Podcasts

KRISTIN

Welcome to Healthcare Workforce Unplugged, a Medical Solutions podcast. I’m your host, Kristin Dahl.

If you’ve ever felt like you’re carrying the full weight of workforce challenges on your own, today’s conversation is for you. For many healthcare leaders, workforce management doesn’t feel strategic. It feels constant: constant coordination, constant problem-solving, constant pressure. And too often, the partners meant to help are sitting on the sidelines instead of carrying that weight with you.

In this episode, we’re talking about what healthcare leaders need from a workforce partner and why the difference between a vendor and a true partner changes everything. I’m joined today by three incredible leaders who bring different perspectives to this conversation.

First, Karin Selfors, Chief Client Officer at Medical Solutions, partners closely with health systems across the country to design workforce strategies that go well beyond traditional staffing.

Next, Natalie Red Eagle, Vice President of Clinical and Quality Services at Medical Solutions, brings a clinical lens, connecting workforce strategy directly to quality outcomes and patient care.

And Dr. Charles Dolan, Vice President of Clinical Operations at TidalHealth, offers the provider-side perspective. With decades of healthcare leadership experience and more than 30 years as a paramedic, he grounds this conversation in real-world operational and frontline insight.

Thank you all for being here today.

KARIN

Thank you.

NATALIE

Thanks for having us.

1. DOLAN

Thank you.

KRISTIN

Between the three of you, there’s a lot of experience in how workforce decisions actually play out, both operationally and on the ground, so I’m really looking forward to this conversation.

Let’s start at a high level. We hear a lot about moving from a vendor relationship to a true partnership, but that shift means different things depending on your role.

Dr. Dolan, from your perspective, what does a true workforce partner look like to you today? And how is that different from what you may have experienced in the past?

1. DOLAN

Yeah, that’s a great question. I think one of the challenges coming out of COVID was the workforce was just a mess. And so, for me, trying to run a health system, we need to have a partner, not someone that’s just a vendor, kind of to what you were alluding to.

I think the challenge for me was we had to find the right person, the right team, and the right organization. I think of workforce vendors in the past as transactional. We would send them a requisition, they would find someone, and we would fill the gap.

What we need today, and what my teams need today, is a partner. Somebody that’s fully integrated into our system, where you can’t tell that they work for an outside entity. To me, that’s what’s really important. It’s seamless.

I don’t want nursing leaders to be stressed trying to get their requisitions, interviews completed, clinical reviews, and all those things that have to happen in order to bring in temporary labor. So for me, and for them, it needs to be fully integrated, operational, and easy.

KRISTIN

Yeah, absolutely. That’s such a great perspective.

Karin, I’d love to get your take on this because you’ve worked with many of the healthcare leaders in our client base. From what you’ve seen, how have expectations from healthcare leaders changed when it comes to workforce partners?

KARIN

Dr. Dolan just said a lot of really great things. I’m smiling because I am definitely experiencing many of the things he was mentioning across the health systems that we work with.

First of all, what we’re observing is our clients prefer to work with fewer partners rather than many. I would say there’s a lot of consolidation ongoing. That’s one trend we’re definitely seeing.

And I think that ties really nicely into what you said, Dr. Dolan, moving from a transactional vendor to a strategic partner. If you have fewer partners, you want to have more strategic partners.

On top of that, you want those partners to truly understand your organization, your pain points, and your issues. And you want them to help you solve those issues. So I truly see that evolution from a transactional vendor to a consultative relationship.

KRISTIN

Yeah, that makes perfect sense.

Natalie, I feel like you’re the perfect mix here. You’ve been on the floor experiencing some of the same things that Dr. Dolan mentioned, and you’ve also worked with many healthcare leaders in your current role.

From your time with clinical teams and as a clinician yourself, can you explain what you’ve heard in terms of frustrations with traditional staffing agencies and maybe talk a little bit about the disconnect between what hospitals need and what they’re actually getting from some staffing partners?

NATALIE

Absolutely. And I second everything Dr. Dolan and Karin have said so far.

I think what’s interesting from my lens is I’ve worked both sides of this. I was in acute care nursing for a decade, and I still actually moonlight there. And then I’m in healthcare staffing leadership as well. Seeing both sides has been so fascinating.

From a broad industry perspective, we are seeing the need to shift into a true partnership and away from transactional staffing. And that became the trend during the pandemic, as Dr. Dolan said. People were just trying to fill quick needs. A lot of times, speed took precedence over quality, and we felt that on the floor. Your nursing personnel and your clinicians totally felt that.

What we’re seeing now is that the most successful staffing companies are the ones who were invested all along, who understand their facility partners’ KPIs, the financial realities that they live in, that roller coaster, the clinical goals they set for themselves, regulatory standards, and are committed to supporting them through the entirety of that, not just filling shifts.

KRISTIN

Yeah, absolutely. I’m sure that a lot of this has resonated with our listeners.

One of the other themes that we hear quite a bit about is that true partners don’t sit on the sidelines. Dr. Dolan mentioned that a little bit. They embed themselves in their organizations.

Karin, would you mind talking a little bit about what that actually looks like to be embedded in a health system’s operations?

KARIN

Yeah. It’s easier said than done, I’m going to say, because you do need a willing client or a willing partner that is openly willing to share a little bit more of what’s going on under the covers, or under the hood. And for that to happen, you have to build a trusting relationship as a foundation first. That doesn’t happen from day one.

When we achieve that, when we achieve being a trusting partner and we can be more honest and open with each other and share information, then we essentially become an extension of the teams of the healthcare systems or clients that we have. And that’s the best of all, right? If we can be an extension and work alongside clinical, HR, or operational leaders in helping them achieve their goals.

For that to happen, we do need to understand their operations. We need to understand the environment that they live in. So it all boils down to being present and engaged and being that consultative partner, and really going from being reactive and transactional to being strategic.

But like I said, I think the bottom line is to be embedded, you have to earn that trust. You have to be open and honest with each other and exchange information for that to happen.

KRISTIN

Dr. Dolan, back to you. From your standpoint, why does that level of integration matter?

1. DOLAN

For us as a health system, it matters because we are very busy. All managers, leaders, vice presidents, no matter who you are, clinical staff, everyone’s busy.

We’ve had something in our area that we’re not seeing everywhere around the country. Our volumes have never decreased. It’s only gotten worse. So we’re busy.

I think what our team is looking for and what we need from our integrated partner is a way to quickly navigate getting the help the team members need, with gentle pushback from our partners when needed, and maybe some guidance because sometimes we think we know everything as health systems, and we do not.

We need our integrated partner to do that. Our leaders tell me all the time how easy the process is here at TidalHealth. It’s a completely electronic request process. It goes through our internal processes to be approved, and then it seamlessly just happens.

I think that is what teams are looking for. They need seamless, painless, fast, integrated partners to help us get this work done. And honestly, it has to be that way.

For our clinical leaders, it is not like it used to be. They’re busy. They’re in staffing. They’re taking groups. So the expectation for them to have to screen every applicant just doesn’t exist.

You can’t do those activities without an integrated partner who understands what each unit’s clinical needs are, maybe the patient populations. That’s why this integrated partner, and not just a vendor, is critical.

It’s something that we demand. It’s something that I demand as a vice president of our health system. I wouldn’t partner with anyone who wouldn’t be willing to do that level of activity. For me, that’s what we have to do. And our teams love it.

I get great feedback all the time on this integrated partner relationship that we’re talking about.

KRISTIN

Things are always getting busier and never slowing down.

Another key shift that we’re seeing is moving away from one-size-fits-all solutions and listening before solving issues.

Natalie, how does that show up when you’re thinking about clinicians and quality?

NATALIE

When I think about clinician and quality perspectives, it’s incredibly complex. And I love that Dr. Dolan talked about this and what we’re doing well, because it really is on the partnership, but also the staffing agency, to absorb that complexity and make it simple for the facility partner, or at least as simple as it can be.

Quality is not one-size-fits-all. It’s about being flexible. What a unit needs today, at Dr. Dolan’s organization, may not be what that same unit needs six months from now.

Think about the evolution of patient care and how much more complex patients are. You have to be able to ebb and flow to meet those needs, which is super hard to do unless you’re integrated and embedded in the organization that you’re partnering with.

When you have those strong relationships and that level of integration, you can really shift alongside the facility, help meet their needs, and even suggest things proactively.

I love Dr. Dolan’s example. Maybe we notice that our clinicians are saying the patients on this med-surg unit are becoming more complex. Are we sort of reaching into more of a telemetry-type skill set now? Sometimes we’re driving that strategic conversation.

And I love that we are doing this during Nurses Week because you can see how clinicians, even our travelers, can contribute to the culture if they’re set up for success. They mitigate the turnover at our partners’ facilities if they’re well-staffed, and ultimately support the core staff and the morale.

When they are all set up for success, their ability to learn and be successful creates a better work environment for all and absolutely better patient care, which is what we all want.

KRISTIN

Yeah, absolutely.

Shifting gears a little bit here, for those who listened, our last episode focused on reactive staffing decisions. We spoke with Chase Farmer, our Chief Commercial Officer, and Erin McKenzie, our VP of Solution Engineering. They talked about the hidden cost of reactive staffing decisions and what healthcare organizations can do to avoid some of those pitfalls.

Karin, from your perspective, how important is it for partners to anticipate challenges rather than react to them, and how can they go about doing that?

KARIN

Yeah, definitely. First of all, it’s super important. I’m sure Dr. Dolan agrees that the best partners are those that anticipate for you and guide you in the right direction.

One simple example that I can think of, that my team and I are constantly having to monitor, is rates, scarcity of roles, or availability of the right talent in a certain location. It’s our job to keep monitoring the market. We have such vast access to information through all of the clients that we service, and that information is powerful for our clients to know and for us to bring to them.

We can share, “Hey, we’re seeing these needs in these markets. We looked at your historical data, and we anticipate you need X amount of roles,” for instance. That’s the kind of proactive, not reactive, information that we should bring to our clients as a partner.

KRISTIN

A lot of what you said leads into my next question. It goes beyond that business relationship into the human side of partnership: having those conversations and open communication.

Natalie, I’m curious, from a clinical perspective, how important is that human communication and connection?

NATALIE

The human connection aspect of partnership is irreplaceable. It’s table stakes at this point.

There are a lot of exciting, bright and shiny toys out there. When you look at AI and technology, it’s easy to get really distracted by that. The innovations can transform our workforce, so I think it’s natural that we’re leaning into that to really help our partners and help stabilize the workforce.

But you can’t lose sight of the human side of things, or we won’t be successful. Today, it really has to be both. You have to be advancing technology to support predictive analytics for our partners, like Dr. Dolan said, helping drive some of the changes maybe before they know about it.

But you also need to keep your white-glove service and your human support that sustains the partnership the entire way. The work being done is supported by that human connection.

When you really bring those two things together, the tech and human connection, that’s the model that’s going to support and scale, protect our patients, and make a staffing partner differentiated from the rest.

KRISTIN

We’re about 20 minutes in, and I was waiting for the first mention of AI. It’s hard to have a conversation these days without bringing up AI, so I appreciate you mentioning that, Natalie.

I also wanted to get Karin’s perspective. Can you expand on that a little bit, on the right way to build relationships that go beyond contracts?

KARIN

I think it’s all about walking the talk. It’s about consistency. It’s about reliability. It’s also being accessible, making sure our teams are always available when our clients need us.

And communication. I think it is tremendously important that we are clearly communicating on a frequent basis with each other and simply executing to the best of our abilities.

Honestly, I think it’s the hardest part, but it’s so critical to build relationships and trust. To me, that is the one thing that makes or breaks the best relationships.

KRISTIN

Yeah. There may be some leaders out there who are listening and hearing some of this and thinking, wow, I am not experiencing that with my current workforce partner or staffing vendor.

But switching partners can feel risky, and it can be a lot of work. So Dr. Dolan, can you talk about why it’s worth the shift from a staffing vendor to more of a workforce solutions partnership?

1. DOLAN

Yeah. I’ll take you guys back in time for a minute.

When I was at another health system, I truly dealt with transactional workforce vendors, plural. The challenge was there was never a connection. There were never the detailed conversations or the relationships.

In this integrated partnership, I know my people and they know me. I consider them our employees. They’re part of our team. I don’t see them any differently. They’re just not here in this building.

For me, that is critical. You have to have that connection. You need to have that integrated partner. The transactional vendor doesn’t work. As an executive at another system where I had that, it was miserable. We did not have good outcomes. We did not have open dialogue.

And it’s not about the contract. That’s a piece of paper. Sometimes the contracts aren’t worth what they’re written on.

But I can tell you, when you have an integrated partnership, I don’t even think about the contract. It doesn’t cross my mind. I don’t say to myself, “Well, let’s go pull out the contract and remind ourselves what the expectations are.”

Our expectations are bidirectional with our integrated partners. There’s no guessing. There’s no ambiguity. There’s no blurriness. We know, and we treat each other like we’re each other’s partners, because we are. That’s how it needs to be.

KRISTIN

Well, this has been a great discussion. Before we wrap up, I’d love to hear one key takeaway from each of you.

For our listeners, what’s the one thing you would like them to take from this conversation?

KARIN

First of all, I want to say that I love what Dr. Dolan said about not wanting to look at the contract. I couldn’t agree with you more. I’d rather never look at contracts and truly deal with the issues at hand on a bilateral basis and have a good relationship. So I really echo that.

My key takeaway from this discussion that I really want to hone in on is to be open about your pain points and your organizational goals to be achieved.

The better we, as a partner, understand your organization, your goals, and your pain points, the better partner we can be. And the more we can tailor our workforce solutions to your specific needs.

That’s not always an easy thing to achieve. We have many partners that keep their cards close to their chest, and that makes it more difficult. And I understand that. There are always circumstances like that.

The partnerships that I can think of, also in my past life in different industries, are those partnerships where we can be very transparent with each other and build that trust. As a result, we have a common understanding of the goals that need to get done.

And as you say, Dr. Dolan, we become an extension of your team. That’s when we are most successful.

KRISTIN

Natalie, do you want to go next?

NATALIE

Yeah. Kind of jumping off of what Karin said too, back to the one-size-fits-all point, you have to have a partner that’s really willing to dig in and understand what your unique needs are, and is able to ebb and flow with you and drive some of the strategy alongside you.

If you really have that synergy and that true partnership, it trickles down to the unit level, down to the staff. They really can feel that, and that ultimately leads to better outcomes and better patient care.

KRISTIN

Thank you. Dr. Dolan, last but not least.

1. DOLAN

I think my key takeaway for all healthcare executives or leaders out there who have a partner and maybe you’re not happy with that partner is to go find one that will do what you need. They do exist. I can attest to that.

We’ve been in a long-standing integrated relationship, and I would say don’t tolerate mediocrity from your vendors if they’re not meeting your needs. Don’t be afraid to change. I know as human beings we don’t like change, but it’s okay to go find a vendor that’s going to meet your needs and integrate fully with you.

Again, back to what everyone else is saying, it has to be open and transparent. They can’t help us if we’re not transparent about the reality, and we can’t help them if they’re not transparent. It’s really a bidirectional relationship. And that’s what it is. It’s a relationship.

So that’s what I would say to anyone. If you feel like you’re in a place that’s not working for you, take the leap. Go find a partner. Spend some time. Don’t look at the numbers. Don’t chase the contract and the legalese. See who fits with you.

If you can talk to that other partner and you’re like, “That’s them,” you’ll know. That’s what I can say about our long-standing relationship with our integrated partner.

KRISTIN

Great advice and a great note to end on.

This has been such a valuable conversation. What we’re hearing loud and clear is that the future of workforce solutions isn’t transactional, it’s relational. It’s about shared accountability, proactive problem-solving, and a deep alignment with the goals that matter most: supporting clinicians and, of course, delivering exceptional patient care.

Thank you to Karin, Natalie, and Dr. Dolan for sharing your insights and perspectives.

KARIN, NATALIE AND DR. DOLAN

Thank you.

KRISTIN

And thank you to our listeners for joining us on Healthcare Workforce Unplugged. If you found this conversation valuable, be sure to subscribe and share it with your colleagues.

For more information on Medical Solutions, head over to our website, medicalsolutions.com. We’ll see you next time.

KRISTIN

Welcome to Healthcare Workforce Unplugged Medical Solutions podcast. If your organization is still thinking about workforce in terms of simply filling shifts, today’s conversation is for you. Healthcare workforce challenges have evolved, and coverage alone isn’t enough. Leaders are balancing cost control, workforce stability, clinician experience and quality outcomes all at the same time. And in today’s environment, the difference between staffing and strategy can directly impact your financial performance. In this episode, we’re talking about how those reactive staffing decisions are costing your organization and what it really means to take a whole workforce approach.

I’m joined by two incredible leaders who bring both financial and operational perspectives to this conversation.

First: Chase Farmer, Chief Commercial Officer at Medical Solutions. Chase brings extensive experience in strategic planning and market expansion coupled with a deep understanding of the healthcare field. Chase, welcome back to the podcast.

CHASE

Thanks for having me back, glad to be here.

KRISTIN

And joining us as well is Erin McKenzie, Vice President of Solution Engineering. Erin works at the intersection of strategy, technology, and real-world operations. Her role is all about turning business goals into solutions that work, making sure the tech supports teams on the ground, grows with the business, and delivers real results. Erin, it’s great to have you today.

ERIN

Thanks, Kristin. I’m looking forward to the conversation. Thank you for having me.

