Seventeen health systems across the country — including Bon Secours Mercy Health, CHRISTUS Health, CommonSpirit Health and Providence — signed an "Impact Workforce Commitment" last year to build healthy and equitable local economies through their hiring and workforce development programs and policies.1 The commitment was designed in partnership with a leadership group of Healthcare Anchor Network (HAN) member health systems and the National Fund for Workforce Solutions. The commitment includes goals to address economic and racial inequities in the communities they serve by aligning hiring and workforce power with clinical and community efforts.
A core focus of the commitment is to reach at least 10% of new hires annually by 2027 as "impact hires" — or individuals from economically disadvantaged areas who are hired into quality jobs that require less than a bachelor's degree and are connected to career pathways. Traditional hiring practices are often designed to whittle down the applicant pool, hindering the consideration of skilled applicants with untapped talent who may struggle to stand out due to a lack of access to education and training, low income or other socioeconomic challenges. By partnering with community-based organizations, workforce intermediaries and education providers to create intentional hiring pathways to quality jobs, health systems can expand employment opportunities for residents who face hiring barriers while improving the efficiency of their recruiting and hiring processes.
REMOVING HIRING AND WORKFORCE BARRIERS
Community-based organizations and workforce intermediaries can help prepare candidates who face barriers to employment through training, skills development, interview preparation and wraparound support, such as child care and transportation assistance. These organizations often play a key role in connecting health systems with specific populations in the community they may not have relationships with, including those who have been released from the criminal justice system.
Other strategies to increase impact hires include training programs that prepare individuals to fill specific positions with consistent openings, paid internships — including "earn-and-learn" programs that offer opportunities for incumbent employees to receive paid, job-specific training to move into more advanced positions — and apprenticeships. These programs are complemented by internal policy changes that remove hiring barriers. In particular, signatories of the Impact Workforce Commitment strive to advance skills-based hiring and revise job descriptions to remove inflated and unnecessary education and experience qualifications.
INVESTING IN EMPLOYEES TO TRANSFORM COMMUNITIES
As part of its Impact Workforce Commitment, Providence views this initiative as bolstering its ongoing efforts to build a workforce that reflects its communities and advance equity for its caregivers and their families. Providence achieves this by building targeted career pipeline programs; developing apprenticeships (including for medical assistants and pharmacy technicians); and partnering with historically Black colleges and universities (HBCUs) and institutions that serve Hispanics and other minorities to ensure students of color are connected to talent pipelines.
Nearly four years after the outbreak of the COVID-19 pandemic, health systems across the country continue to struggle with critical workforce shortages in nursing and allied health careers. Many stem from structural inefficiencies that existed before COVID, like educational programs' inability to meet demand and lack of access to affordable education. For example, according to a report by the American Association of Colleges of Nursing, nursing schools turned away nearly 92,000 qualified applicants from baccalaureate and graduate programs in 2021 due to insufficient numbers of faculty, resources and funding.2 These problems are compounded by high levels of health care employee burnout, a lack of awareness of health care career opportunities and demographic shifts that strain talent pools, including a large number of nurses approaching retirement. The need for nurses and allied health care workers is projected to increase over the coming decades to meet an aging population's needs.3
By preparing and recruiting local residents to fill high-need roles, health systems can increase their talent pools and create economic opportunities for community members. In addition, addressing barriers to retention — such as child care, elder care and transportation — through benefits and financial support services and helping them to navigate these personal challenges can lead to increased retention and dependability. Career coaches can also work with newly hired employees to ensure they receive the support they need to succeed in their role. For example, if an individual has a disability and needs special accommodations, coaches help them navigate the organization to make sure that their needs are met.
A comprehensive impact workforce strategy also includes programs and policies that address bias in recruitment and advancement, as well as benefits that help lower-wage employees overcome financial instability.
Healthcare Anchor Network member Trinity Health Michigan developed an evidence-based hiring process to reduce unconscious bias in recruitment and hiring. This approach evaluates candidates holistically, focusing on the skills relevant to each job and reducing the potential for unconscious bias to impact hiring decisions. This has led to improvements in the quality of hires, a reduced first-year turnover rate and increased workforce diversity. In 2023, the health system was recognized as a CareerSTAT Frontline Healthcare Worker Champion by the National Fund for Workforce Solutions.
