Business person with Clinician
Speakers & Events September 21, 2023

AHA Innovators Connection Podcast

The American Hospital Association featured John Rothwell, Senior Vice President of Sales, Enterprise, and Strategic Solutions for AMN Healthcare, at the 2023 AHA Leadership Summit, July 16-18, 2023, in Seattle, Washington. Listen to the podcast recorded live at the event or read the following transcript to uncover insights on:

  • Predictive analytics to drive decision-making and proactive labor forecasting
  • Strategies that hospitals and health systems can implement for financial sustainability
  • Solutions for flexible, cost-effective care delivery 

Listen to the Podcast

Maggie McKay (Host): Welcome to a special AHA Innovators Connection podcast recorded live at the 2023 AHA Leadership Summit. I'm Maggie McKay, and with me is John Rothwell, Senior Vice President of Sales, Enterprise, and Strategic Solutions for AMN Healthcare. John is joining us today to discuss sustainable workforce strategy for hospitals and health systems.

John, thank you so much for joining the podcast.

John Rothwell: Oh, Maggie, it's my pleasure. Thanks for having me. 

Maggie McKay (Host): Absolutely. So John, how can hospitals and health systems be more proactive when it comes to workforce planning?

John Rothwell: It's interesting because workforce planning is the number one conversation that we're having in the market.

And the realization that providers are having today is that they're not being proactive. They're grasping that dichotomy of how do we leverage analytics to drive data driven decision making within an organization. And on a daily basis, they're looking at their staffing needs, their vacancies, and more often than not, they're running into an issue where they have not necessarily even days, sometimes it's just hours to go fill some positions.

And they're offering incentives and those are working, but those incentives come with added cost. But more importantly, it's causing burnout that we know that the clinicians are facing and exist today. And so part of the solution is really understanding how these predictive analytics and forecasting tools can build a more flexible and nimble workforce by developing an infrastructure that creates and accelerates knowledge gaps and identifying those so proper patient care can be delivered, beds aren't having to be closed, and the clinicians are no longer facing that additional burnout that we talk about. Because these internal workforce strategies, they're providing coverage, and then those have to be augmented with other flexible staffing models to be able to meet the needs of their organization.

Maggie McKay (Host): And how does workforce planning increase access to the health care professionals a hospital may need?

John Rothwell: It's a great question. We really firmly believe that, yeah, outside of some of the monetary strategies that are going on right now, workforce planning is the only avenue to really increase your talent.

Because it's got the added benefit of actually reducing bill rates and increasing fill rates because you now actually have the appropriate time and strategies to plan well in advance and not be susceptible to some of these labor supply and demand issues that we continue to face as a market. And it's important to acknowledge that this approach and the added benefit is bringing transparency across the provider system.

Especially with these frontline workers that are so unbelievably important to providing excellent patient care and the culture of the organization. They need to understand and have context of why are we developing these strategies? How are we deploying these? And understand that we're only bringing in external staff in the form of travelers when it's absolutely necessary.

I just chatted with a chief nursing officer this month. One of her units is a forty-five bed med surg unit. 80 percent of that staff was travelers. And she was unbelievably concerned that, oh my gosh, are the other 20 percent going to do this? And so... educating her on these strategies to leverage predictive analytics, leverage workforce optimization analytics, and these proactive strategies can significantly reduce the burden that she has in terms of external labor.

But that comes right again, that unit specifically. was unbelievably over budget because they are reactive to the situation that they're in, not proactive looking at the analytics and driving a new care model from a staffing perspective. So what are they going to do? So now, that's where we're able to come in, diagnose the situation, but it's can't just have an analytics platform and hand it to a provider and just say, "hey, this is going to go fix everything".

We're actually deploying an entire solution design methodology to bring all of that chief nursing officer's constituents from across the organization to be able to help with implementing these strategies. What are the actual use cases? How do you drill down and provide transparency to all of your staff so they understand why that we're actually doing this?

And frankly, it helps to reduce the burden of change management as a result. In addition to providing greater fill rates and reducing the overall cost associated with those. 

Maggie McKay (Host): John, can you share some strategies that hospitals and health systems can implement to build workforce sustainability? 

John Rothwell: Maggie, happy to.

There are three pillars to these strategies that we believe are fairly mandatory. One of those, the main component is you have to have the analytics to drive data driven decision making across the organization. They have to be as close to real time as humanly possible. Second, you have to have the executive support and buy in from these strategies.