KRISTIN

Sounds great. Let’s go ahead and dive in.

We all know how easy it is to get pulled into solving whatever problem is right in front of us. And for healthcare leaders, that could mean filling a shift, managing a budget line, or responding to something urgent. Chase, I’ll start with you. From your perspective, what’s the financial impact when staffing decisions are mostly reactive?

CHASE

Well, I first I want to acknowledge how difficult it is to be there, leading the departments, and being on the front line. It’s a lot easier to be in this conversation here.

I’ve talked with hundreds of leaders across the country over the years. And one thing resonates all the time — they’re doing absolutely everything in their power to take care of patients and to deliver day in and day out. And healthcare moves fast. So being reactive is often what’s necessary.

When it comes to being reactive as it relates to staffing, I would say it’s how you solve today’s problems. If you need to solve something immediately, you must be reactive. There’s almost no choice but that. But it rarely optimizes total cost. And I think that as we come out of the pandemic and what 2026 looks like, going into 2027 and the future of staffing as it relates to healthcare and taking care of patients, we have to optimize total cost. It’s a consideration that all executives are thinking about.

And when you have, when the reactionary turns into more than just that short-term fix, right? You talk about the idea of consistently rushing hires, consistently using overtime in premium pay, it becomes structural. And when it’s structural, you’re going to drive volatility. And we know that volatility is obviously disruptive, but volatility is also extremely expensive.

KRISTIN

And from your seat, how do you know an organization is operating reactively? What shows up in the financials?

CHASE

Well, it starts day-to-day with decisions, right? The use of, like we talked about overtime in premium pay, what you really start to see then that adds up is how that translates into burnout and how burnout translates into turnover. And when you start having those things compound, where you ultimately see it is in productivity. And the true cost starts to rise, the predictability drops.

And when costs are on the rise, predictability is falling, financial planning becomes really difficult and it becomes less reliable. And that starts to then impact future decisions.

KRISTIN

That makes perfect sense. And I’m sure that resonates with a lot of our healthcare leaders who are listening today. Erin, when you’re working with organizations, where do you see reactivity show up operationally?

ERIN

I think that’s a great question. Chase touched on this a little bit, but what we see most often is reactivity shows up when staffing decisions are being made in the moment. So very, very short-sighted and not through a designed workforce strategy. Like Chase said, healthcare is a dynamic environment. It’s complex, so teams are constantly responding to changes all the time.

So, when processes like technology and workforce strategy are not aligned, facilities end up stuck in this continuous reaction cycle. And operationally, that looks like managers filling shifts one by one, they’re relying on agencies at the last minute, or they’re using multiple systems or in spreadsheets and anything to manage their staffing. I’ve even seen them use papers within their facility to manage day by day. So, this doesn’t really become a people problem. It ends up being more of a design problem. And when that information is fragmented across those tools and the teams, it becomes super difficult for leaders to step back and plan more strategically, which is where I really think the longer-term impact really starts to show up.

KRISTIN

How do you feel that fragmentation can affect longer term planning?

ERIN

Great question. Fragmentation makes it very difficult to design stability, and you really, honestly, need stability across the board. So, if leaders can’t see the full picture, the full workforce model (think about the internal staff, the float pools, PRN, contingent labor, all of those different categories) it becomes incredibly hard to intentionally balance flexibility and cost control.

So instead, I find that organizations really end up adjusting, and they’re constantly adjusting. One unit is short, so agency gets called, overtime increases, and then that cycle just continues over and over and over again. So, when the data and the processes are spread across those different systems, leaders can’t see the patterns because it really needs to have that visual of a pattern.

So those decisions get made shift by shift or in these silos instead of a long-term workforce strategy.

KRISTIN

That’s such an important point, especially around visibility and understanding the full picture. And it actually ties into some recent data we’ve been seeing.

There was a recent national study showing that in most cases, travel clinicians were actually less expensive than permanent staff once all cost components were included.

Chase, can you talk a little bit about that and also explain how that changes things for facilities?

CHASE

Yeah, it emphasizes or reinforces the idea that you’re comparing wage to costs and an hourly rate for a permanent nurse is not total cost. When you talk about fully loaded permanent labor, especially in a high turnover environment, the math compounds and changes, right? Recruitment costs, training time, benefits. And when you have that turnover, the productivity gaps draw out even further. And those factors really matter when you’re talking about true cost. So, if you’re only comparing bill rate to hourly rate, you’re really missing the full picture of what cost is going to be.

KRISTIN

Erin, I’m also curious, what was your reaction to those results? And also, why do you think so many healthcare leaders were surprised to hear that?

ERIN

To be honest, my first reaction was it made sense, but I also understand why a lot of people were surprised by this because I think for years, the conversation has focused on the bill rate. Leaders see a travel rate next to a staff hourly range, and it looks like this massive gap between the two of them, but they’re not looking, as Chase mentioned, to the full cost comparison. So, when you factor in recruitment, onboarding benefits, turnover, vacancy costs, all that math changes incredibly quickly.

So, I think the surprise comes more from the fact that most organizations don’t have a true clear view of like the total workforce cost. So, these decisions get made based on the most visible number that’s in front of them. It makes sense. They’re not seeing that full picture where when they look at the full workforce model, then it’s going to really allow leaders to design a more balanced strategy instead of just reacting in one to one rate that’s out there on a contract.

KRISTIN

You also mentioned turnover. It’s hard to talk about cost of labor without discussing that. The average cost to replace a bedside RN is around $61,000 and turnover is sitting at over 16%. Can you dive in a little bit deeper for us by explaining how reactive staffing impacts turnover?

ERIN

Most definitely. So, hiring more people does not fix your turnover. And I think that’s sometimes where people run into that kind of perception there. So, if the underlying workforce model doesn’t support clinicians, that cycle I chatted about is only going to continue. So reactive staffing puts a lot of pressure on the people that are there. So, when teams are constantly filling gaps with the overtime, the last minute, like call-offs and coverage, or they have inconsistent onboarding, it creates this almost sense of catch-up that they have to do.

So, they’re always catching up and trying to keep on going. And so, then that overtime leads to burnout, burnout leads to turnover as we’ve all seen it throughout. That is when organizations start designing more of a stable staffing model. We really need to make sure that clinicians feel supported, the schedules are more predictable, and then that ultimately makes a workload to be a lot more balanced across the board.

KRISTIN

When turnover reaches that level. How should leaders think about it financially?

CHASE

Yeah, so the way that I frame it is the idea that stability will always protect margin and instability will erode it. So, if the reactive answer starts to become the answer, then that reactiveness is now recurring, right? And that recurring is what drives that instability.

And that instability will always put financial impact, will then start to compound. And you will start to see that it’s ‘one plus one equals three.’ It will compound as you see it. And the problem will grow quite rapidly. And with all that carries a lot of expense.

KRISTIN

We’ve also seen organizations reduce one labor category and expect costs to stabilize, but they don’t. So, can you explain why does that happen?

ERIN

Yeah, I’ll take this one because I have seen this firsthand when someone will try and remove one labor category, but they haven’t really designed what their workforce model is.

So, the cost doesn’t actually disappear. It honestly just moves somewhere else and it shifts. So, if contingent labor was absorbing flexibility and you pull that lever back, well then the pressure is just going to show up in other places. As we chatted about, overtime increases. We also see that positions will stay open a lot longer, productivity is going to drop, and that’s where we also will get that burnout is going to start to drive more turnover.

So, the real issue that I see is not the labor category itself. It’s more whether the workforce model was designed to balance flexibility and stability and cost. And when an organization or a facility step back and look at the entire model together, that is when costs are going to start to stabilize.

KRISTIN

And what makes cost shifting hard to detect?

CHASE

Well, mean, Erin kind of said it, right? So, the idea is that if the costs are dispersed across many departments and across a period, it’s just hard to follow. You must remember and think about the idea that we have different cost centers, floating team members. One team is going to show savings for a period of time; another is absorbing it. Over time, turnover gets absorbed, it gets moved around. The leadership within the nursing group is constantly in this battle. And that’s why I said in the beginning we’ve got to acknowledge the reactionary element that happens on a day-to-day basis, on a shift-to-shift basis. And when you have that, it really obscures the true impact of it because you’re constantly chasing that. And if you don’t have integrated reporting, if you don’t have a single pane of glass to be able to back up as Erin described and to really see the net effect, it’s incredibly difficult to manage.

KRISTIN

You both mentioned it, reactive decision-making increases volatility. So, let’s start connecting the dots a little bit. What does a more intentional workforce approach actually look like?

ERIN

It honestly probably starts with designing the workforce model first. So, instead of looking at managing labor categories separately, what I mean by that is when facilities look at their internal staff, their float pool, their PRN, their contingent labor in separate pieces, it’s not going to work for them. Everyone plays a role, but it needs to be structured where they’re going to support each other to build the overall workforce strategy, as an entirety together. That means aligning the recruitment, the onboarding, the workforce planning. So, then they’re also looking at building capacity ahead of demand instead of reacting to it in that shift by shift as Chase had stated earlier. Not being in the moment, but we’re really planning, so at the end of the day, it’s more about creating flexibility by design and not by accident, which I see oftentimes in different facilities and organizations.

KRISTIN

And when organizations start to design their workforce more intentionally, it doesn’t just change operations, it also changes the financial picture as well. Chase, what shifts financially when that happens?

CHASE

Yeah, so you are less reactive and you’re more prescriptive, you move from rate comparison to cost design, right? You stop asking the idea that says “Well, which option can I do now or which option is cheaper today?” Instead, you start adjusting to, this idea that says, “What adjustments in my staffing model will create the most continued stability over time.” Right? And, and with that shift, you’re driving predictability. That’s the decisions that really support retention. And you start seeing improved retention rates – 16% –  There are organizations that are far worse than 16%… well in excess of 20%. But if you can support that retention and start driving that number down, even from a national average of 16, get closer to 10, get into single digits. Ultimately, those types of decisions will start having dramatic impact and protect the organization’s financial performance.

KRISTIN

If a leader is listening today and realizes they’ve been operating reactively, what’s the first step towards shifting that mindset?

CHASE

The first thing I would say is you cannot manage what you cannot see. So, visibility will always come first. I would really want to look at assessing the workforce from a total cost across all labor categories, not looking at it as an isolated line item, but getting a truthful picture.

And that will set you on a path for not having to constantly shift back and reset. It sounds easy. You’d be surprised how difficult it is, especially the larger the organization, the more complex that exercise is. You will often hear, whether it’s a data scientist or somebody in finance, a controller, as they will always say, is “bad data in, bad data out.”

And, so I always recommend starting with an assessment and making sure that you have a clear, full picture of everything.

ERIN

Yeah, and I’ll tag on to that because I 100 % agree. I mean, you need to have all of your data, all the full picture. You need to make sure that you see what’s happening behind the scenes. I’d also say, and one thing I recommend to leaders often is to be willing to pause long enough that you can step back and you’re looking and evaluating that broader design. I find that reactivity is usually a signal that kind of something in the workforce model needs to be adjusted.

And most teams are working incredibly hard to solve the problem that’s there, that’s in front of them, that keeps on being brought up all the time. But oftentimes we don’t step back enough to look at what is that structure underneath it, as Chase said, the full picture. Because if you don’t look at that, the issues are just going to keep on showing up time and time. So, for me, I think the first step is creating that space to look at the entire workforce model and then ask your team, ask your leaders, “Are we designing this intentionally or are we just responding to the next issue, the next gap, the next thing that’s in front of us and appears in front of us right now?”

KRISTIN

Great advice, thanks to both of you. Before we wrap up, is there anything else either of you would want our audience to keep in mind as they’re thinking about their workforce strategy?

ERIN

Yeah, I can start on this. I think the only other thing that I would bring up is I think the biggest thing I would leave leaders with is that workforce strategy is not about choosing one labor type over another. I find that the organizations, the facilities that are stabilizing their workforce are those ones, like I was saying, that are like stepping back and they are intentionally designing how all those resources, all those categories work together. Because honestly, every labor type has a role.

So, when the balance is supported by the right data and processes, as Chase mentioned, when you have those, the finances, the analytics and all of those details, I find that organizations or facilities move from reacting to the staffing challenges to really managing their workforce a lot more strategically.

CHASE

I would say the immediate, reactive decisions are always going to exist, I said that before, but they’re really optimized for the immediate need. They’re not optimized for outcomes, right? There’s a lot more hidden costs, there’s a lot more inefficiency, and what you don’t want is for that to become a structural part of the organization’s decision-making process.

Whereas a more prescriptive strategy will help leaders to shift to more intentionally creating a stable, predictable, intentioned, first focused on the quality of care, always, but then ensuring is that that isn’t costing at a level that is not sustainable.

KRISTIN

So true. This was a great discussion, and I really appreciate both of you taking the time to share your perspective and expertise with our audience.

ERIN

Thank you for having us, Kristin. This was great.

CHASE

Thanks so much.

KRISTIN

If you’re listening, and this conversation raises questions about your own workforce strategy, or you’d simply like a clear view of your total workforce cost, visit medicalsolutions.com to connect with one of our teammates. Thanks again for joining us on Health Care Workforce Unplugged. We’ll see you next time.

KRISTIN: Welcome to Healthcare Workforce Unplugged, a Medical Solutions podcast. If you’re a nurse executive or a healthcare leader trying to figure out how to build or maybe even rebuild your clinical leadership teams right now, you are not alone. Today, we are talking about something that’s becoming an important part of that conversation: How international direct hire recruitment can help hospitals and health systems strengthen their teams not just today but for the long term.

I’m your host Kristin Dahl and joining me is Laura Messineo, Chief Nursing Officer at Worldwide Health Staff Solutions, a Medical Solutions company. Laura has been a nurse leader for decades and now she’s helping organizations across the country stabilize their workforce and grow leadership capacity through international direct hire recruitment.

Laura, it’s such a pleasure to have you here.

LAURA: Thank you, Kristin. I’m thrilled to be here.

KRISTIN: You had such a fascinating career path from clinical operations to digital innovation and now international direct hire recruitment. I’m curious, with all of those experiences, how has that shaped the way you think about building strong, resilient teams?

LAURA: Well, I think that’s really a great question. Having worked across so many different clinical areas, it really highlights the fact of how much everything connects patients outcomes to team culture and also to leadership opportunities. It all kind of rises and falls together. My experience has really taught me about resilience. It’s not just one individual trait. It’s a whole host of different traits put together, and really building through systems that consistently bring people over time.

KRISTIN: Absolutely. I think a lot of leaders can relate to that feeling of wanting to focus on leadership development but constantly being pulled back into staffing challenges. From your perspective, what’s really driving the ongoing shortage we’re seeing? And how does that trickle down into leadership development for nurses?

LAURA: That’s really such an important question. The workforce challenge in short is multifaceted. We’ve got many different things that are happening all at the same time. We’ve got retirements that are occurring. We have some nursing burnouts that occur. We’ve also have a very large number of new grad nurses that lack experience in the space. But we also have a growing problem across the US related to not enough of nursing schools and that’s really a result of not having enough nursing faculty in order to stand up those nursing programs. It’s really overlooked on how to close the loop on the staffing gap. The international direct hire space is one way that we can close the loop in that space by bringing seasoned nurses, nurses that have you know 8 to 15 years of experience over to the United States in order to help support a long-term strategy of staffing and that really creates a pipeline for bringing seasoned nurses over, which is also going to directly help with leadership opportunities, bringing nurses that have former experience in leadership in a different country and bringing them to the US and as they’re assimilating to US-based practice. There are many different opportunities for them to advance their career in leadership.

KRISTIN: Yeah, absolutely. And I’ve heard people describe it as you’re not replacing your current team, but what you’re really doing is supporting them so that they can really take the time to focus on learning and growing and then of course on that excellent patient care. So, I think many leaders are familiar with international staffing in general, but maybe not the direct hire approach. Can you break that down a bit for our audience and explain how direct hire is different from what we might think of as traditional contract staffing?

LAURA: Sure. Absolutely. At WorldWide, we specialize exclusively in international direct hire. So, what is that really? We have 17 different countries that we recruit nurses from. We contract with US-based hospital systems in order to understand what their clinical needs are, areas where they’re having challenges in staffing. And with that, we decide collaboratively what positions they’d like to recruit for. We then go through a very structured process that we post a position. We have an international nurse that applies for that position. We evaluate their competency and then we place them for an interview with that hospital system. That hospital system interviews nurses like any other domestic nurse. They would determine if they’re a good fit. They would then give them an offer and then the international nurse really has a decision to make. Are they going to accept that offer at that facility and that geographic location? And then once that occurs, we take the nurse through the immigration process. These nurses do receive an EB3 visa. And it takes us about 18 to 24 months for the nurse to come over to the United States. But during that time, we are helping to support them from a clinical perspective and from a legal perspective ensuring that they obtain their visa. That’s just a high-level overview of our program. And then on day one, when they come over to the United States, they are the health system’s employee. They are paid at fair market value. They receive the same benefits and pay as any other nurse that would be working at that facility.

KRISTIN: Can you also share an example of a health system that’s seen measurable impact after implementing a direct hire model?

LAURA: Sure. We have many cases of that. We have a very specific case out in Iowa. We’ve been working with them for over five years and we learned through working with the Chief Nursing Officer there that their current vacancy rate for nursing is at 5% which is 11% less than the national rate. In addition to that, we also found out that they have a 95% retention rate for all of their international nurses that worldwide health staff has brought them. They really feel as though the international nurses have been a great addition to their team and they have many different cases where these nurses have also been promoted to leaders in the organization.