Another Healthcare Anchor Network member, Louisiana-based Franciscan Missionaries of Our Lady Health System, provides financial support for its workforce through a microloan investment fund. Launched in 2018 through an effort with Catholic Charities of the Diocese of Baton Rouge, the fund offers low-interest loans that employees can apply for to avoid predatory payday lending. These loans are part of a continuum of services to help lower-wage employees overcome financial instability — from advance paycheck services to financial counseling and support for debt recovery — provided by a third-party partner to support community development.
Training and investment in employees' career advancement can also improve employee morale. According to a 2023 study on allied health workforce retention commissioned by Ultimate Medical Academy, 60% of health care support workers surveyed said they expect to leave their job within five years. Among current employees, 77% said they "want a job where I can see a clear path for advancement."4 Moreover, managers who participate in job training programs have reported increased pride in working at the institution. As part of the Impact Workforce Commitment, health systems are investing in workforce development and career pathway programs to ensure that employees in lower-wage health care occupations have opportunities to progress into higher-skill, higher-wage roles. Bon Secours Mercy Health has invested in employee benefit and internal mobility programs as part of its mission to improve the health and well-being of its communities. The health system offers full tuition assistance and tuition reimbursement for specific clinical roles for employees who want to advance their careers while working there. This includes an annual benefit of up to $10,000 for in-network nursing and graduate degrees.
Bon Secours Mercy Health also offers employees financial assistance funds — or hardship funds — which can be used to pay for unexpected expenses such as car repair costs. In addition, employees have the option to access their pay immediately after earning it instead of having to wait until the end of their pay period.
By participating in the Impact Workforce Commitment, the health systems involved have agreed to take systemwide measures to ensure fair and equitable leadership opportunities and by continuing to work toward all staff being more reflective of communities. CHRISTUS Health pledged to the commitment goals in recognition that individual health and wellness are intrinsically tied to stable employment and income. By focusing on increasing opportunities for historically marginalized populations, CHRISTUS Health will expand recruitment for individuals from economically disadvantaged areas to fill community health worker roles through a partnership with AmeriCorps VISTA.
Another health system that has pledged to the commitment, CommonSpirit Health, will expand its efforts across its 23-state footprint by educating supervisors about implicit bias and inclusive development and promotion strategies, focusing on competencies and skills needed to be successful in a given role. A partnership with Charles R. Drew University of Medicine and Science, an HBCU in Los Angeles, will help to diversify
CommonSpirit Health's nursing workforce by adding faculty, resources and a mentorship program to the school's nursing program, which will make nursing careers more accessible to its students.5
RAISING THE BAR TO ADDRESS INEQUITIES
The Impact Workforce Commitment, along with the additional Healthcare Anchor Network leadership commitments,6 provides a map for other health systems seeking to meaningfully address the social and economic drivers of health. Developing systemwide career pathways, advancing employee financial stability and investing in workforce development initiatives can help better ensure in the long-term a workforce that is more productive and invested in institutional success.
LAUREN WORTH is project manager of workforce and community engagement initiatives for Healthcare Anchor Network.
NOTES
- "Impact Workforce Commitment," Healthcare Anchor Network, May 10, 2023, https://healthcareanchor.network/2023/05/impact-workforce-commitment-iwc/.
- "Nursing Faculty Shortage Fact Sheet," American Association of Colleges of Nursing, October 2022, https://www.aacnnursing.org/news-data/fact-sheets/nursing-faculty-shortage.
- "Nursing Faculty Shortage Fact Sheet."
- "Sounding the Alarm on Healthcare Staffing: New Study Reveals 60 Percent of All Healthcare Support Workers Expect to Leave Their Job in the Next Five Years," PR Newswire, June 21, 2023, https://www.prnewswire.com/news-releases/sounding-the-alarm-on-healthcare-staffing-new-study-reveals-60-percent-of-all-healthcare-support-workers-expect-to-leave-their-job-in-the-next-five-years-301857064.html.
- "CommonSpirit Health and Charles R. Drew University of Medicine and Science Partner to Diversify and Grow Nursing Workforce," CommonSpirit Health, May 9, 2022, https://www.commonspirit.org/news-and-perspectives/news/charles-drew-university-partnership.
- "HAN Leadership Commitments," Healthcare Anchor Network, https://healthcareanchor.network/han-leadership-commitments/.