Q&A With Providence on Their Record Year of Healthcare Hiring

We sat down with Mark Smith, Providence's Insights, Optimization, and Staffing Executive Leader, to discuss Providence's record year for healthcare hiring. Hiring in healthcare can be challenging—the competition is fierce and turnover is rampant. But, with a new strategy in place, Providence is approaching their pre-pandemic rates of retention. 

Visier: In 2023 Providence filled 33,000 positions, representing a 15% increase compared with 2022. You've also seen a 20% increase in retention. How did you achieve these results? 

Mark Smith: We looked at opportunities late in 2022 to carry forward into 2023 and beyond and we wanted to ensure that we were intentional about placing our primary focus on retention. We set leadership incentives around retention rather than—what we've historically done—around caregiver survey results. Our priority was to ensure that we kept the great people we already had. We set a big goal to bring turnover back toward 2019 trends. Doing that would help us in our next quadrant—recruiting for new talent. 

Recruitment will always be a priority for us. We have to be mindful that we cannot hire our way out of the workforce reality, so we have to a balance approach to our workforce equation.

Q: How did you achieve that balance? 

A: We created scorecards for leaders so they could see how their line of business is performing against set metrics. And we've taken it beyond reporting turnover. We can see thresholds so leaders can see and understand how they're performing against expectations.

We know that many leaders, not just our human resources leaders, are regularly checking the trends. 

Having that combination of leadership buy-in, initiatives that support retention, and being able to monitor our progress has been part of the formula to achieve what we've achieved in 2023. 

Q: Was there a triggering event that spurred this initiative?

A: The reality of healthcare hiring is that there are at least two job openings in the US for every qualified healthcare worker. And we also know, in many instances, there's a significant skills gap between what's available in the workforce and what's required in the job, so we have to be intentional about how we think about the workforce. If we want to grow our caregiver headcount, the erosion can't outpace the gains in hiring. 

Like others in health care, we were seeing too many months in 2022 where more people were moving out than coming in. We always have a pulse on this by observing caregiver demographics and our caregiver movement. And this data showed us that we would have to focus on retention and recruitment simultaneously. 

Q: You targeted lowering your vacancy rate this year. The year started with a vacancy rate of 11.2% and as of October is sitting at 7.74%—explain your progress there. 

Looking at factors like agency use and vacancy rates, we prioritized 12 departments across five hospitals, which we call ministries, where we felt we could make an impact through focused recruiting efforts over a 90-day period. Our Talent Acquisition team worked with local nursing and human resources leaders to develop plans. Together, we met or exceeded the target in four of the five hospitals. 

We’re committed to filling positions, and we recognize that speed is important. To that end, we set targets around the speed of posting requisitions, extending job offerings, and getting caregivers started. We’ve made progress in all three areas this year. In October of 2022 we filled jobs in about 43.5 days. Now, in October 2023, we're filling positions in approximately 33.2 days. It’s a reflection of how we’ve improved processes related to job posting, job offers, and clearing candidates to start work.

Q: So you committed to measuring what matters and then consistently tracked your progress, making data-informed decisions along the way. That’s what moved the needle for you?

A: Yes, I start every morning checking turnover, vacancies, fills, requisition time metrics, and candidate offers. And I'm looking at our caregiver headcount to understand whether we're growing or shrinking. Knowing that I can go to Visier and look through that continuum is helpful for me, and I believe it's helpful for our HR leaders and the leaders they're working with.

Q: What are the next priorities for the Providence team in 2024 and beyond?

A: What we'll see from Providence moving forward is a lot of intentionality in simplifying jobs. We want to understand what's essential in a job, what qualified looks like, what an apprenticeship program can look like, and more. We can only do these things if we have the right data. We can't simplify jobs without a really good understanding of the data that leads to what qualified looks like. We really can't begin to prioritize where we can automate without some understanding of which tasks can be automated or where work can reside. So much of what we'll do in the future starts from a foundation of having the data that we need to begin to unlock possibilities.