KRISTIN: That’s a very important point and leads to my next question. So how does this direct hire model help leaders build the leadership bench that we hear so much about?

LAURA: Sure. That’s you know that that’s important in today’s healthcare environment. These nurses are nurses that have many years of experience in other countries and quite frequently they also have leadership experience. Many of them are charge nurses. They could be managers, directors and really it’s their lifelong dream to come to the United States. And with that, they accept a staff nurse position that allows them to learn about US-based nursing care and allows them to take their previous knowledge and excel. And then, they are also awarded some of those opportunities to advance their career and be put into leadership positions.

KRISTIN: Switching gears a little bit here, the integration piece seems key, especially with culture and patient experience. When an international nurse starts at an organization in the US, how does WorldWide support both the nurse and the organization to make that transition successful?

LAURA: We partner very closely with our clients. We also have offices in the US, in the Middle East, in the Philippines. We understand really the journey on both sides. Our focus is not just on recruiting nurses, but on the transition to practice and clinical integration. We help to ensure that these nurses can be successful at their new organization and that their new organizations are ready for them. And really, we support the nurse through a turnkey approach from pre-arrival preparation and credentialing to onboarding and long-term retention support. We also work very directly with all our hospital clients. We are true partners to them, listening to what the opportunities are and the gaps are and how we can partner together in order to support both the organization and also the nurse be successful when they are actually onboarding.

KRISTIN: So, you’ve touched on culture, stability and leadership growth: all of which really connect back to purpose-driven nurse leadership. For leaders who may be exploring this model for the first time, what are some of the first steps or key considerations when integrating international direct hired nursing into their staffing strategy?

LAURA: It really starts with leadership alignment and setting clear expectations. Organizations that are successful in this space and view international nurses as a long-term workforce strategy. This isn’t a short-term solution. This is about building a pipeline and that is an ongoing pipeline in order to address the severe nursing shortage. It also is important to engage your nurse leaders from the beginning. Helping them to understand what the international direct hire process is, openly being able to answer their questions so that they fully understand that with an international direct hire model, these nurses are part of their nursing team and that building out the ability to assimilate into their culture, and their community are some of the very important things. In addition to that, it’s very important to have a buddy system for international nurses. It helps them with their transition. They’re dealing with many new things at all at the same time. Not only are they transitioning from a clinical practice in another country and in adopting all the US-based standards, but in addition to that, they’re learning how to live there, live in the United States in that local community.

KRISTIN: So, this model really does seem like a viable long-term solution for healthcare facilities. So, I’m curious, what are some of the common misconceptions that you’ve heard from hospital leaders on why they may be reluctant to use international direct hire as a part of their workforce strategy?

LAURA: Sometimes, we hear that international direct hire takes too long. And it really is a longer term strategy and that’s probably one of the key things. There’s a lot of different levers when you’re looking at stabilizing your nursing workforce and international direct hire is just one lever that you’re pulling. Recognizing that it’s a long-term strategy and if you are thoughtful in the process, you blend that very nicely with your contract labor and your US-based direct hire. That really creates a model where you’re bringing in very seasoned nurses into your pipeline in over a period of time.

KRISTIN: Before we wrap up today, I have one last question for you. For any CNOs or nurse executives who are listening today who are considering international direct hire recruitment, what is the key takeaway you would want them to remember?

LAURA: I’d really say that think beyond your short-term filling vacancies. Think about building your future leadership bench. International direct hire isn’t just a staffing solution. It’s a strategic investment in workforce stability, diversity, and the next generation of nursing leaders.

KRISTIN: Perfect. Very well said. Thank you so much for sharing your insights today and for the important work that you do at WorldWide.

Thank you for having me.

KRISTIN: To our listeners, if you’re looking to strengthen your clinical team and leadership pipeline, you can learn more about Worldwide Health Staff Solutions’ international direct hire solutions at healthstaff.org. To learn more about how that all fits into Medical Solutions and our offerings, visit medicalsolutions.com. Thank you for joining us for Healthcare Workforce Unplugged. Be sure to subscribe for more conversations with leaders shaping the future of healthcare staffing. We’ll see you next time.

KRISTIN: Hello, and welcome to Healthcare Workforce Unplugged, a Medical Solutions podcast where we explore the people, data, and strategies shaping the healthcare workforce. If you’re a healthcare leader navigating the healthcare labor crisis in the United States, you’re in the right place.

I’m your host, Kristin Dahl, and today’s episode is all about data. Specifically, what nearly 4,000 clinicians told us in our annual Voices of Care Survey. We’re talking about how healthcare professionals really feel about technology, support, and the factors that shape their job satisfaction. Joining me today are two fantastic guests: Chase Farmer, our Chief Commercial Officer, and Karin Selfors, our Chief Client Officer. Chase, Karin, thanks for being here today.

CHASE: Thanks for having us.

KARIN: Thank you.

KRISTIN: So, let’s dive right in. The Voices of Care survey gathered feedback from clinicians. Everyone from RNs to LPNs to allied health professionals and CNAs. We wanted to understand what they really value in their work experience. Karin, I’ll start with you. What stood out to you in the data?

KARIN: Yeah, what stood out to me is that 66% of all the responses pointed to our clinicians still caring to have both a combination of human interactions along with technology.

Personally, I thought that was a high percentage. On the flip side, only 11% prefer no human interaction or simply engaging with a platform. And so, it’s very clear that the human element continues to be very important to our clinicians. And that’s probably a good thing for the time being. I think that over time that might change somewhat, continue to change, but for the time being, I was surprised to be honest that the percentage is still so high.

KRISTIN: Yeah, absolutely. As you mentioned that theme came through loud and clear. Clinicians don’t want to choose between human support and digital tools. They want a mix of both, and that’s something that we’ve built into our model.

Chase, I’ll move on to you next. You’ve been with Medical Solutions for quite some time now. Can you tell us about how we combine that human support with technology when it comes to supporting clinicians specifically throughout their journey?

CHASE: It really starts with recruitment. One of the core beliefs at Medical Solutions is to meet our clinicians where they are in their journey and that ranges from personal preference, and where they are at what stage of their career. And there’s a wide expectation or need from those clinicians. You could have a nurse that’s on their first travel contract, for instance, versus a nurse that has completed 15 or 20 travel contracts, if we’re talking about contingent staff. And they might have different preferences. You have some on one end of the spectrum that want a white glove service – very involved service – and others that really love the efficiency and the effectiveness of being able to use technology to manage their journey. Most people fit somewhere kind of in the middle. But we spend a lot of energy to really focus on understanding that and hopefully even anticipating it to some extent. Ultimately, we want the clinicians that are working for our clients to have the best experience because if they’re having a fantastic experience then they can focus on the care of their patients, which is ultimately the most important thing.

KRISTIN: Yeah, absolutely. Really great information. Thanks for sharing that. I also want to talk more about what it means to hospitals and healthcare systems that we work with.

Karin, in your role, you’re working with these hospitals and healthcare systems. Can you explain how we support those customers, not just by giving them a platform, but by working alongside them to solve workforce challenges?

KARIN: Yeah, Kristin, what’s important for our customers is that we listen and clearly understand their pain points. We achieve that with human interaction and meeting face- to-face and listening. And we also heavily utilize our data to analyze these pain points and then come up with ways to help our clients best solve their needs. Additionally, of course, we are investing heavily in our tech platforms so that we can complement our solutions we come up with for our clients in the most efficient way. So most importantly, it really isn’t just about providing a self-service technology platform. It’s our experience that the clients value, in combination with people, the right processes and technology to best achieve their desired outcomes for talent acquisition.

KRISTIN: Yeah. Another thing we hear about is how so many companies will throw technology at a hospital or healthcare system and expect them to run with it. But those teams don’t always have time to figure that out alone and they really shouldn’t have to. They should be focusing on that patient care which is number one. So, Chase, from a strategic and data lens, what does our approach look like when it’s done correctly?

CHASE: Absolutely. So, the first thing I would say is technology is a tool. It’s not an outcome, right? Dashboards or spreadsheets alone really hold little intrinsic value. As Karin had said, what really transforms those things into a real powerhouse and gives you meaningful ability to move forward is to extract insight. And with that insight, that’s what helps to drive decision-making and what we really try to emphasize is to understand within an organization: What are their goals? What are the organizational goals that we are trying to achieve? And how can the technology producing that data create an opportunity for us to turn that into meaningful insights and then to partner with those clients to achieve those changes or that evolution to help them to reach those goals?

KRISTIN: With so many hospitals facing pressures like rising patient volumes, tighter budgets, and persistent workforce shortages, we’re seeing more organizations look for a single strategic partner who can help them manage it all. Karin, can you explain how Medical Solutions supports clients beyond just filling roles? How do we partner with them to build a more cohesive workforce strategy?

KARIN: Yeah, indeed. We’re absolutely seeing that, as our clients really want less but more strategic and closer partnerships. We work with our clients really to consult them on the entire workforce strategy not just for contingent labor. Especially as you say in today’s environment with all the pressures that the healthcare systems have in terms of mounting costs, it’s important that we explore every angle holistically. So, for instance, how does overtime in their full-time workforce impact on them? Could that be augmented with contingent labor? What could be the potential savings? So, going deeper and using data to make decisions requires an understanding of the strategic objectives of us of these healthcare systems, our partners that we work with. And so therefore at Medical Solutions Group, we really are looking to be a closer, more strategic partner with our clients to give them the most value.

KRISTIN: That makes a lot of sense. Shifting gears a bit here because we can’t talk about technology currently without mentioning AI. We’re seeing more customers who are talking about AI and there is a lot of excitement out there but there’s also a lot of uncertainty. Chase, how do you see AI playing a role in healthcare workforce solutions?

CHASE: Absolutely. The buzzword of 2025 that’s for sure. You know, in truth, I think we’re a long way away from AI replacing human work, especially bedside care. But augmenting that work should really be the focus. I’ll give two examples. So, the first would be the idea of using AI tools to help to automate processes to streamline, simplify, and improve the accuracy of documentation, coding, scheduling, and these types of things. And what that really does is free the nurses or the clinicians’ time so that they can focus back on what they want to be doing, which is working with the patient, right? Another great example and probably one of the more exciting aspects where AI has really started to push into space today is in virtual care models. So, remote monitoring or telehealth. Very exciting, and is sort of leading that charge and is a way for organizations to improve care, improve efficiency, take some serious workload and burden off of their bedside nurses that they can really make sure that they’re focusing on the quality of care rather than having to scramble to make it to that number of patients within that amount of time. And there’s a lot of focus and a lot of work that’s being done in organizations like Medical Solutions and more broadly across healthcare systems to really take advantage of what the future of those virtual care models will look like.

KRISTIN: Yeah, a lot of interesting things and a lot of developments that are still on the way. One thing that you said really stuck out to me is that it’s not about replacing people with AI. It’s about using it as a tool with people who know how to use it, who know what to do with it. Before we wrap today, I do want to ask each of you, what is one thing you hope healthcare leaders take away from this year’s survey? And Karin, I’ll have you start.

KARIN: Yeah, I think it’s honestly really the notion that fewer partners is probably the recipes for success and the notion that human interaction still is critical. It’s not just a platform that is self-service. That’s what I would hope healthcare leaders take away and I can certainly share that Medical Solutions Group is driving exactly that human interaction coupled with technology and being a trustful and strategic partner to our clients.

KRISTIN: Perfect. Chase, I’ll ask you the same question.

CHASE: Yeah. One thing that was highlighted in the survey and something that I regularly talk about with organizations is the generational transition of the workforce. Today, we’ve got four generations of clinicians working with patients in healthcare systems and we are just a couple years away from where the fifth generation, Generation Alpha, will be joining that workforce and really seeing the shift in how they work, what values they have, what they prioritize. For organizations to understand those differences in the wide range of generational expectations and how the different generations think about work and want to work. There’s a lot there and to better connect and understand your workforce is to understand the shift and the evolution of what’s happening within the workforce and who is working for you and some of that is touched on the in the survey and I think it’s a conversation that probably isn’t happening enough and for organizations to understand what that generational evolution is about and what it means to the future of their workforce is a very interesting conversation and one that Medical Solutions really values having with our clients.

KRISTIN: Yeah, absolutely. And just another thing that we can help them work through as they continue to face these challenges day after day.

Chase. Karin. I want to thank you both for joining me today and sharing your insights.

CHASE: Thanks so much.

KARIN: Thank you.

KRISITN: It’s clear that building a sustainable workforce isn’t about tech alone or people alone. It’s about partnership and that’s where we show up differently. Thank you to everyone for listening. If you want to dig into the Voices of Care survey results or learn how Medical Solutions can work with your team, visit medicalsolutions.com.

We’ll be back next time with more conversations about what’s next in Healthcare Workforce Solutions. Until then, thanks for tuning in to Healthcare Workforce Unplugged.

KRISTIN: Hello, and thanks for joining us for Staffing Unplugged, a Medical Solutions podcast where we delve into the world of healthcare staffing, workforce solutions and everything in between. If you’re a healthcare leader navigating workforce shortages, recruitment hurdles, and retention struggles, you’re in the right place. Each episode, we bring in industry experts to share insights, strategies, and success stories. I’m Kristin Dahl, your host, and today, I’m joined by two incredible guests: Patti Artley, Chief Nursing and Chief Clinical Officer at Medical Solutions, and Ron Hoppe, CEO of Worldwide Health Staff Solutions, a Medical Solutions company. Patti. Ron. Thanks for being here today.

PATTI & RON: Happy to be here.

KRISTIN: Well, we are tackling a big topic today. How can hospitals and healthcare organizations rethink staffing to build a stronger, more sustainable workforce? With budget pressures, staffing shortages, and burnout at an all-time high, leaders are being asked to do more with less. So today we’re breaking down three key strategies that can help: flexibility, international hiring, and virtual care. Let’s start with reality on the ground. We all know hospitals are struggling to keep up with staffing demands. Patti. Ron. Why is it so important right now to think outside of the box when it comes to workforce strategy?

PATTI: Well, I think you mentioned the fact that budget pressures are on for everyone. We have limited resources and that requires us to be strategic and intentional with all our investments. Really investing in our workforce is what is most important for the success of our organizations. And when you understand what is happening in your environment, you can invest in the retention pieces which are so critical to your success. And one thing that we know is that we can’t do the same thing that we’ve always done and be successful.

RON: When I think of flexibility in the workforce, the thought that comes to mind is having choices. And when we talk about thinking outside of the box, we want to maximize the choices that we have. And I think to do that holistically, when it comes to just workforce overall and flexibility specifically, I think it’s important to have a correct understanding of what the challenge at hand is. Filling shifts day-to-day is a challenge, but to obtain the type of flexibility that’s needed, I think it’s important to understand that the root issue that’s being dealt with here is one of supply and demand. If we take all available qualified clinicians, registered nurses, and line them up against all open positions, there’s a gap. And I think understanding the challenge from a supply and demand perspective will cause us to look at it slightly differently than if we’re just considering it to be another recruitment problem.

KRISTIN: One of the biggest pain points that we hear from hospital leaders is retention. It’s not just about filling roles. It’s also about keeping great talent in your organization and, honestly, in the profession. One thing we talk about a lot is workforce flexibility. Patti: What are some ways hospitals can use flexibility to improve retention and keep staff engaged for the long haul?
PATTI: Sure. Flexibility is critical right now. When we think about what our Gen Z’s and millennial staff are telling us. And then in addition to that some of our individuals are more in my age group, and really thinking about how hard it is to work 12-hour shifts. It requires us to really step outside the box and think creatively. And one of the things that I have to say is exploring creative scheduling and how we staff by using resource pools, considering weekend options. I know that sometimes because they’re a little bit pricier, we back away from them, but when you think about being creative and looking at different options, it’s going to make you very successful. Because that’s what our staff are looking for, and one of the things I always tell people is to start with your data because what’s happening in one hospital is not happening in another. It’s important to know your demographics. Where is your turnover happening? What’s the age of your of your workforce? Then you’ll look at that and develop the right strategies. One of the things that I see very successful right now is leveraging eight-hour shifts. Looking at where your biggest turn is at. This is very successful in keeping your seasoned staff. When you think about how difficult it is to work 12-hour shifts and all the complexities that happen there. That’s something that I see: Whether it’s a 4-hour shift or an 8-hour shift, that makes it very successful in retaining some of the staff. And one of the other things that I see is virtual nursing. Whether you are using it today or something that you’re inquiring about. But this has really become very popular in trying to think about flexibility and retaining staff at the bedside. And it really helps with some of our novice nurses really keeping them, giving them a resource and keeping them at the bedside because they feel supported. And it’s another option for our seasoned staff. So, those are a few of the strategies that I see being deployed across the nation.

KRISTIN: Yeah. Absolutely. All great information. Ron: As a staffing and workforce solutions veteran yourself, I’m interested in your thoughts on flexibility as well.

RON: Specifically, from an employer’s perspective. When I think about flexibility, it’s about choice. And I think a key strategy to ensure that you have maximum flexibility as an employer is to first focus on your core staffing and optimizing your core staff. If you’ve got that in order, then you start to have a lot more options and you can be a lot more creative because you’re not focused on constantly battling or constantly trying to keep up with issues from day to day. So, I think that’s certainly a very key element. And then, as we said at the outset, again, thinking creatively – thinking outside of the box and being open to seriously evaluating something like international recruitment (that we’ll talk about more shortly) as a possible strategy or part of a strategy that’s going to put you in a place where you will have maximum flexibility and options available to you.