Because it's so important that they have to allow for autonomy. The ability to make decisions and make them quickly. Where we get into issues from a timing perspective is where we have to go and have umpteen meetings about staffing. Everybody's going to review the analysis. We have to empower our leaders to be able to act and go make decisions.

And then the third is that transparency piece to be able to provide context and visibility. We have clients who are requesting their traveler needs four to six months in advance now by deploying these strategies. and our platform to be able to provide these predictive analytics. The byproduct of that: significantly lower cost from an acquisition standpoint, but a higher fill rate as well because they're able to proactively plan.

They actually have the analytics and they have a unified infrastructure that has been agreed upon and that everybody is working towards. Even another client during the pandemic, they reduced their contingent labor spend in the midst of the pandemic. We don't know many people that were able to do that, but again, it was a very strategic relationship with one of our clients.

Where we were involved on all the day to day activities to be able to help drive this strategy to fruition. And post pandemic, they're down on contingent labor utilization by 50 percent. Wow. A real testament to what they put into place. But it was the buy-in that they were able to get across the system internally that was able to set them up for long term, sustained success.

Maggie McKay (Host): Wow, that is amazing. What is proactive labor forecasting, and what guidance can it provide?

John Rothwell: It means a lot of things to a lot of people. The way that we really look at the predictive analytics is ingesting historical as well as census data multiple times a day to predict staffing needs. We've got to be able to understand volume and understand the needs in the system, and then, workforce optimization data to be able to pinpoint those opportunities and identify the causal areas that are increasing cost. Like your FTE leakage, loss capacity, overtime, your premium pay utilization. These are all aspects that have the potential to significantly drive up cost.

And so how do we create strategies to be able to counterbalance those? And then lastly, it's this roadmap. That we're able to create and deploy with our clients that identify those gaps and care down to the unit level, so a system can proactively deploy these staffing plans well in advance to lower those costs and increase their coverage ratios.

Because it's really a shift in mindset that we at AMN have taken where the problem is over-utilization. And we are committed to partnering with our clients to reduce utilization, create transparency, drive data-driven decision making, but then co on those outcomes. So how do we put ourselves on the hook in their shoes and lock arm-in-arm to be able to create these proactive strategies? Aimed at improving, frankly, their operating margins when 60% of your operating expense is labor. This is top of mind for everybody that we're speaking to and is really resonating with our clients that implemented these various strategies. 

Maggie McKay (Host): And John, how can adopting more flexible workforce strategies that we've been talking about drive financial sustainability?

John Rothwell: Well, the financial sustainability really comes in about three forms. And so, one of those is just the ability to forecast your needs well in advance to be able to not to be susceptible to last minute placements that typically carry the highest premium cost. And so when you have the ability now to be able to go and forecast two, three, six months down the road and proactively plan, you're reducing the overall premium pay, but you're also increasing your fill rates there.

And it also provides the ability to proactively adjust because of, like we said, the census and the historical data that we're able to digest really gets to this as real time as humanly possible. I think the census data we're ingesting multiple times a day to be able to create alerts and be able to assist our clients in operationalizing their cost reduction strategies as it relates to clinical labor.

Maggie McKay (Host): Is there anything else you'd like to add, John, that you would like people to know? 

John Rothwell: This is not something that's going to be fixed overnight. We recognize that providers need strategic partners, not just to provide an analytics platform, but assist them in the implementation and the sustainability of these initiatives.

Because it's one thing to go and create a quick fix, but you've got to be able to continue to monitor, measure, and then co-own our clients outcomes to ensure their long term success. But they need a partner that has a roadmap, they need a partner that has the twenty years of historical data that we're able to go and assist with the prediction, as well as the validity of what the appropriate staffing models are, where do they need coverage, where do they need assistance in their float pools, where do they need assistance in driving down and predicting what their future needs are, and we couldn't be more excited to be on the forefront of that.

Maggie McKay (Host): Thank you so much. You gave us a lot to think about and very useful information. Fascinating.

John Rothwell: Maggie, it was my pleasure. Thank you so much for having me.

Maggie McKay (Host): Absolutely. John, thanks for joining us today at the 2023 AHA Leadership Summit. For our listeners, if you'd like to learn more about AMN Healthcare and listen to other podcasts, visit

This has been an Innovators Connection podcast brought to you by the American Hospital Association. Thanks for listening.