Iman Abuzeid MD, CEO of Incredible Health and David Jones, CHRO of Stanford Health Care spoke in a no-holds-barred conversation titled “How to hire and retain top nurses during COVID-19 and beyond.” It was hosted by Becker’s Hospital Review. We firmly believe that bringing some of the top minds from the healthcare industry together can help us move forward on the topics of nurse hiring, retention, and margin expansion.
Leaders presenting on hiring and retaining nurses:
David Jones: With over 30 years of experience as a Chief Human Resources Officer, David has led several large-scale organizational change and HR transformation efforts. He has a strong track record of driving business results through the development and execution of Human Resources strategies in diverse industries such as e-commerce, financial services, academic medicine and health care. David came to Stanford Health Care in January 2017. He and his team have embarked on redefining and transforming the HR function to fundamentally shift how HR Services are provided, how to leverage innovative technology, and deliver a preeminent employee experience.
Iman Abuzeid: Iman Abuzeid is the Co-founder and CEO of Incredible Health, a career marketplace whose custom matching technology offers hospitals the fastest, most effective way to hire qualified permanent nurses in less than 20 days (national average is 90 days). Incredible Health is on a mission to help healthcare professionals live better lives, and find and do their best work. Incredible Health is based in San Francisco, backed by top tier venture capital firm Andreessen Horowitz, and is used by hundreds of leading hospitals across the country, including Cedars-Sinai Medical Center, Stanford Healthcare, Baylor Scott & White and many more. Iman is a MD, and holds an MBA from The Wharton School of the University of Pennsylvania.
Overview of the market for employers hiring nurses
The supply of, and demand for, nursing talent is increasingly unbalanced. The United States needs more nurses than ever to help care for an aging population. But the number of nurses has not kept pace with the demand. In fact, U.S. hospitals will face a shortage of over 1 million nurses by 2024. This trend is the largest employment crisis in the country.
We already see impacts of the nurse staffing crisis. On average, it takes a hospital 82 days to fill a permanent, specialized nurse position. Additionally, 17% of nurses leave their job every year. This nurse turnover rate is at record levels across the country.
Hospitals have adapted to these challenges by paying more overtime to their existing nurses and paying a premium for travel nurses. As a result, the overall amount of money dedicated to paying nurses’ salaries has increased. Unfortunately, the quality of care has declined at an accelerating rate. Because hospitals are understaffed, there is increased risk of medication errors and readmission rates. There is also a negative impact on nurses. Nurse suicide rates are at all time highs. More nurses report burnout, and job satisfaction is at all time lows.
How algorithms help hospitals hire nurses faster
Incredible Health built custom-matching technology hospitals use to hire high quality permanent nurses in less than 20 days. In order to do this, Incredible Health’s software collects dozens of data points from both employers who are hiring nurses and nurses who are looking for a job. Then, the algorithm matches nurses with employers who are a good match for each other. There is also a pre-screening algorithm that checks for nurses’ skills, experience, licenses and certifications to ensure they meet all the job requirements.
Another feature of the Incredible Health hiring platform is employers apply to nurses instead of the other way around. Nurses love this. They simply need to create one profile and have the power to accept or decline interview requests from employers. Nurses who use Incredible Health to find a job attain, on average, a 17% salary increase and 15% reduction in commute time.
The results of this technology-based solution is stunning. Hospitals who use Incredible Health’s matching technology increase their nurse hiring efficiency by 25x compared to traditional job boards. They also fill their nursing positions 3 times faster than the national average, in under 20 days.
The primary challenges to hiring nurses at Stanford Health Care:
- The nursing shortage: While all nurses are in high demand, very specialized nurses (ICU, OR, etc) are particularly in high demand. While there are new graduate nursing programs at our hospitals to help address this gap, it is insufficient to meet the hospital’s needs. In addition, we are seeing an aging nurse workforce and many of the most skilled and experienced nurses are on track to retire before the next generation of nurses is prepared to fill their shoes. The current prediction is that there will be a shortage of one million nurses by 2024.
- High cost of living: Nurses in many of the larger cities in the U.S. face steep prices for basic necessities such as housing and transportation. For example, even nurses in the San Francisco Bay Area who make six-figure salaries struggle to make ends meet when they’re faced with a skyrocketing cost of living.
- Nurse leaders are highly selective: Many nurse leaders have challenging expectations around the qualifications they expect nurses to possess. Our organization often requires a BSN, years of experience, and other criteria that significantly reduces the size of the available talent pool.