KRISTIN: And Patti: Back to you again. Do you have any examples of hospitals that have successfully used flexible staffing to improve retention? And what can other leaders learn from those experiences?

PATTI: Sure. We work with a lot of clients today that are really on this journey to create flexible staffing, but one that I saw was successful in Oregon. They knew that they wanted to get ahead of some of the legislative requirements that were in place for Oregon for 2025. And so, about a year ago, they embarked on an opportunity to think about how to staff breaks and meals to make sure that the ratios were maintained. And that’s what the new legislature was really pushing towards. And so, they introduced staff shifts from 11 a.m. to 3 p.m., and then they did the same from I think it was 5 to 9 when they started. They tweaked those hours using their data and really looking at where their movement was, but they were very creative so that they could create flexibility around lunch and dinner coverage. And the way they really drove those 4-hour shifts was instrumental in making sure that their coverage model was there. And they started out by unit-based and really moved it into a more flexible model by creating those shifts in the float pool, as well and really offering those 4-hour shifts which then they also offered eight-hour shifts in between to help with that kind of coverage. They really broke away from that every shift has to be a 12-hour shift, but it helped with nursing satisfaction, and it ultimately helped them with retention.

KRISTIN: Another major strategy that’s making a big impact is direct hire international recruitment. Ron: This is your world. Can you break down how hospitals can integrate international hiring to fill gaps and bring stability to their teams?

RON: So, as I mentioned before it’s important to understand that the reality that health care providers face in America as it relates to their nursing workforce is they are facing a supply and demand challenge. Obviously, the first response that one would come up with would be for the education system to produce additional or greater numbers of new graduates. That’s already happening. The US in recent years has graduated more new registered nurses than ever before. We’ve been talking about this for the last 20 years. And yet the hole is getting deeper in terms of supply demand imbalance. International recruitment – more specifically direct hire international recruitment – can play a very significant role in a medium- and longer-term staffing strategy in that it is one of the few levers that employers have to add to the absolute supply within the workforce. So, I think this is a very important consideration. The international workforce when it comes to registered nurses. It’s also important to understand that we’re not just talking about another person or another body to fill a position. The typical international candidate arrives in the US with anywhere between four and 10 years of experience on average. And that valuable experience is exactly what US employers are in most desperate need of. So, international recruitment – specifically direct hire international recruitment – is a significant strategy to address the supply demand imbalance. It’s also a significant strategy to combat what is known as the experience complexity gap, where we have an ever more novice nursing workforce while we have patients in our hospitals and nursing homes whose needs are more complex than ever before.

KRISTIN: Patti: As a nurse and nurse leader yourself for many years, have you been on units where international health care professionals are contributing? And, if so, can you tell us what other advantages there are for including international professionals on your team? Sure. I’ve always been a strong proponent of international nursing. They have always brought a strong dedication to the organization and the unit that they’re working with. And the individuals are great members of the team and their work ethic, I think, is hard to beat, but truly, they have been instrumental in providing a different kind of experience. They bring a unique perspective that’s different than what most of the graduates that come out can really learn from, and it diversifies your entire workforce. Many of them, like Ron had alluded to have four five 10 years of nursing when they’re coming here which really does help bridge that experience complexity gap. Our academic partners have been great in really stepping up to the plate and producing more nurses because of their ability to expand clinical resources and their partnerships have been wonderful. But this really helped our novice nurses grow and develop by really helping them think differently. They share their expertise, they are highly technical, and I know that in the last organization that I worked for, we had this as part of our long-term strategy for medical surgical nursing and our dialysis unit and we continued to hire them quarter over quarter, knowing that we would then have that where our highest churn was. We were able to have experienced nurses in those areas.

KRISTIN: And you’ve both mentioned the experience complexity gap. So, let’s spend a couple of minutes talking more about that. With seasoned nurses retiring and patient needs becoming more complex, newer clinicians are stepping into high stakes environments with less hands-on experience. So, Ron, talk a little bit more about how international hiring can help when it comes to that issue.

RON: First let me just paint a little clearer picture of just how significant an issue this is. Scholarly research that was completed in 2018/2019 indicated that the US nursing workforce would be losing 2-million-person years of experience each year from 2020 to 2030. That is a staggering number that’s almost hard to comprehend. The cumulative effect over 10 years is 20-million-person years of experience leaving the workforce at the same time where patients’ needs are more complex, are of greater acuity, and individuals are requiring care many times over extended periods. So, just not to put too fine of a point on this, but this is not a minor issue. When it comes to the delivery of high-quality health care services, which of course is a high priority for every provider, as I’ve mentioned the international nurse doesn’t just provide another body or another set of hands, they come with experience – many times working in other developed countries around the world. Sometimes even in workplace environments that are even as advanced or more advanced than the work setting, they relocate to when they arrive here in the United States. We have employers that routinely will find that if they are hiring 50 or 100 international nurses and they do a survey of the average years of experience, they would very regularly find that, at the time of interview, that individual has somewhere between seven and eight years of experience on average – which means, by the time they arrive in the US, they’re going to have eight or nine years of experience. From a patient perspective, this is a critically important issue. And from a HR talent acquisition position perspective, it’s also critical to fully understand what is happening. You know, if I’m working in a recruitment office or in a talent acquisition office and I get a spreadsheet report at the end of the day on Friday that says, “This week three nurses left, but we hired three to replace them.” It would be easy to conclude: “We lost three. We hired three. We’re good.” When what likely has happened is you’ve probably lost three nurses that are very well tenured – maybe 20-25 years of experience, and most commonly, they will have been replaced with nurses that are far closer to the front end of their career. So, while on a spreadsheet, it says we hired three; we lost three you may have lost 50 or 60 years of nursing experience, which has a cumulative effect that can be devastating. International recruitment directly addresses this issue, and it does so with the international candidate who comes with seven or eight or six or five years of experience and is still very much in the front half of their career. They still have a lot to offer.

KRISTIN: Wow. Yeah. Shocking numbers that you brought up. Thank you so much for that information. That’s really kind of eye opening I hope for all our listeners out there that are tuning in. Patti – Ron discussed international recruitment as kind of a way to remedy the experience complexity gap, but are there any other ways to take on the experience complexity gap?

PATTI: Sure, I think one of the most common right now, and most popular, is really that virtual nursing that we’re seeing. When we think about the challenges – having the seasoned nurse replaced by a novice nurse, it really does give us that little bit of flexibility. When you think about how demanding it is to work through that 12-hour shift, as we talked about. This provides a different option. So, it allows seasoned nurses to stay in the nursing profession for a longer period. They provide resources for nurses that are at the bedside, and it really does extend your workforce. So, I see that very often happening. You know, we talked about flexibility, and when you’ve created some flexible opportunities. There are several organizations that are doing the “We want you back” campaigns and really target those experienced nurses that have left the workforce. This allows them to offer them other options other than those 12-hour shifts – having them come back for 4 hours for 8-hour shift to act as a virtual nurse and help really remove a lot of the tasks or help the nurse practice to the top of their license. These are some of the things that, as nurses, are getting more creative. They’re really thinking through: How can we leverage and extend? How long have our nurses been at the bedside or how long have we had them in the in the profession? Really giving them meaningful ways to contribute to our profession.

KRISTIN: And you did mention virtual nursing. I wanted to ask you about that. Can you explain what you’re seeing in terms of how virtual nursing is playing out in the real world?

PATTI: Sure. You know, if I had 10 different virtual nursing programs, I’d have 10 different ways of doing it. One of the things that we are seeing right now is that there is an evolution of trying to create some standard guidance on virtual nursing. And what really defines that virtual nurse is rapidly evolving as we’re speaking. There are more virtual platforms that are out there that are providing different technologies to be utilized and that’s changing every day. And the professional organizations are offering new certifications to really expand. They recognize that virtual nursing is so important to us as we provide care and think about different ways to provide care. So, I think that we’ll see a lot of that evolving over the next few years. But when I look at how a lot of our partners are utilizing that. They are using them in critical roles – letting them really evolve to help the nurse at the bedside. And they are part of that integrated care model where they’re part of the team that’s providing admissions, discharges, teaching and helping them with second sets of eyes. Whether it’s for quality indicators or whether it’s for second dose checking. And then, we have EICUs where we’re seeing larger hospitals of the systems able to provide ICU support and support for rapid teams so that they’re making sure to keep their patients safe. And what it’s doing for both organizations is really a huge win for hospitals and the patients because we’re keeping patients closer in their community and allowing them to be closer to their families and still providing very safe care for them. So, really enhancing the care that they’re able to provide at the community hospital. And I really think that we’re going to see a lot more innovation and a lot more of the AI being leveraged here, and that’ll help us be even quicker and smarter as this evolution takes place. We’re seeing a lot of economy of scale on virtual sitting. You know, once the patient – while they still may need monitoring, but might not need that elbow-to-elbow support – in helping just provide that extra layer of support. And that’s really an economy of scale. Keeping them safe so that you reduce falls and all the other patient safety opportunities by really making sure that the patient is safe but in a more effective and cost-efficient way. And what that does, at all avenues, is really vital to support the nurse at the bedside. And when we’re thinking about retention strategies, this is a critical element for organizations. And that’s why I say thinking outside the box and not necessarily thinking about the actual ratios but thinking about how you can provide care differently.

KRISTIN: Yeah. Absolutely. Out of the box. That was what I was thinking the whole time you were talking. Really, taking that out of the box thinking and maximizing that – sounds like what you were covering. So, Ron: I’m also curious about your thoughts in terms of virtual care in healthcare. What are you seeing?

RON: Yeah, so I think there’s just a tremendous opportunity as Patti has already been describing, and I’m excited to think through and to start to bring to the market you know the contributions that the international workforce can make in this area of virtual health as well. Virtual health in some respects is something that is relatively new, relatively recent, and it’s attractive to certain workers in the health care system. But employers are already finding, in some cases, that they’re having the same challenges in staffing their virtual programs as they are in staffing their ongoing operations. This is particularly true at the present time in the area of virtual patient sitting, and given the acceptance of remote work and the acceptance and development of new technologies, we’re excited to see how virtual patients sitting here in the US can be very well supported – safely, effectively, efficiently supported by a workforce force that’s actually outside of the United States. And I think when we really think through the reality that US healthcare employers face, virtual is key. And I would put an even finer point on it by simply recapping the whole thesis for virtual health and how an international workforce can support that is by recognizing again that we have a longstanding workforce shortage that’s going to be with us for the foreseeable future. The US education system has not kept up in terms of putting out the number of graduates and we’re now for the first time facing in America a decline in college and university enrollment, which is only going to make that that aspect of generating new grads more difficult over time. International recruitment provides a great solution, but the reality is there’s a limited number of international workers that can come to the US each year – given the current US immigration system. So, that means there’s a limited number of workers that we can bring here to where the work is. So, then the next approach logically is: What work are we doing here today that, with technology, we can safely take to where the workers? That’s virtual patient sitting, and I think, soon, we’re going to see that roll out to various other clinical applications that will have a registered nursing component to it – other administrative components to it. I think it’s going to be a significant contributing factor to employers being able to provide high quality services with a high-quality workforce given the domestic shortages that we’re going to be facing for the foreseeable future.

KRISTIN: Very exciting stuff. Very exciting solutions to some of the problems that we’ve all been experiencing for a while now. So, thank you for sharing that. So, we’ve covered flexibility, international hiring, and virtual care – three powerful strategies for tackling today’s workforce challenges. As we wrap up, I want to ask both of you: If there’s one key takeaway for healthcare leaders, what would it be? Patti: I’ll have you go first.

PATTI: Well, I think I’d have to say – You must be creative and willing to innovate. When you’re open to new ideas and not just thinking about how we’ve always done it in the past, it truly will make a difference in retention, and most critical, the quality outcomes for your patients. When you think about being adaptable and really embracing the opportunities that are in front of you, I think you’ll be more successful in overcoming the workforce challenges that we have in front of us.

KRISTIN: And Ron, same question for you?

RON: Yeah. I think the key takeaway that I would hope is taken from today’s conversation would be this understanding of viewing these new ideas, innovative ideas, out of the box ideas, that they are considered in the context of trying to solve a supply and demand problem. Because ultimately, that is the challenge at hand. And innovation is not optional. It’s essential. I think for survival and certainly to have any opportunity to provide high quality care, supply and demand – the principles are simple. No health system is having a meeting today to discuss how they might decrease the demand for their services. So, the demand side is only going in one direction, which means we must be thinking clearly about the supply side. We do need to educate as many graduates here in the US as is possible without diminishing the standards of education and the benchmarks that we have for particularly professional staff such as nurses. That absolutely is a must – various other retention strategies can have some impact as well but there’s no retention strategy that’s going to have the 64-year-old nurse stay until they’re 72. To be real about it. So, international recruitment is one of the few practical strategies available now to significantly add to the supply side of the equation as opposed to simply you moving registered nurses from one employer to the next – who may have a higher sign on bonus this month – only to have them move back again 12 months to another employer because they now have some bright shiny new program that is attractive in the moment. So, that would be my one key takeaway, is just to evaluate all these potential solutions that we’ve discussed today in the context of trying to solve a supply and demand problem.

KRISTIN: Very well put. Patti. Ron. This has been such a great conversation. Thank you both for joining me today and sharing your insights and expertise with us.

PATTI & RON: You’re very welcome. Thanks for having us.

KRISTIN: And thank you to all our listeners for tuning in. If you found today’s discussion helpful, be sure to join us next time as we keep diving into the latest trends and workforce solutions in healthcare staffing. For more information, check out medicalsolutions.com. Thanks for listening, and we’ll see you next time on Staffing Unplugged.

KRISTIN: Hello and thanks for joining us for Staffing Unplugged, a Medical Solutions podcast that delves into the world of staffing and recruitment. Each episode, we bring you insightful discussions, expert interviews, and thought-provoking conversations with industry experts. I’m Kristin Dahl, your host, and I’m joined today by Patti Artley, Chief Clinical Officer and Chief Nursing Officer at Medical Solutions. Thanks for joining me today, Patti.

PATTI: Thanks for having me, Kristin.

KRISTIN: Can you start by telling us about your role at Medical Solutions and maybe a little bit about your journey into the healthcare staffing industry?

PATTI: Sure. Well, my role. I’ll start with that first is a Chief Clinical Officer, Chief Nursing officer, and I’m responsible for the quality of the clinicians that we share with our partners. Really making sure that our clinicians have the support that they need, as well as the clients have the support that they need. I have multiple teams that help do that. I have a team of nurses that ensure that we interview and make the right placement. I have a team of credentialing specialists that are responsible to make sure that each one of those individuals that we send on assignment are ready to practice in that area and are licensed and credential to do so. Then, I have a quality team that really looks at our regulatory requirements (the state and federal requirements) and makes sure that we’re meeting all of those. So that’s really about my role that I do now.

How I got involved in the stuffing industry, my history is really all in healthcare. From the time I started, pediatrics has always been one of my focuses, and I started in that realm. I have evolved in leadership roles in the children’s hospital space or women’s space. Then, my chief nurse really felt that I needed more well-rounding and one of the areas that I started to work in was I started a resource pool, worked with staffing and scheduling, and we purchased a scheduling system and then partnered with a software company. So, it really has evolved in there and I did that again in another health system where we really worked to streamline staffing and all those things that really put nurses and other clinicians at the forefront and make sure that they have the tools that they need to do their job. And then I transitioned to a staffing company about 20 months ago.

KRISTIN: Perfect, and I’m curious Patti – In your time in nursing, I’m sure you’ve seen a lot of change, so how do you feel right now about the industry overall, and what are you seeing in terms of workforce trends?

PATTI: I’d say we’re in a state of influx. After the disruption that we have seen through Covid. I think we’re really seeing a lot of innovation and a lot of things change. Sometimes, what I am seeing in different areas is really recycling different things that we’ve done at different times in my career. I’m looking at care models from when I came out 38 years ago. We’re looking at a lot of those models being recycled and resurfaced at different areas of the country. I’m seeing scheduling practices that are evolving like what I’ve seen in the past. I think that we are really looking at what is the best model of care now. What are the best ways to provide care to an ever-growing population and do it more efficiently? I think that’s the part that everybody’s trying to not just do it the way we’ve always done it, but really look at – do we utilize technology? Do we utilize different systems in a variety of ways so that we can get a different result? When I think about those things that we’re looking at – technology and systems, that’s where I see the biggest change. When I look at how we’re providing care in Med-Surg areas or in ICUs in remote facilities – through virtual nursing – that’s probably one of the more innovative areas that I think has just scratched the surface. We’re just starting in that arena so that we’re allowing nurses to practice differently or we’re allowing individuals to provide care in a different way. So, I think that’s one of the areas that we’re going to see more. I think we’re going to see more innovation in the AI space. Right now, we leverage early warning symptoms systems and that takes different data elements and puts together a warning for the nurse either at the bedside or virtually to really do something with and it’s hard to navigate an electronic medical record where you’re constantly trying to figure out what data elements you’re trying to put together and some of them aren’t as easy to find. These AI models allow us to alert the nurse or alert the clinician so that they can make the right decisions. So, I think that we’re going to see a lot more of those things happening and a lot more of those will help us provide better care at the bedside.

KRISTIN: A lot of exciting things to come it sounds like. Well, you also work with our healthcare clients as part of your position with Medical Solutions. You’re really trying to make sure that they’re successful in their staffing strategies, and you have a great connection with those who have their boots on the ground. Can you tell us what are you seeing in terms of challenges? I know we’ve talked a lot about shortages and burnout over the last couple of years. Are those still the top challenges facing healthcare systems that you’re currently working with?

