Ep. 50 |Unlocking Workforce Agility: Building Sustainable Strategies with Flexible Labor Pools
In this episode of the Elevate Care podcast, we sit down with Jackie Larson, Senior Vice President of Client Experience at AMN Healthcare, to explore how healthcare leaders can take greater control of their workforce strategies. Are you ready to move beyond traditional staffing models and embrace a future of true agility?
Jackie breaks down the evolving "flavors" of float pools—from internal agencies to innovative gig-based models—empowering leaders to make choices that align with their unique needs. By deeply understanding the data behind contingency demand, organizations can move from reactive filling to proactive strategy. We discuss how optimizing these diverse resources allows you to save costs, support your core staff, and navigate any operational challenge.
This conversation is an invitation to rethink how we deploy talent. Whether it is leveraging technology for seamless integration or building trust through transparency, the path to a resilient workforce is within reach.
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Timestamps
00:00 – Introduction
02:13 – The Spectrum of Labor Pools
05:34 – Innovation and the Gig Model
10:21 – Selecting the Right Strategy
13:34 – Understanding Demand
16:11 – The ROI of Optimization
23:06 – Technology and Integration
26:50 – Future Trends
About Jackie
Jackie Larson serves as the Senior Vice President of Client Experience at AMN Healthcare. With extensive experience in workforce optimization, she is dedicated to helping health systems build sustainable, flexible staffing strategies. Her expertise spans the full spectrum of labor management, from traditional float pools to cutting-edge gig economy solutions. Jackie is passionate about empowering organizations to understand their unique data, optimize their labor mix, and achieve financial and operational excellence through strategic innovation.
About Liz
Liz Cunningham, Vice President of Digital Solutions at AMN Healthcare since 2020, drives digital transformation for a seamless user experience powered by self-service, AI, and automation. She manages a diverse team of senior leaders and team members across product management, digital marketing, engineering, analytics, and user experience. In 2023, Liz also assumed the role of transforming AMN's enterprise customer support department, implementing new technology and a streamlined operating model.
In her 11-year tenure with AMN, Liz has taken on various roles, from heading AMN's clinician strategy during COVID-19 response to leading enterprise operations and branding for the Healthcare Staffing Divisions. Presently, Liz leads her team in managing the industry-leading healthcare professional application, AMN Passport, and spearheads new digital experience platforms, fostering digital-first engagements for clients and candidates.
Outside of work, Liz is dedicated to innovation and entrepreneurship. As a Board Member for the ZIP Launch Pad, a San Diego State-funded Innovation center, she actively champions early-stage startups founded by SDSU students and faculty. In her free time, Liz is cultivating a unique passion for cheese and is working towards becoming a cheese monger, adding a flavorful layer to her diverse interests.
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Transcript
00:00:00:00 - 00:00:34:01
Speaker 1
Welcome to the Elevate Care Podcast, the show where healthcare professionals, visionaries and thought leaders come together to explore the limitless possibilities of healthcare innovation. I'm your host, Liz Cunningham, and with me on today's podcast episode is Jackie Larsen. Welcome, Jackie. Jackie is our SVP of Client Experience at AMN Healthcare. And today she's going to share a little bit with us about the evolving flavors of float pools and flexible labor pools, and how health systems are using them to build more flexible and sustainable workforce strategies.
00:00:34:03 - 00:00:53:23
Speaker 1
Together, Jackie and I will be chatting through emerging models and workforce strategies that we're seeing in real world examples with some of our clients, and also talk a little bit about what's next for workforce innovation. So, Jackie, welcome to the podcast. We'd love to just hear a little bit more about you and your background. And, you know, how you started getting engaged and all the different flavors that float?
00:00:54:01 - 00:00:54:23
Speaker 2
Yes, absolutely.
00:00:54:23 - 00:01:02:13
Speaker 3
Well, thank you for having me. I've been with AMN for, I think, 16 years and.
00:01:02:15 - 00:01:05:11
Speaker 2
Helping healthcare systems solve for.