How hospitals adapted to address the challenges of hiring RNs
Top hospitals like Stanford Health Care have invested heavily in building a strong brand as being a top place for nurses to work. We have achieved this by building a strong training program for nurses, obtaining Magnet status, adopting technology that improved the efficiency of the hiring teams, and paying very well.
Hospitals who don’t have as strong of a brand as Stanford Health Care still have many levers to hire nurses. The first option is to embrace technology to help with sourcing, screening and hiring. Hiring nurses in a tough talent market is, by definition, high touch and relationship driven. But there are many repetitive tasks that can and should be automated so that recruiters and hiring managers can spend more time building relationships.
Examples of elements of the recruiting process that should be automated include:
- Identifying candidates who are a good fit for a role
- Pre-screening candidates for baseline qualifications
- Checking a nurse’s license
- Scheduling interviews with a recruiter or hiring manager
- Repetitive tasks in the Applicant Tracking System (ATS)
Recruiting activities that are still very human-driven:
- Providing a candidate with a very realistic view of life at the hospital
- Recruiters and hiring managers building a strong relationship with each other to understand current and upcoming needs, the realities of the talent market, and improvements to the candidate experience
- “Selling” the nurse on the upside of working at the organization
- Screening for soft skills that the hiring manager considers crucial to success in the organization
How to improve nurse retention at hospitals
Address work / life balance concerns to avoid burnout
The first step to creating work / life balance for nurses is to make sure we have a sufficient number of permanent nurses on your team. We use a hiring technology platform like Incredible Health to ensure we fill permanent positions quickly after there’s an open nursing position. Requiring nurses to work overtime makes a very negative impact on their job satisfaction and mental health so we plan in advance to ensure we don’t consistently ask our nurses to work extra shifts.
Create scheduling flexibility for nurses
Many nurses have numerous responsibilities in their lives besides just working as a nurse. For example, one nurse may need to take care of his/her aging parents. Another nurse may need to spend more time with his/her child. In response to this, some nurses may need the flexibility to work part time. Others may not want to be tied to working 3 days 12-hour shift schedule. Creating flexibility in our nursing schedules allows us to be a desired employer for many experienced and highly skilled nurses.
Foster nurse career advancement opportunities
Stanford Health Care is well known for an excellent career advancement program. There are several things we do that any other organization who hires nurses can replicate. First, we formalized a Professional Nursing Development Program (PNDP) and have formal mentorship programs, and special projects high potential nurses can volunteer for. We also encourage their nurses to obtain additional professional certifications.
Our leadership is also intentional about engaging nurses in decisions that determine hospital policies and procedures. By doing this, leadership can hear directly from people on the floor who work with patients and directly see the impact (either positive or negative) of new policies. By doing this, the hospital is in the 99th percentile of patient satisfaction and boasts countless awards and scores related to patient outcomes and nurse satisfaction.
In addition, Stanford Health Care has made a very intentional commitment to diversity in our nursing leadership. By intentionally focusing on diverse and talented nursing leadership, we have grown the ratio of diverse nursing leaders from 21% to 48%. We do this both by intentionally recruiting talented, diverse leaders as well as by developing and promoting the most talented leaders from within our organization.
How HR, talent acquisition and nursing can save hospitals money
First, it’s important that regardless of where team members are in the organization, whether they are a team leader or individual contributor, or in HR or nursing, that we each recognize that we’re a business leader. A hospital is a business, it has financials, there are targets, there’s a bottom line, and everyone on the team should have this mindset. In addition to providing world-class patient care, we’re also running a business.
Although some hospitals don’t have operating budgets as large as Stanford Health Care’s, every hospital can learn from our philosophy. Top hospitals take a long-term view on compensation. By doing this, we recognize that vacant positions and high turnover rates are incredibly expensive for the hospital. So ensuring we pay enough to hire and retain the top nurses is an investment that pays dividends for years to come.
As a result of COVID-19, individuals across all functions in a hospital are being asked to do more with less. Integrating technology into existing processes has provided a massive increase in savings. For example, integrating a hiring platform like Incredible Health allows hospitals to increase nurse hiring speed from the national average of 90 days, to less than 20 days. At Stanford Healthcare, Incredible Health enables us to hire experienced, specialized nurses in 21 days. This allows units to increase their patient capacity and reduces the hospital’s needs on prohibitively expensive overtime and travel nurse expenses.
Resources for hospitals looking to hire nurses
If you are interested in learning more about hiring and retaining top nurses, Just reach out to Incredible Health here and we’d love to walk you through a free 30 minute consultation to see whether we can help meet your needs.