PATTI: I think from an aggregate perspective, workforce is in the top five. I think that is contributed to the fact that there is burnout and it’s constantly in the forefront, which I honestly have to say that in 2019, if we surveyed what was part of a strategic plan, probably half of my colleagues would have said they’re doing something around the workforce support and burnout and ensuring that people have the support that they need. Now, it is probably amongst almost every one of our individual contributors. One of the things that I have seen that’s different in the workforce is really around the technology – that’s in front of everybody, but it is a challenge because it’s a costly investment and when we’re coming out of this, while we see a lot more of our partners who now have a margin, and they now have gotten out from behind some of those deficits that they’ve been in, this is really an investment that they’re trying to figure out – How do I make the kind of investments in technology that help support our teammates and help make their job smoother? Because that’s what contributes to the burnout. I think the big challenge for health systems is how they provide value to the consumer. And that really means that we have high quality at a reasonable cost. With salaries to make them a competitive market – they have consistently gone up since 2019 – it makes it harder and harder and when we think about the cost of supplies and the cost of technology. It’s all gone up. So how to make the right decision for what they’re investing in is a big contributor for most of our health systems. Then, when we talk about quality, we are doing a much better job in the quality of care and patient satisfaction is starting to rebound as well because we saw those fall for quite some time during Covid. Especially our nurse sensitive indicators where we have seen falls increase. We saw pressure injuries increase and now we’re starting to get a control over central line and catheter-related infections. So, we’re doing a little bit better, and I know that we’re working on those falls and pressure injuries. So, quality of care is still one of those things that individuals are always working towards.

KRISTIN: Patti – One of the things that we like to do on our podcast is really provide some insights, some actionable advice that people can take and apply to their own settings, so I’m curious as well. When you’re visiting these facilities working with leaders in small facilities and larger systems – what are you seeing in terms of new solutions and how people are adapting to the current reality when it comes to staffing challenges?

PATTI: So, I think the biggest thing that I see (we touched on it a little bit) is that virtual care, it’s that integrated care models – they’re trying different things so that they can make sure that individuals are supported. One of the things as we address nurse burnout is really related to nurses being overstressed, overworked and how they can provide care in a different way. So, the integrated care models – whether they are introducing LPNs into the workforce; we have eICU which is supporting a lot of our smaller facilities with their larger facilities’ oversite and having a virtual nurse doing eICU or virtual nursing doing admissions and discharges and education – taking some of those tasks off of the nurse at the bedside and really a collaboration that’s taking place to provide care, I’m seeing in a lot of different ways. Remote patient monitoring is another part of that virtual care and how they are providing that in different facilities and in different ways – improving access to care through that virtual platform, I think, is a big thing that has really taken off in the last several years. One of the other things that I’m seeing is leveraging technology. And one of the areas I never would have thought I would see in our facilities the robots. And the number of robots that I’m seeing in some of these organizations that are really doing some of those tests -whether they’re what the pharmacy technician was doing and bringing medications to the floor or collecting linens or delivering linens or delivering supplies from a central supply space. It’s around how do we streamline the work and at the same time making sure you’re paying attention to the right things that will decrease the frustration, allowing individuals to practice to top a license so that they decrease burnout and decrease turnover.

KRISTIN: That leads nicely into my next question. I really wanted to talk to you today about top of license utilization. I feel like it’s a topic I’ve seen in the news and something that could be helpful to our listeners, so Patti – Can you explain why top of license utilization is so important?

PATTI: Sure, well this is part of why nurses are burned out. So, what top of license actually means is that you’re utilizing your education and the training to your fullest potential – Where you have individuals doing the things that they are trained to do and not really doing all the other tasks that maybe others individuals could be doing that don’t have the same education and training that the registered nurse might have, as an example. So, it really has challenged us during this time to really look at our models and how we provide care differently. So, when we think about what roles can help contribute to a nurse practicing to top of license, the LPN role which, we just spoke about – many hospitals are bringing back into the into the workforce – creates more of a team environment where you have a tech, an LPN, and a registered nurse, and each one of them has different things that they’re responsible to do. When we think about all the education that a registered nurse has with four years of trying to put together what’s the diagnosis? What are the contributing factors to some of the meds that I’m giving them and side effects that I should be looking for? And what might be going on? That’s really allowing them to practice to top of license, whereas we probably don’t need them to do some of the other things like maybe feeding the patient – the patient care techs can take some of those responsibilities over. Or giving them their bath and making sure that they’re ambulating and getting outside and or getting out of their bed and getting to the chair. And making sure that individuals each know their role and what they’re responsible for. We spoke a little bit about that virtual nursing, and that’s a model of really allowing nurses at the front line to do the things that we need the nurses at the front line to do. They have a very busy schedule and there’s many days that they can’t accomplish all the tasks, but by removing some of those things that they need a nurse to do – part of the assessment and the intake and the care planning and some of those things, that the virtual nurse will remove from the frontline nurses responsibilities – it allows them to practice to the top of their license and give the best experience because the nurse at the bedside is really focusing on the care that they’re providing.

KRISTIN: What are some of the things you’re seeing as possible solutions or ways organizations and leaders are helping nurses best utilize their skills and expertise.

PATTI: Yeah. Like what we’ve been talking about. You really must start by evaluating the way you’re providing care. I think that each hospital and health system is going to come up with a different answer and that’s why I don’t think there is a one size fits-all solution, but it really allows us to think about all the work that we’ve been doing over the last several years. What are some of the Hallmarks, the infrastructures that have taken place and transitioned maybe differently in our own health systems? And then take that assessment, go back to the individuals who are providing the care, look at what some of your options are, and validate what’s most important to them. What is causing the challenge that they have in front of them? And then how are they able to look at things that are out there in the industry that can help decrease those frustrations and help eliminate the turnover? I really think that it is up to the leaders in the health system to really do their due diligence and go to the units, go to the shared governance, go to the individuals that are doing the work and understand the big frustrations and that’s where you get started.

KRISTIN: Looking forward, how do you see the focus on this top of license utilization evolving the future of nursing?

PATTI: Yeah. I think top of license is going to be important for every organization. When you think about – you must be financially responsible. You really must keep quality and access at the top of a driving force, so how do you provide care keeping all of those things in intact is really important. I really do believe that top of license and making sure that when we have resource constraints – we know that there is a gap in what the supply and demand is for registered nurses – it’s going to be so vitally important to be financially savvy and provide high quality care when the person needs it. So, I think it is going to be more important now than it has been in the in the past several years and that’s why I think organizations that haven’t started to really look at how they’re providing care and are individuals practicing to top of license will need to do that quickly in order to prevent the kind of turnover and burnout that we’re seeing in our industry.

KRISTIN: All great information, Patti. If anyone has any more questions about this topic, are there any good resources out there they can check out?

PATTI: Sure. First, as we all know nursing practice is really governed by your state, so know what your Nurse Practice Act is. I know that when I was going through my doctorate degree, I really wasn’t up to speed on the Nurse Practice Act and what we were able to delegate and what we weren’t, so it’s really our responsibility for us to look and start there. And I think that gives your ideas about where do you have opportunities? And where are these things in your own health system that that might be different than what you could be providing? I think that really helps drive us as your first opportunity but the other areas – the American Nurses Association, the American Organization for Nurse Leaders, any of the professional organizations. So, if I’m running a labor and delivery or I’m in a children’s hospital or an operating area, those professional organizations are tremendous resources for top of license in those professional areas.

KRISTIN: Excellent! Before we end today, I do have one more question for you. Being a nurse yourself, and being in the industry for more than 35 years, what are you up optimistic about or looking forward to seeing in the coming years in terms of nursing?

PATTI: Well, I think I’m excited – first, I’ve been a nurse this long and I can’t imagine any other career or any other thing I’d like to do – but I’m very excited about where we’re at and where we’re going. This is an opportunity for us as a profession to really look at what we have been doing and what worked well and what are opportunities that we can embark on? What do we learn from other industries and how we can provide care in a very different way? I also think technology is advancing rather quickly, and I think this is an exciting time to be a nurse leader. I think this is an exciting time to be a nurse. There will be a lot of challenges. I think, as we move through the systems that we’re moving through rather quickly, and a lot of trial and error and I know that for some that’s a bit scary, but I think this is an opportunity for us to embark on all new adventures and trial things differently than we’ve ever done them before, so I’m excited as to where we’re going.

KRISTIN: Great! That’s a perfect note to end on! Thank you so much for joining us today, Patti, and sharing all your knowledge with our listeners.

PATTI: Thank you for having me.

KRISTIN: Absolutely and thank you to our listeners. Please join us every month as we unravel the complexities of healthcare staffing and recruitment – sharing expert insights and actionable advice that can help you with your staffing efforts. In the meantime, visit our website medicalsolutions.com for more information on our healthcare talent ecosystem and how we can help your facility reach its full potential. Thanks again, and we’ll see you next time.

KRISTIN: Hello, and thanks for joining us for Staffing Unplugged, a Medical Solutions podcast that delves into the world of staffing and recruitment. Each episode, we bring you insightful discussions, expert interviews, and thought-provoking conversations with industry experts. I’m Kristin Dahl, your host, joined today by Robert Crowe, Executive Vice President of Per Diem, and Local Workforce Strategies at Medical Solutions. Thanks for joining me today, Rob.  

ROB: Yeah. Thanks for having me, Kristin. Excited to be here. 

KRISTIN: Can you start off by telling us about your role at Medical Solutions and a bit about your journey into the healthcare staffing industry? 

ROB: Yeah, sure. I’d be happy to. I came to Medical Solutions through the acquisition of Matchwell, which is a company I founded back in 2017. As such, my role at Medical Solutions is to find ways leveraging the Matchwell technology or others that help healthcare organizations access and engage a flexible workforce in new and more direct ways. We’re really focused currently on hiring that local “gig” or shift workforce. 

KRISTIN: You had mentioned you’re also the founder of Matchwell, which is a tech enabled job marketplace which is a part of the Medical Solutions family of brands. Can you tell us more about Matchwell and how it’s transforming the healthcare staffing landscape? 

ROB: Yeah, absolutely. So, after working for two decades in the staffing industry, I started Matchwell as a way for healthcare organizations to post jobs and directly access that flexible workforce, as I mentioned previously. Part of that is when the fastest growing segment of the workforce are people maybe not seeking full-time jobs, we wanted to help organizations quickly post jobs, track path of candidates, and make it easy to access that growing flexible workforce – again, without going to a bunch of job boards or maybe the traditional agency approach. What we did first was build technology to help healthcare systems organize their existing workforce – so organize that workforce into float pools that could then be deployed like Uber or some other quick button to cover those open shifts. This simply helps healthcare organizations optimize the existing workforce that they already have before having to go out and find new resources. We then built a hiring marketplace where healthcare systems can again quickly post those jobs out to that marketplace to find new people that could join their organization. Then, finally, what we did was we added a W2 employer of record. So, if that healthcare system did not want to hire and onboard that new resource into their existing inter internal payroll, we could be that employer of record for them – we could provide all that service so they get all the benefits and the protections of a W2 relationship with a maybe a traditional staffing agency, etc., but without maybe some of the cost of doing that so. In other words, it’s technology and support that helps healthcare organizations expand their own existing workforce to be more flexible, and then also this do-it-yourself hiring platform. 

KRISTIN: Perfect. That’s all exciting and kind of seems like new and innovative ideas coming into the staffing industry. So, Rob, I know you’ve been in the industry for quite a while – you mentioned over two decades, so I know you’ve probably seen a lot of change. I’m curious: How do you feel about the industry overall, and what are you seeing in terms of workforce trends? 

ROB: Yeah. So, I have admittedly become somewhat of a workforce junkie over the years. Over now 25 years in the industry, so I love being part of an industry that evolves as people’s working relationship with work evolves throughout all of society. 25 years ago, we were transitioning from paper and fax machines into basic applicant tracking systems and leveraging email. I remember when our office got one shared email account for all of us. Then, what we did was, we saw this the rise of managed services and vendor management technology to communicate your jobs out to a lot of different agencies at once and manage that traffic. I did have the opportunity to build two early vendor management systems as that trend was coming out. The latest employment trend is about work-life harmony. People in all industries and all jobs are seeking more flexibility. Call it the “gig economy,” I’ve heard it called “Freelance Nation,” but the reality is this flexibility is becoming the new normal with a lot of employment out there, and healthcare is no different. So, especially with the pandemic, I think that fast-forwarded some of this trend that put this workforce into overdrive. So, now we’re leveraging technology like the Matchwell platform and others to help organizations better tap into that flexible workforce. 

KRISTIN: For anyone who has heard you speak before, they’ve probably heard you talk about how flexibility is the new currency. That really sticks out whenever I’ve heard you talk in the past. And it also goes hand in hand with what Matchwell is trying to achieve. Can you expand on the importance of flexibility in the current work climate and explain some of the key benefits of flexible staffing for both healthcare facilities and for clinicians? 

ROB: I do believe that flexibility is becoming table stakes to attract talent, but then also to retain those people in this modern work era. In some industries, when people can work from home, they’re getting a little bit more of that flexibility and work-life harmony into their lives. That’s a little easier to achieve, but when you’re in a clinical workforce and you’re seeking that work-life harmony, you still must be on site treating patients and so how do we provide some of that flexibility for them? In some ways, we’re talking about alternative shifts – so instead of the traditional 12-hour shift maybe it’s a 4-hour shift or an 8-hour shift. Or maybe it’s weekends only or maybe it’s joining a float pool where you’re kind of moving around. One of the trends we’re seeing right now are healthcare organizations setting up “internal agencies” so they can embrace flexibility. Maybe they’re putting somebody on quota contract for three months or six months within their own organization. For one, a nimble workforce helps balance that patient census that is fluctuating so up and down, but really interested in helping that workforce achieve that flexibility to help prevent burnout. How do we retain this workforce? How do we keep them from leaving us in the first place? So back to the table stakes. If you’re a healthcare system and you’re not offering some degree or a program of flexibility, but there’s another healthcare system that is, you’re vulnerable to lose your workforce over to that other organization. So, by investing in these flex work programs internally, healthcare systems again can better attract a new group of employees and maybe keep the ones that they have a little longer. 

KRISTIN: Implementing flexible staffing sounds great in theory, but just like with everything, I’m sure there are some challenges that come with it. Can you also explain some of the challenges healthcare facilities might face when it comes to flexible staffing and how they can overcome some of those challenges? 

ROB: For sure, 100%. Change is hard. It can be fearful. Everybody talks about innovation, but then they usually just keep doing the same thing. For example, some organizations are fearful that if they do offer flexibility to their employees, maybe all their employees – their entire workforce – will want that, and that’s overwhelming to think about. The reality is, yes people want more flexibility in their life, but they don’t want a paycheck that’s flexible. They do want that full-time continuity of pay. Their mortgage is not flexible, inflation is real, college is expensive, etc. The danger is less that you’ll get less hours out of your workforce, it’s about offering more flexibility just in terms of when they provide that care. Also again, back to what we were talking about earlier, opens new ways for more people to work for you. So, it is a tool for both attracting and retaining when you embrace that flexibility. Speaking of innovation, we did just kick off – and you’ve probably seen some of this out there in the industry – the nation’s first statewide resource pool. And this is in collaboration with the Indiana Hospital Association. So, imagine having one database where all these clinicians across the state are organized and then hospital systems/ healthcare systems across the state can post jobs and access those people with no middleman involved. So, that’s new. It’s also hospital members of the association across the state recognizing that they share a common challenge and by working together across a statewide level, they can be a little further along in implementing change. When you’re operating in your own silo and you want to do something different, that’s a little harder than if there’s lots of organizations taking that step together. The other piece of that is the more people collaborate, the more we can get people working together. Adoption will just lead to better outcomes so that lifts the tide for everyone, and the exciting thing is that other states have looked at what Indiana is doing, and now we have multiple other states wanting to follow that trend. 

KRISTIN: Yeah, that is exciting. Again, just those innovative solutions. It’s great to see those gears kind of changing and finding new ways to help solve some of these problems that have been out there for a while. So, I did want to ask you – I know you’ve kind of mentioned this a little bit already, but given the current nursing shortage, can you also expand on how adopting a flexible workforce model could not only help healthcare organizations retain their existing staff but also attract new clinicians who were looking for more of that work-life balance? 

ROB: As of this past March, Staffing Industry Analysts (and I think it was a McKenzie study if I’m getting that right) reported roughly 36% of the US Workforce – which is roughly 60 million people – are in the workforce are currently participating in that “gig economy.” They also are saying that roughly 20% of the entire workforce now work exclusively within that “gig economy,” meaning they don’t have a full-time job. They’re piecing things together. That’s a significant number, and so when we see this rapidly growing segment of the workforce not looking for that traditional full-time job and really embracing flexibility, we have to offer flexibility and create roles that these people want. I think that’s kind of step number one. Shift and contract work is a way to offer that flexibility and if you’re offering those kinds of programs, you’re better positioned to fill in gaps or float people around more nimbly within your organization. Those organizations can maximize the use of this workforce while keeping costs down. If they only go to the more expensive options to access these people, it may not make sense, but if you can keep costs down and start optimizing that workforce, it can work to your advantage. More directly to answer your question, I do believe that every healthcare system in the country should have a robust internal flex work program – almost like that internal Uber pool of clinicians we talked about earlier that lets employees have more flexibility on when and where they pick up shifts. In doing so, you just get access to more people to join your workforce and take care of your patients. 

