By Bethany Friedlander, President & CEO, NewBridge
PROBLEM STATEMENT
Chasing adequate staffing levels in hospitals has become a national health crisis. Without adequate staff hospitals are forced to cancel elective surgeries, patients are forced to wait for beds, and the continuity of care is sacrificed. Meanwhile, staff are burnt out which often leaves them considering alternative employment opportunities which further reinforces the turnover cycle and challenges that come with it.
The challenges around healthcare staffing are exacerbated when considering entry level healthcare careers; Patient Care Assistant (PCA), Environmental Services and Nutrition Services have some of the highest vacancy rates, and unfortunately the highest turnover rates. NewBridge, with the Healthcare Sector Partnership and powered by Arena Analytics, can reverse the spiral.
CONTEXT
Low wage healthcare jobs are highly segregated by race and gender, contributing to the racial and gender equity problem. This is especially poignant because of its impact on women, African Americans, and Latino populations. As of 2019 79% of workers in health services were women. Research further suggests that wages for these professions are suppressed because they are associated with “women’s work”. Additionally, black workers make up nearly one third of the entry level healthcare workforce, and we suggest that that percentage is even higher in urban areas such as Cleveland, Ohio. Because healthcare workers make up 12% of the entire labor force these occupations have a particular and powerful effect on all labor market dynamics.
Even when these positions are staffed in the hospital, the retention of this staff is low. The current turnover rate for hospitals in the North Central part of the United States is 28.6%. The cost of turnover and staffing gaps is well documented. For example when a hospital staff member leaves, the hospital must account for:
- Staffing costs in overtimes to cover shifts
- Continuity of care problems leading to lesser outcomes and patient dissatisfaction
- Training costs
- Staff workloads
- Accident rates
- Absenteeism
- Staff job dissatisfaction
Given that hospital staff is turning over every three years this leaves fewer resources for training and upskilling and fewer mentors and coaches. This leaves women and people of color in jobs that are less than family sustaining wages, job hopping, or out of the labor market entirely.
The environmental analysis of Cleveland mirrors the National data and reflects an even larger problem. Cleveland is currently the poorest large city in America. Yet despite the conditions of poverty, Cleveland is a healthcare focused city with over 300,000 healthcare jobs throughout Northeast Ohio. Healthcare and hospitals are the largest employers in Cuyahoga County and in Ohio.
THE GAME-CHANGING SOLUTION
To address these significant employment needs a group came together to form a healthcare sector partnership. The partnership includes our five largest hospital systems, funders, the Workforce Development board, educators, and nonprofits. New Bridge serves as the intermediary for this partnership, convening the partners, helping to set priorities, seeking funding for initiatives and programs, and compiling data.
NewBridge has proposed a radical idea, the use of AI to simultaneously address the hiring needs of all of the hospitals, to better communicate opportunities to the community, to increase the number of applications, and to increase retention of entry level healthcare workers. This has never been attempted citywide and holds vast potential to economically impact the city and to improve health outcomes and equity within the community. Our partner in this work is Arena Analytics, a technology company that uses predictive analytics, data science, and artificial intelligence to transform the way organizations identify, match, and hire people. Importantly, by providing objective, unbiased retention predictions through AI, that’s been field tested for more than a decade, Arena fills the gaps left by assessment tools.
Arena was specifically developed to empower healthcare organizations to:
- Increase Retention: Predict with confidence who will thrive in what role.
- Reduce Turnover Costs: Labor is the biggest operating cost driver for acute and post-acute care.
- Improve Care and Satisfaction: Satisfied staff provide better care, and enhance patient outcomes
HYPOTHESIS
What if an entire community is presented with opportunities across the hospital systems, and if the hospitals agree that job fit and retention helps health equity, and then true systemic change can occur?
What if this initiative will move the labor market in Cleveland across sectors, improve economic sufficiency and access to benefits, and increase access to education for our community members?
We contend that hospitals can and will invest in more training and upskilling opportunities if retention of entry level healthcare workers increases and hiring costs are reduced. Furthermore, individuals who are retained are more likely to take advantage of training opportunities, become eligible for advancement, and receive increased wages to help sustain their families.
How will we do this work:
Reduce or Eliminate Bias in Hiring
Arena’s technology platform uses AI and predictive analytics to focus on matching candidates with jobs based on outcomes rather than assumptions and historical approaches. Arena is able to significantly reduce bias by using a sophisticated adversarial fairness model that works alongside its retention prediction model to root out any potential bias which ensures a hiring pool that mirrors the applicant pool and the community at large.
Increase the overall number of applicants
We are currently building out a healthcare hub with funds from a sector partnership grant from the State of Ohio. This will serve as a one stop shop where an applicant can explore job openings for all of our hospital systems in one location. Arena will partner with New Bridge to develop a portal of high-turnover roles across all the hospital systems, embed the Arena Experience to then reveal only jobs where that candidate is expected to be retained. The platform will allow for a quick-apply feature and flag the candidate as an “Arena-Likely” candidate for the hiring team. This flag helps the hiring team to prioritize these candidates and ultimately impact retention in these key roles. This approach will open up the flow of candidates from community members who may never have known about, or did not think they were eligible for entry level healthcare jobs.
Increase Retention
Arena’s retention prediction model uses a wide variety of datasets specific to each individual role, organization, and location to predict the likelihood that a given candidate will be retained in a particular position. As evidence of this impact, one hospital system saw a reduction in turnover of 35% which correlates to an estimated savings of $19 million per year in hiring and training costs.
The Time is Now
This city wide, sector wide, solution has never been tried and will offer unique insight and processes that can connect community members to one of the largest sectors in the Country. Using AI to eliminate hiring bias and to specifically look at employee fit for position as well as hospital system, has the ability to significantly improve the quality of care, improve health outcomes, and diversify the workforce in healthcare.