly stressful environments, churn rates increased as well.
Even as clinician demand has begun to stabilize, staffing challenges continue, and macro trends suggest the challenge of finding nurses will only increase. During the pandemic, many clinicians turned to travel nursing to increase their flexibility and pay, or dropped out of the workforce all together. And like their peers in other industries, the nurses that stay in the field are increasingly demanding more control over their schedules.
With all the volatility and uncertainty in the industry, it’s no wonder Becker’s Hospital Review found in a 2021 survey that clinical workforce shortages are the number-one overall concern for hospital CEOs.
According to a Trusted 2021 survey, nearly three-quarters of nurses (71%) say their experience as a nurse would improve if they had more control over their schedule.
Historically, hospitals maintained a small pool of flexible clinicians. But COVID-19 showed that the “old way” of staffing was unsustainable, as clinicians all over the country left healthcare systems in favor of better pay and more flexible options offered by travel nursing agencies.
With over two years of experience tapping into flexible opportunities, many clinicians have no desire to go back to “the old way.” Those that can travel, do, and those that aren’t able to travel due to personal or family obligations, are choosing to leave the bedside.
In order to solve for these challenges, the composition of the nursing workforce employed by the health systems must change.
It’s no longer possible to rely on contract labor and small flex pools. To achieve a flexible nursing workforce ecosystem that is operational, efficient, and consistently meeting staffing needs, healthcare facilities must find better ways to engage their existing workforce, and find ways to become more creative to meet the demands of the modern workforce.
With an internal travel program, hospitals can give nurses the ability to gain schedule flexibility, learn new skills and experiences from working across multiple departments, hospitals and even geographies, while receiving more competitive wages. This leads to a more engaged workforce, higher retention rates and the ability for hospitals to finally reduce their reliance on costly contract labor expenses.
According to Mckinsey Research, the United States may have a gap of between 200,000 to 450,000 nurses available for direct patient care, equating to a 10 to20 percent gap in supply by 2025.
Consider this: throughout the life of a clinician, there are many life factors that may change their ability to commit to a traditional full-time schedule.
These are just some of the many reasons clinicians may need flexible work. Without flexible options, many of these clinicians simply drop out of the workforce, contributing to the growing turnover and churn rates of the workforce. Internal travel programs give clinicians the benefits of working within a trusted healthcare facility, plus the flexibility and benefits offered by external travel agencies.
In exchange for providing this flexibility to staff, facilities also gain flexibility in the way they leverage their internal resources, making it easier to match nurses from a variety of internal pools to the greatest need. Hospitals that adopt flexible staffing programs – like an internal agency program – report the following benefits:
There are many types of programs that offer flexibility to clinicians, but an internal agency program has specific attributes. Programs of this nature are comprised of a team of flexible clinicians (RN’s, CNA’s, etc) or allied health professionals employed by the health system that work long-term contracts (4-26 weeks) or day of staffing assignments spanning multiple specialties, facilities and states.
Most programs offer full-time or part time employment, vacation hours, insurance and other benefits, while providing nurses with the pay and flexibility offered by external agencies – including traveler rates and stipends for floating outside their home region.
Building a self-managed, flexible internal staffing program is achievable, but it does take planning and effort. The following steps are a roadmap for hospitals looking to move toward the development of an internal travel program.
Mercy partnered with Trusted Health to build an operating system for Mercy’s flexible workforce.The combined team first modernized Mercy’s procurement of long term agency labor by removing burdensome legacy processes, driving workflow automation and refocusing the user experience on a critical but often overlooked stakeholder - the clinical hiring manager. Mercy and Trusted have since expanded their partnership to develop intelligent shift management, laying the groundwork to programmatically fill open shifts with the right clinician at the right time, place and cost, regardless of source
After rolling the program out at their Springfield location, the team experienced the following benefits:
That’s really nice— and not common,” she said. “You have a lot of flexibility, and the pay is still really good.”
In addition to improving the hospital’s ability to meet its goals, focusing on flexibility has made life easier for clinicians too. Valerie Frohwein, 37, of Republic, Missouri, near Springfield, learned about Mercy Hospital Springfield’s gig worker program a few months ago, and decided to start picking up shifts. Frohwein had worked as a pediatric nurse at the hospital previously. But for the past year she’s been working asa school nurse at her daughter’s elementary school, so that they could have similar schedules. Working in the pediatric floor at Mercy helps her keep up her skills caring for patients in an inpatient setting, which she may want to do full time again when her daughter is older. And as a gig worker she can take shorter shifts, of eight or even four hours, instead of 12. “That’s really nice — and not common,” she said. “You have a lot of flexibility, and the pay is still really good.”
Flexible staffing programs can introduce complexity. But with a technology platform like Works, it’s easy to create and self-manage programs that provide ultimate operational flexibility at a lower cost. From creating and managing your own internal agency or travel program, Works automates and facilitates the hiring process, moving from requisition and approval through interview and offer, then allows management to track compliance, onboarding, and system provisioning as employees move from site to site, to dramatically simplify the operations of an internal agency or travel program. When it comes to cost-savings, WORKS delivers Hospitals use Works to reduce administrative and contract labor costs, reduce overall churn and talent acquisition costs, and rely on easy automation instead of expensive middlemen to manage talent acquisition and the source to pay process. Built-in analytics help hospitals understand exactly to where they are tracking budget, so it’s easy to make shifts in hiring strategy when needed.