KRISTIN: Absolutely, that makes perfect sense. Now, I’d like to shift our focus over to float pools, which are often mentioned as a solution to staffing challenges. Can you explain what a float pool is and how it functions within a health care facility? 

ROB: These float pools are those resources where they may work full-time schedules, but they just don’t work in the same unit all the time. So, maybe they’re moving around based on census or based on just need – somebody called out sick, etc. So, in some cases, this employee may float and work one or two days a week instead of full-time or maybe it’s one or two days a month. It’s a program that allows an organization to have a large pool of resources that move around based on the business needs – based on those gaps – so it’s very dynamic in that way. Of course, managing such a program via spreadsheets or cell phones has some limitations and we’ve got massive healthcare systems across the country that sometimes have a very small resource pool because they don’t yet have that technology. They don’t yet have that infrastructure to really expand it and that’s where technology comes into play and leaning into what’s available to us in this era to really be able to manage large groups of people with the press of a single button.  

KRISTIN: What role does technology play in managing float pools and how does Matchwell specifically support that? 

ROB: Matchwell is an enterprise technology platform that can be white labeled. It can sit on different domains. So, this can sit on a healthcare systems internal website and be really powering their internal workforce or that float pole program. It also then, as mentioned earlier, it has this hiring marketplace integrated, so when they have gaps and they just need to hire more people, they can release those jobs out there and attract qualified clinicians that are pre-vetted and seeking new opportunities. So, it has all the functions – tracking who is working where, it has the timecards, the evaluations, and so much more just to simply organize that workforce and maximize its productivity. Again, this is really about healthcare systems managing their internal workforce programs and giving them the solution to really grow a robust program. 

KRISTIN: And Rob – with AI being the big topic across all industries right now, can you also talk more about the overall role of technology and how AI will help healthcare staffing in the coming years? 

ROB: AI is speeding up how quickly we can identify scheduling gaps and see available resources even before that job is created. It’s creating draft communications for reaching out to people. It’s helping read resumés and speeding up that hiring process. It’s helping us make better business decisions based on data. But we are still in the early days of unlocking and linking data between systems, which can allow these tools to really flourish. I do believe that is coming very quickly, and so we’re dabbling with it – everybody’s kind of dabbling with it to see how we can maximize the use of this. So, imagine when a recruiter can focus his or her entire day just building relationships with people – just talking about what drives them, what they’re looking for in their career, what their career path is looking like – instead of worrying about data entry and instead of trying to connect all the dots in these different technologies. OR imagine when a scheduler is simply reviewing a pre-populated schedule and confirming it versus trying to put all the puzzle pieces together and figure out where people go. AI are the types of tools that can make those lives, those positions, very effective. Even going so far as – imagine having reports that take data from multiple systems and bring to you the next best action that you should take instead of trying to take all this data and figuring out what to do with it. It’s an exciting time as technology is rapidly evolving and a lot of this is just going to make these types of flex work programs or even just hiring in general a lot easier. 

KRISTIN: Absolutely! Well, we’ve covered a lot of valuable information today, but before we wrap up – I always like to ask: What is one key message or piece of advice you would like our listeners to take away after listening to our show today? 

ROB: Yeah. Wow. I think we’ve covered a lot. In closing, I simply want to stress to our listeners that embracing flexibility does not have to be scary. I think the contrary. If you’ve got the right technology, if you’ve got the right partners, it can be quite innovative and energizing to open the doors for a lot more people to work for you. 

KRISTIN: All right, perfect! Great advice! Thank you for joining me today, Rob. 

Yeah. Thanks, Kristin. It’s fun. 

KRISTIN: Absolutely and thank you to our listeners. Please join us every month as we unravel the complexities of healthcare staffing and recruitment, sharing expert insights and actionable advice that can help you with your recruitment efforts. In the meantime, visit our website medicalsolutions.com for more information about our healthcare talent ecosystem and how we can help your facility reach its full potential. Thanks again, and we’ll see you next time! 

KRISTIN: Hello, and thanks for joining us for Staffing Unplugged, a Medical Solutions’ podcast that delves into the world of staffing and recruitment. Each episode, we bring you insightful discussions, expert interviews, and thought-provoking conversations with industry experts. I’m Kristin Dahl, your host, joined today by Rich Thompson, Chief Human Resources Officer here at Medical Solutions. Thanks for joining me today Rich.

RICH: Hey, thanks Kristin. Thanks for having me.

KRISITN: Can you start by telling us about your role at Medical Solutions?

RICH: Absolutely, as a chief HR officer I’m responsible for HR across the entire group and so really, it’s our department’s role to make sure that we are an attractive place where people want to join – that we have good people programs that enable and empower the employees to develop and grow. Also making sure that they’re rewarding and that we have rewarding and aligned engagement programs that keep people here after they join us and focus areas and initiatives that drive performance and accomplishments, including a leadership and coaching program that enables the leaders at all levels to be empowered to make sure their teams grow and that they can win through their teams and through themselves. And then also create a culture wrapped in a way that people feel aligned and rewarded and appreciated but hopefully have fun at the same time.

KRISTIN: And you’re fairly new to the company. Can you tell us about your history and what you’re passionate about?

RICH: Thanks for the question because I feel like I’m different than a traditional or stereotypical HR professional in large part because I come from operations and I lean really closely to the revenue generating parts of the company more so than technical HR and so luckily I have a great team that is super comprehensive that enables me to do that and kind of focus in that area. I think in large part I’m that way because of my sports history. I played football at the University of Wisconsin, and I was a free agent with Green Bay and that taught me a lot of those skills that I felt like were kind of transferable to the professional environment. Once I got cut from Green Bay, a long time ago, I wound up landing and kind of starting in the staffing and recruiting industry, so I did that about 30 years ago. I started on a recruiting desk making temporary placements of an office in clerical administrative professionals in downtown Chicago. I moved up through the ranks – I went from Chicago, I changed companies and then started out in the suburbs of Chicago as a division director that took me to Houston to then St Louis where I then moved out of the business and running finance and accounting staffing teams. Then moved over to talent management. I think that was a little bit kind of the lean to my sports background, but I just love the idea of building L&D programs and talent management programs to help align people to leaders and help drive performance that way. From there, that took me to Zurich where I was the global head of talent for Adecco group across the 60 different country footprints, responsible for the culture programs, the performance programs, and leadership development. And then back into the U.S. as the chief HR officer. So, I say all that because I’ve got three different career tracks where I was out in staffing operations. I was responsible for talent management as well as CHRO, but what I really enjoy most and what I think is kind of interesting about my background is I’ve been able to find a way to marry my experience with my history but also with my passions and so what I love most about this industry is that it’s competitive, it’s gritty but it’s also fair. Kind of a nod or lean to the sports side.

KRISTIN: Rich, you’re so passionate about culture, you wrote a book about it. You recently published Relentless where you discuss ways to build a strong team culture. First, congratulations. That’s a huge accomplishment!

RICH: I think the evolution of that, Kristin, is interesting because in one of my early roles in Zurich or one of my kind of my early priorities in my role in Zurich is I was tasked with creating a leadership program that helped the organization go out and identify who were the upcoming leaders and who were the existing executive leaders that were doing well and so that gave me this opportunity of traveling across the footprint, the different global footprint, to get inside of leadership teams to identify what made people successful as leaders. Why did people follow them? Which is super interesting because – same company, same role, but different social cultures. So, I got to see what made him successful, what made him click, why did people follow him and didn’t follow the others? The interesting thing was that I realized that often many of the characteristics that made these people successful were also the same characteristics, Kristin, of my coaching staff in football and so all those things that were kind of applicable not only the professional was also on the coaching or on the athletic side. And so that’s where the book kind of evolved from is just this intersection between leadership development in a professional environment as well as coaching from an athletic environment which is why we built the book. It was a great process, and I love leadership, and I love the task of building teams that perform at a very high level and there’s so there’s so many parts that are important in doing so right there there’s process there’s people but above all things, to me, it all starts with culture. Culture is identity, it’s the personification of a company, but it’s hard because it’s not the one or two things that you do from 10-11 on Tuesdays. It’s not the pancake breakfast or the theme Zoom calls, but culture is everything – everything that you do all the time. It’s the compilation of everything that you do, and it’s got to be intentional, so it’s the lens through which every employee views the company, and it gets defined whether you actively define it or not. And so that’s what makes it hard, but it also makes it very interesting to me.

KRISTIN: Yeah. A very, very important topic. In health care staffing and particularly with the current nursing shortage, a strong culture is key to success, so what are some of the fundamental values you believe are essential for creating a strong culture that could apply to healthcare organizations?

RICH: Yeah. That’s a great question and I think it goes back to this idea that culture is personality – it’s the personification of a company or a department or even a team. So as the leader of that, you must ask yourself, “If my culture was a person, would I want to hang out with it? Could I stand to go on a vacation with it? Or can I only stand having dinner with it? Or is it the kind of culture that I can only have a coffee with? As silly as that sounds, you really must try to figure out what is your culture? I mean how does that speak to you? Is it a good friend that is aligned with you? It’s trustworthy, it’s honest, it’s interested in you, it provides you with opportunity, it’s demanding, but it’s also fair, but hopefully it’s rewarding and it’s fun. In the healthcare environment, it’s demanding, it’s stressful, it’s emotional and in the end, we’re talking about teams and there’s nothing more. A team is really nothing more than just a collection of people. People who have all different lives, they have different aspirations, they have different wants, they have different needs. And a strong culture empowers, enables, and encourages the individual to find that connection and that path to success. So, I was recently talking to a director of nursing and a nursing manager of a large healthcare system who said culture starts with investing in your employees, in their growth, and in their development. If the people feel vested or invested in, then they feel valued, and it really comes down to that.

KRISTIN: In your book, you seem to be talking directly to those in management and leadership roles. It seems to me, at least, that a strong culture really starts from the top. So, can you expand on the role leaders play in shaping and maintaining that positive culture?

RICH: Yeah, and it does start at the top. It’s the same example I was talking about earlier. They gave an example of their CEO coming to the floor in scrubs and spending two and a half hours shoulder-to-shoulder doing whatever they needed to do. That just speaks volumes about the commitment and how essential it is in creating culture – how important that is because it trickles down. So, it all starts at the top. There’s a great saying, “Your actions speak so loudly I can’t hear a word that you say.” And that’s it because you must make sure that your leaders identify, define, they communicate, they model, they reward, but they also protect the culture all the time, relentlessly. Where it goes wrong is that maybe the cultural identity is not as authentic to the leader’s way of working, priorities or their own personality, or maybe leaders focus too much on short-term or reactive – kind of like a windsock, everything is changing all the time, and the culture identity gets a little bit deprioritized or kind of deleted. Or even leaders just are only looking for a bullet point comment on a marketing brochure about culture. It’s that authentic, intentional, deliberate approach to identifying and modeling that culture and that behavior. That’s got to start to the top. Otherwise, it’s just not going to have any legs.

KRISTIN: A strong culture also factors into retention, which is a big issue for a lot of our listeners, so can you explain how strong organizational culture directly impacts employee retention?

RICH: Yeah, a great question – so important, and it just comes down to connection, Kristin, honestly. We talk about that in the book – the power of connection and the impact on retention, but also the impact on performance because when an employee or a person is connected, that means they find meaning, there’s purpose. And when there’s purpose or there’s meaning, there’s a deeper alignment to that situation, but also there’s typically a greater performance because when there’s connection, people care more. They become more curious, they perform at a higher level, they hold themselves more accountable, they even hold each other more accountable, and they become a lot more patient. And some of the things that typically are annoying are not so much so when there’s a connection. And lastly, they tend to be a little bit less entitled, and when all of that exists people want to stay. So, you must ask yourself, “How do you connect people then to the situation?” There’s four connection points we talk about in the book: It’s role, it’s their boss or their leader, it’s the team, or the company. What I mean by that is when they look at their situation, whether it’s their role, or the boss or their leader or their company, they feel like there is a unique connection so much so that they can’t find that somewhere else. And if they can do that, then typically they stay. They’re saying, in that example, they’re saying that my boss, my leader and I have a relationship and a camaraderie and an appreciation and a partnership that I don’t feel I can find anywhere else, and therefore I am going to stay. And so, from a leader, you must look at that and be like, “Okay. So how can I drive those connections across one or of or many of those four?” Because it’s intentional, and it’s your job to do that – your role is to drive the connection, so you do that by discussing their goals. What can you do to help them achieve them? How can you develop them in their current position? How can they possibly know that they are performing? And how can they advance throughout their career within your system? How can you provide them with opportunities for growth? Maybe it’s not even how to perform the job as much as it is can you provide them education and opportunities? Investing in their development keeps them from leaving almost all the time, and you’ll find that if they are connected, and you are showing that you are invested in their development, that’s a lot more important than any signing bonus they’re going to get from anywhere else.

KRISTIN: Those are all such great points, and you don’t really think about it but when you put it that way it makes so much sense, so I’d like to dig a little bit deeper. As I mentioned, a lot of the hospitals that we work with have expressed issues with retention especially coming out of the pandemic so in your experience, what are the most effective strategies of retaining professionals that would apply to the healthcare setting?

RICH: Yeah, it’s tough. I mean I have got friends and family in that space and who were on the front lines during the pandemic. I can’t imagine all that they have gone through, and I imagine they’re tired, probably overworked, maybe even feel unappreciated, and retaining people in healthcare can be tricky because there are a lot of different options and there are a lot of different incentives for nurses and for staff to leave because they are in demand. But I go back to that fact of these teams, again, are people. Teams are a collection of individuals who have different wants, and they have different needs, and they potentially have a different definition of success. So, as a leader, you need to know all of this about every individual in your team. I mean it’s important that you are 100% aligned, understanding, and clear on what is the role, and what is your expectation of them. As your leader in the role, how are they doing in real time, all the time and 2-3 things that they need to work on to improve their performance year over-year.  By giving them a path that it’s clear, it’s not ambiguous, or it’s not unknown, can be very important and that’s where I find that retention starts to wane is: If I’m in a situation where I don’t feel like I’m clear on what role I’m supposed to do and you could say listen if I’m a nurse, everybody knows what the nurse role is but that’s not necessarily true all the time because there are different components to performance. You got to be clear, but if it’s ambiguous on what’s the role what are the expectations but more importantly of how I am performing them and how do I need to get better that just becomes a disconnection and people start to get a bit of a wandering eye. So, it’s the understanding of where I am and where can I go as well as driving those connections that I talked about earlier that are important for every leader to have for all their key people.

KRISTIN: Now when it comes to a lot of what we’ve discussed so far leaders, and especially those at the top, usually want to know if these strategies and initiatives are actually working so when we’re talking about overall culture, do you have any recommendations on how healthcare organizations can measure the success of their culture or identify those areas that may need to be improved?

RICH: So, first, you need to really care about that. I mean you can engage in a lot of different ways, but you need to do something about it. It’s more than just running a survey and collecting information. Communication is important, and communication is two-way. Communication isn’t just me talking to people, but it’s me having a conversation. As an organization, to understand what people are experiencing, what is important to them, where it goes wrong …  When you’re doing a survey, as an example is: I’ve seen examples of companies where they will only survey small pockets of people that will only give them good scores. I mean, look, come on, that doesn’t do anything because it’s not full representation of the organization. Where it also can go wrong is when you do a survey or you’re collecting information whether it’s through a focus group or whatever is – you’re not communicating the results. Sometimes the results are kind of tough – maybe they’re not so nice, but it’s okay as an organization to stand up and say, listen, we’ve heard you, here’s what we’ve heard, and you got to kind of own up to it. That’s that trustworthiness that I think is important. Another mistake I think is made off of results is that they’re not validated because sometimes the wording in the surveys are a little bit tricky – they can kind of be interpreted multiple ways so I found you know as a good practice is when we get feedback is we take that back to the population even if it’s a small group to say here’s what that feedback is, tell us what you think that means so that we’re ensuring that we’re closely aligned. But lastly, which is probably most important is you got an action to it, so commit to this is what I’ve heard, this is what we validated, and now these are the actions to try to go make change in that space, so they know that they’ve been heard. You can gather that information off surveys, you can grab them from glass door reviews, comments, and exit interviews and stay interviews, but promotion rates, internal retention rates, those are all things that are telling you that you’re doing the right thing.

KRISTIN: Perfect, that’s a great answer! Well, Rich, we’ve covered a lot of great information today, but before we leave today, I wanted to ask you one more question. If you would like our listeners to remember one key message or piece of advice what’s the main thing you’d like them to remember or take away?

RICH: No it’s great, and listen I’m going to go back to where we started right, which is that I am in my – even though it’s been a little while – is that athletic lean to me, so it’s about grit, it’s about competing, but it’s always about winning, and no matter what you’re doing is, “Can you win?” “Can you win as an employee? Can you win as a leader? And to be a champion leader is the relentless pursuit of what matters, and in my opinion, what matters is being courageous, driving connections, communicate transparently, be a people developer who coaches, and always be consistent because if you prioritize those things you’re not only able to drive success of your organization but you’re creating a lasting impact on those who are in it.

KRISTIN: Great advice! Thank you, Rich, and thank you so much for joining us and sharing such thoughtful insights with us.

RICH: It’s good to see you. Thanks Kristin.

KRISTIN: Absolutely and thank you to our listeners. Please join us every month as we unravel the complexities of healthcare staffing and recruitment, sharing expert insights and actionable advice that can help you with your recruitment efforts. In the meantime, visit our website medicalsolutions.com for more information on our healthcare talent ecosystem and how we can help your facility reach its full potential. Thanks again, and we’ll see you next time.

