The Business Challenge
With the onset of the COVID-19 pandemic,
the family of organizations that make up the Providence healthcare system faced
a severe shortage of healthcare workers. Long before the pandemic hit, myriad forces
had been at work that portended a crisis-level talent shortage in healthcare. Specifically,
enrollment of students in nursing schools had been nowhere near the rate needed
to meet current and future needs. Compounding this, nursing schools across the
country were struggling to expand capacity to meet the rising demand for care in
view of the national move toward healthcare reforms.
In addition, nurses had been
leaving the workforce in
significant numbers in the U.S.; doubling in the past decade from 40,000 in
2010 to an estimated 80,000 in 2020, due in part to a significant segment of
the nursing workforce being close to or nearing retirement age.
Then came COVID-19, which only
served to exacerbate the existing strain on the healthcare talent
Founded in 1859, the Providence health system operates 51
hospitals, more than 1,000 clinics, and a comprehensive range of health and
educational services across Alaska, California, Montana, New Mexico, Oregon,
Texas, and Washington. Providence is committed to advocating for vulnerable
populations and its leaders are passionate about driving needed reforms in
While Providence leadership at
the local and system levels had been at the beginning stages of revamping how
they build, grow, and retain talent prior to the pandemic’s onset, this effort
needed to accelerate to ensure they could successfully meet the needs of their
patients and communities.
“We’ve been planning for the
future of work, workforce, and workspaces for a long time. And despite all the catastrophic
impacts COVID-19 has brought with it, one silver lining—at least in
healthcare—is that it has probably accelerated our progress in a lot of these
areas by at least five to 10 years.” says Greg Till, Chief People Officer at
The Institute for Corporate
Productivity’s (i4cp) recently published 2021 Priorities and
Predictions report confirms that
high-performance organizations are 2x more likely to prioritize talent
mobility than low performance organizations. Further, the research found
that the ability to move talent (as well as innovative ideas and critical
knowledge) across an organization’s ecosystem can help build, develop, and
sustain bench strength in critical roles, establish and strengthen key
interdependencies, and break down destructive silos.
Building an Internal Talent Marketplace
With a view of this landscape and
the added burden of COVID-19, Providence was able to accelerate the development
and use of an internal talent marketplace. i4cp’s research indicates
that high-performance organizations view talent as enterprise-wide team members
rather than belonging to a leader, team, or business unit. In addition, high
performance organizations make intentional internal mobility a priority.
Till explains how Providence was
able to leverage these practices: “We partnered with our clinical, functional,
and operational leaders to define the critical skills and capabilities that
would help our facilities deal with the pandemic effectively. Then, we did our
best to assess which of our 120,000 caregivers had those skills, regardless of
where they served.”
The approach Providence took was
to fully deconstruct and then reconstruct all components of their talent
management system with a focus on flexibility and agility to ensure local
facilities’ urgent needs were met. An internal talent agency mindset was
adopted to handle dynamic shifts in demand more quickly and effectively.
To that end, an internal team
developed and sent a survey to each Providence caregiver, asking them to
provide information regarding their certifications and current qualifications.
The collected data, which was binary (one either has the skill or not) was then
manually collated into a low-tech database.
To utilize this data, an internal
talent marketplace committee was established comprised of 75 people who in
total represented each health care facility. This committee, whose goal was to
assess needs across the system and ensure each had caregivers with the needed
skills available to meet dynamic demand, initially met several times per week
to review the current status of each site. A smaller team then took this input
and developed a “red/yellow/green” assessment. When there were sites with a
forecasted red or yellow (immediate or near immediate need of certain skills),
those with the skills needed were redeployed to those sites until the urgency
Says Till, “From the very start,
everyone had the same goals—provide exceptional compassionate care where needed
in our communities and ensure all of our caregivers had meaningful work, even
those in facilities that saw a significant decrease in volume at the beginning
of the pandemic.”
