The Imperative for Strategic Workforce Planning and Development: Challenges and Opportunities

A critical need exists to elevate the discussion about workforce planning and development
to ensure it becomes a standing, rather than crisis-driven, component of comprehensive
strategic planning for hospitals and health systems. Given the dramatic changes occurring
in the field, health care organizations should begin now to align workforce planning and
development with general operations as well as identify and employ innovative solutions
to traditional workforce challenges.

The workforce influences almost every aspect of providing high-quality care. Without
an adequate and appropriately trained supply of health professionals, the hospital
field will not be able to meet the needs of an aging population, care for patients in rural
communities, address and integrate behavioral and physical health and provide the
breadth of services our changing health care environment demands. With the rapid
evolution of the health care system, illustrated by the fundamental shifts in how care is
provided and paid for and compounded by hospital transformation and redefinition, an
urgent need exists to begin comprehensive workforce planning.

AHA’s Committee on Performance Improvement (CPI) recently engaged hospital leaders
and experts in the field to discuss current challenges and to identify key workforce topics
that will impact patient care delivery. Many challenges already exist and likely will be
further exacerbated as transformation continues and pressures mount.

The Current Health Care Landscape

The hospital of the future, led by today’s and tomorrow’s workforce, will continue the
promise of providing health and healing to those in need. However, this commitment will
extend beyond the traditional walls of the hospital and focus on better coordinated, patientcentered
care that advances the health of the community.

Numerous workforce challenges face the health care field today, including:
Regional workforce shortages

• An aging workforce and population
• Increasing diversity and inter-generational differences
• Rapid technological advances, including the use of telehealth
• Regulatory constraints
• Changing and new workforce roles
• Changing and growing consumer/patient demand for care

The current workforce is inadequately prepared to function in a transformed care
environment that often supports taking care of patients outside of the hospital. The
changing health care landscape requires new approaches to workforce planning and
development.

Building the Business Case for Workforce Development

Key steps for the board, CEO and executive leaders to take in building the case for
continued workforce investment include:

• Prioritize workforce planning and development
• Support a culture of engagement and trust among current workforce
• Communicate effectively with staff about how national health care challenges are shaping the organization and emphasize the critical role they play in that transformation
• Understand patient and community needs that impact your workforce needs, i.e.,
• “Who is the care team needed to address patients’ needs?”
• Identify long-term workforce goals and the investment needed to achieve them,
• understanding that a return on investment may not be achieved in the short term

Key Workforce Topics

The committee developed 10 key topics based on their discussions and input from hospital
leaders and experts:

• Rural communities challenged with recruiting health care professionals and providing needed education and training opportunities for existing staff
• The current inadequate supply of behavioral health professionals
• Enhancing the educational pipeline and strengthening partnerships between academic and medical institutions
• Recognizing and appropriately harnessing the potential of technology to meet future workforce needs
• Expanding community partnerships to improve workforce pipelines and collaboration among health care entities that bolsters community health and wellness
• Regulatory and policy constraints that impede the ability of hospitals and health
• systems to recognize the full potential of the current workforce
• The vital role of strong leadership to implement innovative change
• Ensuring a safe work environment as part of any discussion on workforce
• The need for a more diverse workforce at all levels – from senior leaders to incoming
• staff
• The vital role of human resources as workforce planning and development becomes a component of comprehensive strategic planning

Recommendations for Strategic Workforce Planning

Workforce planning and development also should assess the current and future needs of patients and communities, redesign the organization to meet those needs and ensure health care professionals have the appropriate skills and capabilities.

The committee’s report offered the following 12 recommendations for strategic workforce
planning:
1. Know your system transformation strategy.
2. Know your system model of care (and/or help create it).
3. Develop a workforce plan based on community needs and continuum model of care.
4. Know the timeline for implementing/transitioning various components of your
system strategy.
5. Develop an education plan for the different/new roles and  functions of your
workforce.
6. Create an overall transition plan and timeline for all areas of the care continuum.
7. Budget for staff education and training.
8. Budget for transitions to and from areas along the continuum.
9. Educate all leaders on your timeline, their roles and responsibilities in developing
a system-wide talent mapping process, development plans for staff and effective
transition plans.
10. Use provider skills and expertise in your talent mapping process.
11. Collaborate with other community entities.
12.Collect and use data; create dashboards to assess progress.

Additional resources and case examples are included in the full report, which can be
accessed at www.aha.org/workforce.

Discussion Guide for Health Care Boards and Leadership

• What criteria would we use to describe a workforce that is well-prepared for the future?
• How do we currently engage in workforce planning and development? How are we using workforce data and analytics to build our strategies?
• Who is responsible for workforce planning? How do we know whether it is working well? Who is responsible for closing any identified workforce gaps?
• How is workforce planning and development integrated into our organization’s overall strategic planning process?
• To meet our strategic commitments, what human resource capabilities will our organization need in three to five years?
• What are our organization’s overall leadership strengths? What are our leadership development needs and how are we addressing them?
• What do we know about our state’s/region’s/county’s workforce data?
• How are we investing in workforce planning? What percent of our total budget is spent on building workforce capacity?
• What training and development opportunities does our organization need to provide to ensure our current employees develop the skills we need?
• What is our budget for overall employee development? What results have our development investments produced?
•  How are we educating and training our current workforce to expand their capabilities to work outside of acute care across the health care continuum?
• What are the workforce planning implications of striving to improve the health of the community? How have we used our Community Health Needs Assessment to guide workforce planning and development in order to deploy care teams responsive to patient/community needs?
• How have we collaborated with community partners to:

1. Design educational opportunities?
2. Enhance recruitment efforts?
3. Engage in inter-professional education?

• What are our greatest risks in preparing to meet future workforce needs?
• How confident are we that we will meet our workforce needs in the coming year? In the next three to five years?

Kimberly McNally, MN, RN, BCC (kamcnally@me.com) is a trustee of UW Medicine; and president, McNally & Associates in Seattle, WA.
Veronika Riley (vriley@aha.org) is the senior director of the AHA Workforce Center in Washington, D.C.