KRISTIN: Hello, and thanks for joining us for Staffing Unplugged, a Medical Solutions podcast that delves into the world of staffing and recruitment. Each episode, we bring you insightful discussions, expert interviews, and thought-provoking conversations with industry experts. I’m Kristin Dahl, your host, joined today by Patti Artley, Chief Nursing Officer, and Scott Armstrong, Vice President of Client Growth. Thank you both so much for joining me today.

SCOTT: Happy to be here.

PATTI: Our pleasure.

KRISTIN: Well, our show is relatively new, and this is the first time we’ve had two guests on so let’s start with some brief introductions. Patti, can you kick us off by talking about your role at Medical Solutions?

PATTI: Sure. I am the Chief Nursing Officer and Chief Clinical Officer, and I’m responsible for the clinical and the credentialing teams that we have here at Medical Solutions. My responsibility is to make sure that the quality of our clinicians exceeds the standards that we and the Joint Commission expect. We support not only the partners that we serve and our travelers but so that we make sure that both have the best experience possible.

KRISTIN: Thank you, Patti. And Scott, your title is Vice President of Client Growth. Can you explain what that entails?

SCOTT: Absolutely. So as VP of Client Growth, my primary role is to drive the new business efforts of our company as we support clients with our direct business and MSP service lines. I also have the pleasure of supporting some of our top MSP clients through their strategic initiatives and making sure that we’re creating the proper value for them.

KRISTIN: Thanks, Scott. Today we’ll be talking about our Medical Solutions’ Voices of Care survey, and for those who may not be aware, it’s a survey we complete each year by gathering responses from registered nurses. Our goal is to provide insights on their thought process and feelings so we can advise our healthcare partners and better serve our clinicians. I’ll start with Patti. Can you explain why it’s important to complete surveys like this and give some examples of how we use the results?

PATTI: Sure, so surveys like this really are designed so that we can support and listen to the voice of the nurse and that’s what’s so important is that we are better understanding what they are looking for and what they want in a work partner. When we can best use this, we’re able to share not only what they said, but we can also start developing strategies to help our clients develop their own retention strategies.

KRISTIN: And this year, we surveyed more than 7,000 registered nurses including traveling, per diem, and permanent nurses. We received responses from a wide variety of perspectives, so let’s go ahead and dig into some of the findings. Scott, was there anything that stood out to you from the survey results?

SCOTT: Absolutely. There were a lot of valuable insights to unpack for sure. I found it interesting that the bulk of our responses are still coming from tenured nurses. We saw 40% of the nurses or clinicians that were surveyed.

having over 10 plus years of experience. It was also clear that clinicians are looking for different work experience — we saw flexibility, career development, and avoiding politics stand out as three key drivers for clinicians as they are considering where to work. However, the most impactful point for me was that 40% of our clinicians don’t feel recognized and 65.5% don’t necessarily feel safe in the environment that they’re working.

KRISTIN: Those are great points, and we will explore that a little bit further here in a little bit, but first I want to ask Patti that same question. Was there anything new or surprising that you saw in the survey results?

PATTI: Well, mine would be like what Scott said. I really was surprised that the largest number were over 10 years of experience because we’re seeing such a shift in the average age of the nurse that is really decreasing. So, with many of our nurses who have over 10 years’ experience sharing this information, I thought that was impressive. I found it surprising that with all the work that’s happening across the nation on retention that 42% of our nurses still said they aren’t recognized for the work they’re doing. Really, that was surprising just based on the volume of retention strategies that I hear about.

KRISTIN: So, it seems like you both agree this was one of the key findings, so let’s dig a little bit deeper into that. One question in the survey asked respondents whether they agree with the statement ‘my hard work is normally recognized.’ From 2022 to 2023, we saw an 8% decrease in agreement with that statement, which implies these nurses feel they’re not being recognized for the hard work they do. Patti, what do you get from that result?

PATTI: Well, meaningful recognition is at the Hallmark of retention strategies as I said, and when we are so stretched for resources – whether it’s financial or it is just your time, you have to understand what’s most important, and I think that this is really showcasing that we’re probably doing a lot of things, but is it really meaningful and is it really hitting the mark? The things that we did in the past to support our teams aren’t going to be the same things that we have to be doing to be successful in the future. So, I think the most important part is that we must really pay attention to what our team needs and understand what’s most important to them so that we’re paying attention to the right things.

KRISTIN: Another finding I’d like to discuss deals with compensation. Only 42% of respondents feel they’re paid fairly for the work they do. I’ll start with Scott this time. First, what is your initial reaction when you hear that, and the second part of my question is what do you think factors into this result?

SCOTT: Yeah. I think pay always seems to find its way to the top of the ‘reasons why’ list. I mean it’s why we all come to work every single day; however, I think the core issue goes a lot deeper than that based on what we’re seeing in the survey. The common themes of not feeling recognized and valued combined with mental health struggles and not feeling safe at work come through as more concerning in my opinion. When those elements are lacking in any organization, the default response of any employee will be ‘well, if I’m going to deal with this stuff then I certainly need to be paid a lot more.’ And I think Patti’s point earlier, we’ve seen a huge movement from healthcare leaders to really invest more, time energy, and resources in areas that impact job satisfaction and retention within our clinical professionals nationwide.

KRISTIN: And Patti, what is your reaction to that number?

PATTI? I don’t find it surprising. Every place I’ve ever worked, this comes up as one of the top issues. And I don’t think it’s even just in healthcare. When you look at the nursing salaries specifically — they’ve really increased in the last three years I would say. The mean salary has increased. I have three children, all in the workforce and none of them are in nursing, but they all say they’re not paid enough so I really do believe that this is translatable to all other professions as well.

KRISTIN: That’s also a good point. Now Scott, earlier you mentioned retention which is a topic we discuss frequently. Results from the survey show 19% of permanent nurses and 14% of per diem nurses intend to transition to a travel nurse role. Did they explain in the survey what may be factoring into nurses’ desire to switch to travel?

SCOTT: Absolutely. I think it showed that regardless of their nursing type, the primary reasons prompting a nurse to consider leaving the profession are the pursuit of better salary and benefits, along with job-related mental health issues, stress and/or burnout.

KRISTIN: That makes perfect sense. Now, there are a lot of useful insights in the Voices of Care survey we didn’t get to. We could probably spend all day talking about these results and digging deep into the numbers, but we are running low on time, so before I let you two go, is there anything important that we didn’t discuss that you’d like to mention? Patti, I’ll let you go first.

PATTI: So, I think it’s important that we recognize leadership’s hard, but it’s harder if you’re doing things that aren’t important for the people that you serve, and so I think the most important thing is really recognizing what are those pressure points for your team? And how with the limited resources that you have do you support them moving forward?

SCOTT: Yeah, and I would just add. It’s very important for us as a company to be able to share valuable insights like this with healthcare organizations across the country. Clinical job satisfaction and retention are huge initiatives that will make a long-lasting and meaningful impact on workforce challenge solutions and it’s going to take us all working together to create a better future for healthcare workers across the country.

KRISTIN: Most definitely. Thank you, Scott, and as I mentioned there are more great insights in our Voices of Care survey. If you’re interested in viewing the full results, please visit medical solutions.com we will also share the direct link in the description of this episode. Scott. Patti. Thank you both for taking the time to break down these numbers with me. Very, very valuable information.

PATTI: Thank you.

SCOTT: Absolutely. Appreciate the opportunity.

KRISTIN: And thank you to our listeners. Please join us every month as we unravel the complexities of healthcare staffing recruitment, sharing expert insights and actionable advice that can help you with your recruitment efforts. And again, please visit our website medicalsolutions.com for more information on our healthcare talent ecosystem and how we can help your facility reach its full potential. Thanks again, and we’ll see you next time.

KRISTIN: Hello and thanks for joining us for Staffing Unplugged, a Medical Solutions podcast that delves into the world of staffing and recruitment. Each episode, we bring you insightful discussions, expert interviews, and thought-provoking conversations with industry experts. I’m Kristin Dahl, your host, joined today by Matt Neel, Vice President of Allied Health, and Rebecca Mollak, Director of Client Success.

Thank you both for joining me today.

REBECCA: Happy to be here! Thank you!

MATT: Yeah, thanks for having us.

KRISTIN: Let’s start with some brief introductions. Matt, can you kick us off by explaining your role at Medical Solutions?

MATT: Yes. Matt Neel, Vice President of Allied Health here at Medical Solutions, and my role is to oversee both recruitment and sales of our allied health staffing teams. We deal with four main staffing divisions — cardiopulmonary, imaging, laboratory, and rehabilitation services.

KRISTIN: Alright. Thanks, Matt! And Rebecca, your title is Director of Client Success. Can you explain what that entails?

REBECCA: Yes. I’ve been with the company for about 14 years. Matt comes with a wealth of knowledge — going on 20 years, so congratulations this year, Matt. My role is specifically to talk to the clients, making sure that we are providing a white glove service. It’s important that we’re constantly pivoting and moving with the market the way that it is. My job specifically is to make sure that, operationally, we’re running smoothly and then to align initiatives with client success and our fulfillment team, as well as what the initiatives are of the client.

KRISTIN: Alright, perfect. Thank you, Rebecca! Well, today we’ll be talking about allied healthcare staffing and what you’re seeing as far as trends and challenges with the allied healthcare market. Before we dive into those questions, Matt, you kind of alluded to this earlier, but can you start by providing a high-level explanation of allied healthcare and which specialties we classify as allied?

MATT: Certainly. I will just start off with the disclaimer that some of our client hospitals may look at allied health a little bit differently, but at Medical Solutions we divide our allied health team into four main our divisions — cardiopulmonary, which includes respiratory therapists, and we throw some other specialties in there such as sleep techs and dietitians. It really is just to make sure we have a team covering those specialties. Imaging services or imaging is our largest division. It’s all imaging specialties to include some of the more popular ones like MRI techs, sonographers, CT techs, and nuclear med techs. Laboratory services is our other division. As it sounds, it is all lab specialties, so medical technologists, medical laboratory technicians, histologists, and cytotechnicians. Then, our last division is rehabilitation therapy and includes physical therapists and occupational therapists, but we also include pharmacy techs, as well as speech language therapists in that division. So, 37 specialties that we cover here at Medical Solutions, but we divide all 37 into one of those four divisions.

KRISTIN: Wow! That’s a lot! Thank you so much for breaking that down for us. So, when you’re looking at the market for allied healthcare professionals, how would you describe the current demand and how does that differ from what we’re seeing with nursing demand?

MATT: Sure. Demand really is like the four divisions. It’s a tale of four cities. So, when we look at what is in high demand today, it would be imaging services and rehabilitation therapy. For imaging, all specialties inside of imaging — all 13 that we categorize — are really seeing a higher than historical demand, especially post-COVID. It depends again on the context, but CT techs, for example, are seeing overwhelming demand right now. Across the nation, it’s not even regionally focused. Nearly every state is looking at high demand for CT techs.

Rehabilitation therapy is also seeing a high demand. I would not say it’s the highest that we’ve ever seen, but it is near-highest that we’ve seen, especially post-COVID, and it is for all specialties when you look at the therapist. So, as I mentioned before, it’s physical therapist, occupational therapist in all states, all regions. This is not abnormal. I guess if you were to look at rehabilitation therapy, but it is still in high demand, and it’s been that way for quite a long time.

On the other side of the scale would be our laboratory division. The lab today currently is seeing a relatively low demand, especially if you look at the time I’ve been with allied health — 20 years. It’s near a 20-year low as far as the demand across the nation. There’s a lot of reasons for that and I’m sure we could talk about that, but that is that’s the other end of the scale.

And then right where we would consider a normal market is cardiopulmonary and primarily respiratory therapists. It’s about what we would see for a summertime time frame for demand across the nation. Now, one thing with cardiopulmonary is that they do see seasonality, so as the winter comes along a little bit more influenza affecting the demand, we would see an uptick, but that’s a normal seasonal demand thing that we would see. Cardiopulmonary is right there as we as we look at the market today.

KRISTIN: Rebecca, I know you watch the market closely in your role as well so I’m curious from your perspective as well in which specialties are you seeing the most demand.

REBECCA: We’re seeing more demand within the imaging area, specifically. I’m more impressed that Matt, you were able to rattle off all those specialties without messing up, but, yes, we are seeing more demand within our imaging areas specifically. Matt hit on therapy a little bit. What we are seeing more is our post-acute centers have increased their need within post-acute and they feel like the older generation, we obviously must fill the vacancies within that. We have seen a decrease within our lab positions — a lot of those are going towards central localized lab and we think that is kind of why the demand has gone down there. But, certainly, most of our clients still need those imaging professionals.

KRISTIN: And can you also expand on what’s causing that demand and why we’re seeing higher demand for some allied positions than others?

REBECCA: Imaging, specifically. I don’t think there’s one rhyme or reason, but one of the main reasons that we’ve talked to and have been collecting data from is that there are more less invasive surgeries; therefore, this has caused the need for the imaging professionals and imaging testing to go up. And we need those imaging professionals to be able to run that equipment. So, with that we’ve seen an increase. If you think about it today, if you have a less invasive surgery, there might be 3-4 tests to be able to approve to do that less invasive surgery; therefore, the increase of demand and to be able to run that equipment.

KRISTIN: I’m also curious, Matt, how do you think the COVID-19 pandemic impacted allied healthcare demand, and is the market still recovering from any of those effects?

MATT: Yeah. I think what we saw in 2021-22 and into 2023 was allied did not see the overwhelming demand that nursing saw. Nurses obviously need to deliver direct patient care, so allied did not see the spike in demand during that time frame, especially in the height of the COVID time. In fact, we saw probably more of a cooling of the market because we needed all hands-on deck, especially for nurses to get out there and help those patients. During the recovery from COVID is really when we saw a lot of what Rebecca had described. People coming back. They needed those imaging services. They needed that MRI exam that they did not have before, or they might have put it off. It was important but it wasn’t exactly necessary or medically necessary.

So, we saw a lot of the rebound, and I think what we’re seeing is, as is with everything, an aging population. Imaging service is a is a very good diagnostic tool for physicians to determine the next course of action for patient care, so I think that’s why we’re seeing the overwhelming demand with imaging. I think with COVID we’re out of an after effect for COVID. I think what we’re seeing now is really a generational demand that’s back, and if we don’t have any other major issues across the country, we don’t see the demand cooling for some of these specialties. That’s good news for clinicians that are looking for work, looking to help clients. It puts a bit of a strain on supply and our ability to help clients is really where we’re going to see a constraint and especially in imaging. It’s such a hot topic that I don’t think that we can blame anything more on COVID today. I think it’s where we’re at with the country.

REBECCA: It’s fair to say our we had all-time high within the respiratory therapy division, cardiopulmonary during that COVID and I can see that we probably saw less demand over the last year within that area specifically but as we ramp up for more cold and flu season that area will also begin to go up again.

MATT: Agree. Yeah, you have good point, Rebecca, with respiratory therapists. We did see an overwhelming demand for that direct patient care with helping those patients to breathe and now that we are seeing that COVID is nearly non-existent in many places, that the demand has returned to what we would say is a normal market — A normal demand curve with that seasonality coming into effect that we really start to see normally pick up in late September or early October.

KRISTIN: Okay, great answers! Shifting our focus a little bit here, Rebecca, I know you work with healthcare facilities, and I’d imagine the high demand for certain allied positions is causing challenges for some of the facilities that you are working with. Can you share what you’re seeing from clients?

REBECCA: Yeah, we’re offering up strategies and they’re filling us in on some of the internal strategies that they have. A couple things that they have done that we’ve talked about being on site is that they are paying for some of the allied professionals to go to school. They’re also offering flexible work scheduling — different shifts than you would ever think, in 4-hour increments, being able to do more 8-hour days. The flex scheduling and flexible work environment is very popular right now with our younger generation of employees. So those are things that they’re also offering is ‘how can we let them enjoy the work and kind of be around them?’ so that’s kind of what they’re doing.

KRISTIN: Matt, are there any different challenges that you’re seeing from your perspective?

MATT: As far as the challenge that we have is really time. Everybody’s pressed for time. We understand hiring leaders at our client facilities are pressed for time and the clinicians are looking for a shorter timeline to make decisions. They’re having a lot of opportunities especially in imaging as we’ve mentioned and so they’re being offered a lot of opportunities across the country and it really is who can speak with them first and talk about their department, talk about reasons why they would want to come to that facility and help those patients out. Time is of the essence so I think that the time constraint on everybody is really pressing the market and the person who can move quickly usually has an advantage with being able to speak to that clinician get to know them, ask them the pertinent questions, allow that clinician to ask them questions and make a decision, to bring them on board their team and that’s probably the biggest thing that we’re seeing with our clients that everybody’s pressed.

KRISTIN: So, Rebecca, I’ll ask you — what are some tips that you have for those facilities who are looking to quickly fill those vacancies or even just need a contingency plan in place for unexpected staffing shortages?

REBECCA: Yeah, we need to be able to interview as quickly as possible. We are still in an environment where time cuts deals and so the faster that you can interview, call them, sell them on your facility, let them know of all the benefits that you have internally, that’s going to be for the better. The quicker we can get offers in place, that helps the clinician be able to accept the offer quickly. We are in an environment where the clinician may be sent out to ten positions, especially within our imaging space or pillar. So being able to quickly get them on the phone, determine if they’re a good fit clinically for your unit, and then make that offer is so very important right now.

