Health care’s workforce of the future

New challenges. New trends. New solutions.

Two truths and a lie
Posted by David (Chip) Newton on June 20, 2017.

In many ways, health care providers are like any other service organization, subject to the same global economic, demographic, technology, and talent trends and challenges. But providers also face specific workforce challenges and, of course, the flipside: opportunities. Let’s look at some of the ways providers can improve workforce management to better meet their mandate in an increasingly complex operating environment.

First, the challenges
A primary challenge for health care providers is consistency in care delivery, which is in part a quality issue and in part a by-product of the nature of the work. Some of the work is quite predictable; some (such as the ED) is inherently unstable, making it challenging to provide more standardized care, particularly in areas that have more fluidity. The landscape is changing for health care providers, and their workforce will likely change with it.

Second is an employee generational and expectations challenge. There’s a new “social contract” between employers and employees, and it affects how health care is provided to patients. Employees overall are seeking more flexibility in how they work and with whom they work. Health care employs workers from every generation, and meeting the needs and expectations of these various groups can call for different social contracts and expectations for employees to be engaged and satisfied and the provider to be seen as an employer of choice.

For example, Millennial employees favor transparency in knowing their schedule and using social media or a mobile device to not only see their schedule but also affect it. They also tend to be more team-oriented than even Gen X or Baby Boomers. Gen Z employees, who have always had the Internet, want to have more telecommuting and video conference options, because “being there for the meeting” can mean being virtually present. All of this plays a role in scheduling and assignments within a workforce management system.

Many providers are finding it more necessary to offer greater flexibility, but are having to start from scratch to create the necessary policies and support systems.

A third major challenge is acuity and census integration to the workforce management system—determining and scheduling the right skilled clinical staff to match the level and type of patient need. This can be quite fluid in a traditional acute care facility and demands the ability to be nimble in scheduling and staffing, both in advance and on the day of need.

This ongoing challenge comes with substantial implications for quality of care, workforce satisfaction, labor costs, marketplace reputation, and employer brand. While many providers have some type of technology solution to assist in time capture, scheduling, or both, it is often outdated, as are the policies and processes surrounding it. Outdated pay practices and shift premiums, for example, can be a significant source of labor overspending. We routinely see unintended payroll overspend of 1 to 1.5 percent of total annualized payroll that could be recouped with improved scheduling and pay practices.

Now, the opportunities
Many of the 2017 Human Capital Trends, briefly outlined below, present opportunities for health care providers to address these challenges by improving workforce management.

  • The organization of the future: Arriving now—As digital transforms the business landscape, the successful organizations of the future will likely be those that can move faster, adapt more quickly, learn more rapidly, and embrace dynamic career demands. For health care providers, shifting their organization structure to incorporate digital solutions (mobile, telehealth) can help them adapt to patient needs and their workforce’s day-to-day and longer-term career needs.
  • Careers and learning; Real time, all the time—The half-life of skills is rapidly falling, placing huge demands on learning in the digital age. The good news is that an explosion of high-quality content and digital delivery models offers employees ready access to continuous learning—an essential element for a provider’s workforce to deliver a high and consistent standard of care and stay current as health care protocols evolve.
  • Talent acquisition: Enter the cognitive recruiter—Recruiting is becoming a digital experience as candidates come to expect convenience and mobile contact. Savvy recruiters now have access to new technologies to forge connections with candidates and strengthen the employment brand. A large provider I work with recognized its employment brand was uneven across markets. One of the major differentiators in brand perception among the talent pool was how mobile the provider’s clinical workforce was in some markets versus others,. Deploying mobile technology, training the nursing population, and ensuring accountable use helped the provider improve its overall brand in the market.
  • The employee experience: Culture, engagement, and beyond—Rather than focusing narrowly on engagement and culture, many leading organizations aim to improve the employee experience as a whole, supported by a multitude of pulse feedback tools, wellness and fitness apps, and employee self-service technologies. Some workforce management systems build in incentive-based rewards for those that improve particular metrics within the pay cycle or within the quarter. These rewards include things like movie tickets, a convenient parking spot for a month, and “culture cash” or point systems that accumulate to fund employee purchases of premium items. Performance tracked via the workforce management system can be tied directly to an employee’s performance rating (as noted in the next trend).
  • Performance management: Play a winning hand—Across industries and geographies, many companies are redesigning performance management from top to bottom, from goalsetting and evaluation to incentives and rewards—and seeing the business benefits. In health care, there is great opportunity to redesign performance management to focus on business outcomes/metrics. Workforce metrics are a key component of many business outcomes, including budget-neutral labor costs, productivity percentages, schedule optimization percentages, employee engagement scores, and patient satisfaction scores, which can all be collected in the workforce analytics capabilities.
  • Leadership disrupted: Pushing the boundaries—Today, many organizations need a completely different kind of leader: a “digital leader” who can build teams, keep people connected and engaged, and drive a culture of innovation, risk tolerance, and continuous improvement. Providers can use workforce management systems connected to ERP, performance management, and people analytics to help identify and even predict which employees will be the most effective leaders.
  • Digital HR: Platforms, people, and work—HR is being pushed to take on a larger role in helping organizations to “be digital,” not just “do digital.” New workforce management technologies are available and quite powerful, giving providers the opportunity to support mobility through a phone, device, or tablet and incorporate text/SMS capabilities.
  • People analytics: Recalculating the route—Analytics is no longer about finding interesting information and flagging it for managers. Now, data are being used to understand every part of a business operation, and analytical tools are being embedded into day-to-day decision making. For providers, the opportunities are huge. Unlike other system data, workforce management data are detailed in such a way that, when combined with other business data (clinical, diagnostic, performance, behavioral, ERP), can provide very compelling and sophisticated context for managers. For example, analytics can identify how turnover affects various departments in terms of overtime, performance changes, and open positions. Or, it can easily show trends in the data that reveal negative behaviors (such as pay premium “gaming”) employees have had, do have, or are likely to have in the future.
  • The future of work: The augmented workforce—Paradigm-shifting forces such as cognitive technologies and the open talent economy are reshaping the future workforce, driving many organizations to reconsider how they design jobs, organize work, and plan for future growth. Workforce management systems can be designed to include contingent, freelance, and gig economy talent to save providers time and money, increase quality, and improve operational flexibility and scalability.

Stepping up
It’s common in my work with health care providers of all types (acute, non-acute, academic medical, integrated delivery networks, nursing homes) to see significant lags in the use of workforce management tools and technology compared to other industries. Providers have a real opportunity to improve workforce management processes, policies, and technology to make a measurable difference in quality of care, labor costs, institutional brand, and employee and patient satisfaction.


David (Chip) Newton is a senior manager in the Human Capital Workforce Strategy and Insights practice of Deloitte Consulting LLP. He works primarily with health care providers on workforce management strategic planning and technology enablement.

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