Collaborative relationships with
organized labor and the temporary relaxation of government restrictions
supported this approach, allowing caregivers to be temporarily redeployed to
the areas of highest need.
Building on these manual
processes, Providence applied advanced analytics, using historical patient
volume, COVID-positive rates, retention statistics, and other data to effectively
predict staffing needs several months in advance, which not only ensured each
site had the support needed, but also reduced vacancy, agency expense, and
additional overtime for caregivers who were already working incredibly hard.
goal of developing Providence’s internal talent marketplace was to ensure all
caregivers had and continue to have the opportunity to work in roles they feel
“called” to do. Says Till, “Ensuring caregivers are able to do the work they
love is one of the primary contributors to job satisfaction and personal
fulfillment. People find meaning in work they are call and trained to do. Every
minute a nurse, pharmacy tech, or finance analyst spends doing work they feel
is ’below their license,’ is wasted—it contributes to lower engagement, less
connection to the meaning in work, and creates excess cost.”
Further, Till shared
that prior to the development of the internal talent marketplace, it took a highly
skilled nursing manager several hours to create a bi-weekly schedule. Using the
input of the predictive models referenced earlier, several Providence facilities
are now piloting a ‘schedule optimizer’ which automates the task of taking all
the information about patient demand and workforce supply, caregiver preferences,
and other criteria to create the schedule. What used to take several hours now
takes less than a minute which means the nursing managers can turn their
attention to the work they are most passionate about.
More HR Innovation
Resistance to hiring before a
need presents itself is not uncommon—but using the data described above,
Providence has been able to demonstrate the benefits of doing so. Because their
facilities now have data that allows them to predict demand in advance, they
can post roles ahead of the need, ensuring they are scrambling to meet hiring
needs much less often. Till says that, for instance, if it’s already
established that it takes an average four months to hire an ICU nurse at a
particular facility, they shouldn’t wait until someone gives notice to start their
By hiring ahead of the need,
Providence has been able to show that this approach ultimately is more cost
effective as it reduces overtime, external agency utilization, and the need for
patient deferrals—and at the same time increases caregiver engagement.
Till is also focused on turning
HR into a revenue generator rather than a cost center as is historically the
case. While they are still in the early days of this effort, Providence is in
conversations with a number of large organizations that are looking to enter
the healthcare space with the goal of creating a saleable and monetized product
that other companies would be able to use to design and develop their own
internal talent marketplace.
Till noted that while leaning on i4cp’s
Talent Ecosystem Integration Model™ to drive the development of an
internal talent marketplace has been very beneficial, healthcare is an industry
in which the collection of skills and certifications are easily assessed (one
is either qualified to intubate patients or not).
Skills and certification
collection can be much more complex where responses aren’t as clear and/or
might require a qualitative element (i.e., leadership effectiveness). However,
organizations regardless of type, size, geography, growth stage or focus can
benefit from utilizing the i4cp model to ensure all areas of the talent
landscape are being reviewed, the right questions are being asked, and no
element is overlooked.
It is also worth consideration
that talent leaders not wait for complex systems or advanced technology to get
started on building an internal talent marketplace. It may be enough to have an
internally built and administered survey and access to basic spreadsheet
software (i.e., Excel) to get started while simultaneously investigating
technology solutions that will scale.
The pandemic and the other
disruptive events over the past year have pushed many organizations to make significant
changes that must be executed at lightening-speed and to adopt new ways of
thinking about talent—perhaps before they were ready. Now that we are here, it
may be time to leverage the burning platform that has presented itself and take
some real steps toward new ways of managing talent.
use of an internal talent marketplace is a next practice in innovating
solutions to business challenges; i4cp defines next practices as strategies
that show correlation to better market performance but that are not yet widely
adopted. Typically, next practices are applied more often by high-performance
An internal talent marketplace is one of six
key components of i4cp’s
Talent Ecosystem Integration Model ™.
Click the link to view other case studies that bring this model to life.
Kari Naimon is a Senior Research Analyst at i4cp.