Forecasting — we’ve also talked about that. We’re coming up into seasonality with the winter season. So, if you feel that you’re going to need respiratory therapists, now would be the time to look at it and say: ‘How many did we need last year?’ What did we go through?’ Ask your partner, whether it’s FocusOne or Medical Solutions Plus, your MSP, and partner with them. Ask them, you know, ‘What did we see last year?’ ‘What can we help forecast for extensions?’ If we know that we’re going to need imaging professionals, CT, x-ray — all of them, let’s get them extended now throughout the holidays. We’re seeing lots more six-month extensions. We’re seeing 4- or 5-month extensions. We’re seeing longer contracts. We need to be able to keep them there for as long as we can. So, those are just a few things that we can do as a partner to be able to help you to make sure that these next few months, we don’t see as much need.

KRISTIN: All great advice. Well, you’ve both been in the industry for quite some time and I’m sure you’ve seen the market change. I’ll start with Rebecca. How do you foresee the future of traveling allied healthcare roles evolving in the coming years?

REBECCA: Yeah. I don’t see much of a change with imaging. I think it’s going to continue to go up. I think we all are evolving into a tech world. We’re starting to see more AI on the nursing side. We’re going to see that too. I do see with labs specifically, more hospitals adapting to a one- source lab, which will cut into more of that lab demand. I see therapy — I continue to see it go up within our post-acute centers. Our older generation, we’re going to have to help them. The more less invasive surgeries that you have, the more therapy you need after the surgeries, and so I see those continuing to stay stagnant or going up. I foresee that imaging is going to continue to be a demand and that we’ll just continue to see that rise.

KRISTIN: And Matt, is there anything that you’re looking forward to or excited about when it comes to the future of allied staffing?

MATT: Well, I would say it’s always exciting for us to know that we have an ability or will have an ability for the future to help our clients. We realize that there’s a lot of focus on nursing out there and it’s understandable that nurses directly impact patient care — there are certain ratios that need to be there and that’s a very important role. When it comes to allied health, we’ve kind of flown under the radar a little bit, especially in the past, but with the demand rising, we recognize that we need to be at the top of our game. When it comes to talking with clinicians, getting them prepared, and getting them prepared for the environment that they’re going to be faced with. There are a lot of a lot of people asking for their help and there’s not enough of them to go around so it’s exciting to be able to know that we’re going to be an important part of the solution for our clients, but also a little bit nerve-wracking to know that there’s going to be a lot of pressure on us.

I agree with what Rebecca said. I think the demand is going to be consistent and it’ll be up to us to make sure that we’re talking with those clinicians, preparing them for the questions that the clients will ask and deciding quickly so those clients can get on with their day. So, I think that it’s exciting to be part of the solution. It’s exciting to be more a little bit more into the focus but we’ve got to make sure that we’re holding up our end of the of the deal.

KRISTIN: Alright perfect. That’s a great note to end on. Matt/Rebecca, thank you both for joining me today to share your insights into allied healthcare staffing.

REBECCA: Thank you very much for having us.

KRISTIN: And thank you also to our listeners. Please join us every month as we unravel the complexities of healthcare staffing recruitment, sharing expert insights and actionable advice that can help you with your recruitment efforts. Please visit our website medicalsolutions.com for more information on our healthcare talent ecosystem and how we can help your facility reach its full potential. Thanks again, and we’ll see you next time!

KRISTIN: Thanks for joining us for Staffing Unplugged, a Medical Solutions podcast that delves into the world of staffing and recruitment. Each episode, we bring you insightful discussions, expert interviews, and thought-provoking conversations with industry experts. I’m Kristin Dahl, your host, joined today by Kevin Walsh, Vice President of Client Success at Medical Solutions. Thanks for joining us today, Kevin.

KEVIN: Thanks, Kristin, for having me on.

KRISTIN: Can you start by telling us a little bit about your role at Medical Solutions?

KEVIN: Yeah. As the Vice President of Client Success, I oversee the account management team. That includes our MSP, FocusOne Solutions and all our direct and third-party client relationships. Our focus is on ensuring client satisfaction through timely job fulfillment, relationship management, and alignment of strategic goals to create a seamless client experience.

KRISTIN: And your title says it all—Vice President of Client Success—so what are some of the things healthcare organization should be aware of in order to find that success?

KEVIN: I immediately think about clinician quality and talent acquisition and retention strategies. The last few years, the focus on cost reduction has overshadow the importance of attracting and retaining the right clinicians. Clinicians are demanding flexibility and they’re increasingly mobile, especially with the expansion of the compact licensure, so things like burnout, decreased job satisfaction, and high turnover ratios can contribute to a decreased level of patient care. Healthcare organizations should prioritize creating an appealing workplace through a strong culture, transparent leadership, growth opportunities, and fair compensation. It’s not just about paying the most but creating an environment that makes people want to come back. The number one focus should be on retaining the talent you have, but you also need to make sure that you have strong recruitment support, whether that be permanent or contingent labor. You need to help supplement gaps with top talent.

KRISTIN: And you mentioned clinician burnout. That’s a big issue that could factor into retention so can you talk about some of the things organizations can do to cut down on burnout?

KEVIN: In a recent webinar with Medical Solutions, Don Sull, who is a professor at the MIT Sloan School of Management, shared research on nurse attrition. He talked about identifying unhealthy subcultures in your organization and then learning from staffing agencies whose best practices typically center around treating clinicians like patients or customers and this helps employees feel a greater sense of value and belonging.

Also Patty Artley, Medical Solutions CNO, has extensive bedside and nursing leadership experience and she advocates for enhancing staff retention by prioritizing flexibility. She often discusses the importance of creating an environment that is accommodating to a diverse set of workers at different stages in their career. Think, for example, shorter shifts for senior team members or working mothers. This allows for a more balanced work-life dynamic. And adding this level of flexibility helps you retain workers that you might have otherwise lost.

KRISTIN: Kevin, overall healthcare organizations are dealing with issues across the board, especially coming out of a worldwide health pandemic with a nursing shortage. Can you discuss why it’s so important to address staffing issues and what happens if you don’t?

KEVIN: I think it’s simple. Neglecting issues like burnout or high staffing ratios can compromise patient care; it decreases morale; it creates operational inefficiencies, and results in a financial strain which ultimately impacts the health system’s reputation.

KRISTIN: Absolutely, and what you’re describing kind of sounds like a domino effect when at the end of the day quality patient care should really be the number one priority.

KEVIN: 100%. Patient care is the foundation of trust and satisfaction that any community is going to have with a healthcare system.

KRISTIN: Moving on now from all those challenges, I’m curious—What are some of the positive trends that you’re seeing that make you excited about what might still be to come for healthcare staffing?

KEVIN: I’m excited about the continued influence of technology in healthcare staffing. We rolled out our cero platform to our clients and our clinicians. This improves our ability to make quality candidate matches. It provides enhanced data analytics, and it streamlines the onboarding process. I also see this leading more to self-service options which align with what many clients are looking for these days. I’m also an advocate for transparency. It’s exciting to see our industry increasingly embracing visibility and openness among organizations. Misinformation often stems from a lack of understanding, and I believe that our service benefits both clients and clinicians and we bring significant value and the more openly that we can demonstrate that value, the stronger our partnerships become.

KRISTIN: And Kevin can you expand on that? What are some of the specific things that we’re doing to integrate more transparency into the industry?

KEVIN: Transparency is everywhere. Especially in client and clinician rates. Contrary to previous assumptions, agencies don’t set bill rates. The market trends guide the decision making and clients control the cost by continually adjusting rates and our data platform provides extensive information and helps clients make informed decisions that align with their goals. Then, on the clinician side, clinician pay rates are accessible on our website. Everybody can see them. I just see both scenarios as positive shifts in our industry.

KRISTIN: Do you feel the increased transparency has led to any changes with how the industry operates overall?

KEVIN: We’ve identified cost savings by adjusting rates for clinicians who live near client facilities. We previously avoided working with any individuals that lived within a specific distance to prevent the use of traveler rates for local talent and adjusting that philosophy has helped us maximize regional talent utilization for our clients which delivers a financial benefit to them. Then, adding visibility here helps them prioritize temp-to-perm conversion targets.

KRISTIN: And to me that sounds like a win-win for both clinicians and healthcare organizations.

KEVIN: Yeah, absolutely. The way we see it, clinicians in your geographic area, that’s your workforce and if you need our help in mobilizing them, we’re here to do that.

KRISTIN: And before we end today, I feel like I’d be remiss if I didn’t ask you about AI. It seems like the big topic that everybody is talking about, so what are your thoughts on AI and staffing?

KEVIN: AI can transform staffing by automating manual processes. It frees up teams to focus on the high value, human-centric actions. It’s a little bit cliche, but people say instead of replacing people, AI is going to shift the tasks that they perform. So, think of how much time a recruiter spends reviewing resumés or collecting onboarding paperwork. AI can create efficiencies in those areas and that’s going to really lead us to re-evaluate which skills are most important in those roles.

KRISTIN: Well before I let you go today, is there anything else you’d like to mention that I haven’t already asked you?

KEVIN: Just that our commitment to services, strategy, and technology will continue. Our goal is to leverage the tech advancements as a way of enhancing the human touch-tailored solutions that we’re known for.

KRISTIN: Perfect note to end on. Thank you so much for joining us today, Kevin.

KEVIN: Thanks for having me.

KRISTIN: And thank you to our listeners. Be sure to join us every month as we unravel the complexities of health care staffing and recruitment, providing expert insights and actionable advice to help you with your recruitment efforts. In the meantime, visit our website medicalsolutions.com to learn more about our healthcare staffing ecosystem and how we can help your facility reach its full potential. Thanks again. We’ll see you next time!

KRISTIN: Hello, and thanks for joining us for Staffing Unplugged, a Medical Solutions podcast that delves into the world of staffing and recruitment. Each episode, we bring you insightful discussions, expert interviews, and thought-provoking conversations with industry experts. I’m Kristin Dahl, your host, and I’m joined today by Chase Farmer, Chief Commercial Officer at Medical Solutions. Thank you for joining me today, Chase.

CHASE: Thanks for having me.

KRISTIN: On our show, we like to discuss successful staffing strategies, and that wouldn’t be possible without a strong executive team. Can you start by telling me a little bit about your role at Medical Solutions?

CHASE: Sure. I serve as the chief commercial officer. The commercial team is really responsible for solutions design. I probably categorize that into two different forms. The first is working with a prospective health care organization who is either looking for a first-time partnership, maybe looking to replace an existing partnership, or to find an organization to help them to achieve a set of goals or objectives. The second category would be an existing Medical Solutions’ customer. Most customers will partner with Medical Solutions with a set number of objectives or goals to achieve, but as the organization matures and continues to evolve itself it also needs the partnership with Medical Solutions to continue to evolve.

KRISTIN: Perfect, and since this is our first episode we really wanted to give our listeners an introduction to Medical Solutions so can you talk a little bit more about what the company is and what we do?

CHASE: Sure. Medical Solutions is one of the largest healthcare staffing firms in the United States. What that really means is we work with client partners to help find them great people and at the same time to work with our clinicians to help them find great organizations to work for. Our mission is to connect care and the way that we really focus on that is through the partnerships with hospitals across the United States. We have offices from coast to coast. We work in all 50 states and our dedicated recruitment group with which works with tens of thousands of clinicians, nurses, and allied professionals alike to find them their next either full-time, permanent position or if they’re interested in short-term contract labor.

KRISTIN: I know a lot of people hear “staffing” or “agency” and they may have an idea of what that looks like but can you explain how Medical Solutions differs from a traditional staffing agency?

CHASE: Sure. Medical Solutions has been around for a little over 20 years, and I think in the original origin of Medical Solutions it probably did answer that as a staffing agency. I think the thing that has really driven the success at Medical Solutions is not only our people but a real drive for innovation and as we work with these organizations, as they become more sophisticated and larger and are looking for a more sophisticated or robust partnership that innovation is what really drives Medical Solutions and in doing so Medical Solutions has actually created the first healthcare talent ecosystem and that’s really a big piece of focusing on the strategy and the services that clients are looking for from a partnership. I think the COVID-19 pandemic maybe made that necessary for some agencies to kind of evolve and offer other services aside from what they were offering before.

KRISTIN: To expand on that a little bit, could you explain what are some of the advantages of a healthcare ecosystem as opposed to a traditional staffing agency?

CHASE: Yeah. In a traditional staffing partnership, organizations are really faced with a situation where they come up with a need turn the need over to a staffing partner and the staffing partner does what it can to help in a transactional type of partnership – they need the request, and they try to meet the request. Rather, an ecosystem is focused not only on the aspect of staffing but really focused in on the strategy and that strategy often incorporates is understanding not only how to fill a position but why is the position needed to be filled and what can be done to reduce an organization’s reliance on a traditional travel contract. That’s where Medical Solutions has really come a long way in building out the number of services that we provide. An ecosystem is not just about a travel contract relationship. For instance, Medical Solutions provides services of not only travel, but also local. We offer permanent direct hire solutions as well as international solutions and together those two pieces both the strategy and the services really allow Medical Solutions to have a more prescriptive approach to the partnership with these organizations help them to control cost better help them to have more efficiency more effectiveness in what they do and really looking towards the future of what the goals and objectives of that organization are when it comes to staffing bedside care.

KRISTIN: It seems like a win-win for everyone involved.

CHASE: Absolutely.

KRISTIN: Switching gears now, you’ve been with Medical Solutions for 14 years. Can you tell me how has the company changed over that time?

CHASE: Sure. It’s been a lot of change not only for Medical Solutions but really the industry as a whole. When I started back in 2009, Medical Solutions was a boutique staffing firm, and I think that the way that organizations use contingency sort of the  why and the how, I think that’s the biggest change that we have seen and what I really mean by that is the why start with the why so the why on how organizations were using a partnership like Medical Solutions was looking for short-term coverage if and when they had something like an FMLA or a department was just short staffed really kind of more of a of a transactional relationship and as the organizations and as the industry has gotten more sophisticated then so too has the way that Medical Solutions works with those clients. So if you think about the way that Medical Solutions approaches it today, we’re not just focused on something like FMLA coverage but a real strategic partnership in trying to achieve the objectives of an organization. A great example of that might be an expansion project. An organization could add a new department say a cath department in a relatively rural area where they don’t have the equipment or the staff to maintain that cath lab so they either lease or acquire the equipment move it into space that hasn’t been utilized and then an organization like Medical Solutions can help in come to provide whatever they might need from a staffing perspective: mid-levels, nurses, techs, etc. Then is to open up and to create a great opportunity for that organization in a market that maybe didn’t have the capacity or capability to provide cath lab services to that community and now they can. You can see a real transition in the strategy on why an organization uses a partnership like Medical Solutions. The other half of it is the how and I referenced managed services so Medical Solutions is one of the largest MSP or managed service providers in the industry and what that really allows Medical Solutions to do with its partners is to centralize and streamline any of the interactions with outside agencies that an organization might need to have. It allows them to centralize through a single contract, a single procurement process. Pricing can be standardized, protocols and processes to onboard the clinicians can be standardized, billing, etc., can all be standardized so the industry has really changed a lot in the last 20 years. A lot of innovation, a lot of technology improvements, and I think organizations like Medical Solutions are really the ones driving that forward.

KRISTIN: That does sound like a lot of change. What has it been like for you to witness that growth and change over the past 14 years?

CHASE: Incredible. It’s a lot of work and certainly a lot of challenges to be faced, but solution design and its heart that’s really what the commercial team is about. It’s the piece of it that I love the most to sit down with an organization, to sit down with their leaders, to understand the specifics of their problems and what their goals are to come out of that. Certainly, we see a lot of the same themes running through organizations, but there is always a level of unique expectation or unique circumstances that each organization will bring into the partnership and that’s really the part that I love personally is working with the organization understanding the challenges, understanding the goals, and then building out a solution to be able to achieve that. It’s been incredibly rewarding. I don’t think very many people have had the privilege of working for an organization that is so focused on its people, so focused on innovation and that the work that we do every day really means so much. I mean it’s bedside care that we’re talking about, and we’ve had an incredible journey to this point and really looking forward to what comes next.

KRISTIN: Absolutely and speaking of continuing that journey ahead, we just started a new year so what are you looking forward to the most for the company this year?

CHASE: We are on the cusp of some innovative services and strategies that we are going to be bringing to customers this year. I would say that one of them that I’m most excited about is the recent update and release of our new technology platform which is called cero and the capabilities of this technology and what it will allow organizations to do. For instance, to use the technology not only to manage the part partnership of its staff through Medical Solutions as a partner but also to use that technology within the organization itself to manage its own float pool, for example. The technology has a number of different sequences that we’ll be releasing over the coming months so just really excited about what technology we’re bringing to the market and how that will help to influence and to really provide access to the organizations to streamline their processes. That’s probably the most exciting thing for 2024 for Medical Solutions.

KRISTIN: Absolutely, it sounds like it and that is also a great note to end on, so I just want to thank you so much for joining me today.

CHASE: Thank you very much for having me.

KRISTIN: Of course. And thank you to our listeners. Please join us every month as we unravel the complexities of healthcare staffing recruitment, sharing expert insights and actionable advice that can help you with your recruitment efforts. In the meantime, visit our website medicalsolutions.com for more information on our healthcare talent ecosystem and how we can help your facility reach its full potential. Thanks again, and we’ll see you next time.