00:01:05:11 - 00:01:13:15
Speaker 3
Their greatest challenges has been one of one of my greatest passions over the last many, many years. And so that's really how it started.
00:01:13:15 - 00:01:15:14
Speaker 2
It's what's what's.
00:01:15:14 - 00:01:19:07
Speaker 3
Happening. Where do they have resource gaps? How can we help them.
00:01:19:07 - 00:01:19:16
Speaker 2
Solve.
00:01:19:16 - 00:01:25:02
Speaker 3
For those and shoot like flavors of float? Have it's been around for so long.
00:01:25:04 - 00:01:25:22
Speaker 2
And there's ebbs and.
00:01:25:22 - 00:01:27:22
Speaker 3
Starts, right. Like we know that there was.
00:01:27:22 - 00:01:28:20
Speaker 2
A a little.
00:01:28:20 - 00:01:36:12
Speaker 3
Bit of a lull in terms of the discussions around the different layers, and now we're seeing a resurgence, and so many of our clients are coming.
00:01:36:12 - 00:01:39:06
Speaker 2
Up to us saying, gosh, how how can you help us?
00:01:39:09 - 00:01:42:19
Speaker 3
What are you hearing out in the field? What are other clients doing?
00:01:43:01 - 00:01:45:07
Speaker 2
What's the trend? How do we start?
00:01:45:08 - 00:01:48:09
Speaker 3
So and here we are.
00:01:48:11 - 00:02:13:07
Speaker 1
Well, there's definitely been, you know, a big evolution I would say post-Covid. So would love to hear from your perspective when our clients or health systems are saying the term float pool or flexible pool, you know, what does that mean? What are the different types of labor pools you're really hearing about today that clients are experimenting with and ensuring our options to meet their, ever changing workforce needs?
00:02:13:09 - 00:02:38:22
Speaker 3
Yeah. You bet. I'll break it down into two categories. I'll I'll call it one category is the client owned resources. The other category is your more traditional agency owned resources. So under client owned resources, you continue to hear about your traditional float pool. Internal float pool can be both sole and part time, employed by the client. Oftentimes benefited.
00:02:39:00 - 00:02:43:23
Speaker 3
And then your second layer is really that pairing flex pool.
00:02:44:04 - 00:02:46:07
Speaker 2
Those are also client owned.
00:02:46:09 - 00:03:11:00
Speaker 3
Traditional needs are not benefited. They have a very low commitment sometimes, you know, when you look at their system, they might show up as a point one so they're as needed. And then the third category really is internal agency. And those are also client owned resources, but also an arm's length from, the stable of the hospital.
00:03:11:00 - 00:03:33:14
Speaker 3
They're in a different entity. They're benefited differently. They're paid differently. They're oftentimes, I'll call it, treated differently. They just have a different, different make up, a different employment model. And then on the other side with the agency owned resources, I'm going to put in traditional travel, even though that's not necessarily float. That is a lever that.
00:03:33:16 - 00:03:35:11
Speaker 2
Hospitals have to pull to.
00:03:35:11 - 00:03:43:23
Speaker 3
Help them layer in where they have gaps in their core staff. But there's also local per diem and so local per diem.
00:03:44:01 - 00:03:45:01
Speaker 2
Most clients.
00:03:45:01 - 00:03:50:18
Speaker 3
View that as an extension of their current and traditional travel.
00:03:50:18 - 00:03:52:21
Speaker 2
Contracts. There is just a.
00:03:53:02 - 00:04:10:05
Speaker 3
A, removal of that radius role. So sometimes you hear we have a 50 mile radius role, that means that that agency really shouldn't be sourcing and recruiting for talent within that 50 miles. But for local per diem, that certainly is local.
00:04:10:07 - 00:04:11:21
Speaker 2
That is individuals.
00:04:11:21 - 00:04:14:02
Speaker 3
That want to pick up as needed.
00:04:14:04 - 00:04:16:00
Speaker 2
Shifts and it is local.
00:04:16:00 - 00:04:34:18
Speaker 3
To the community. The third is really the gig model, and we share so much about that. There's there's probably a lot of different understandings about that gig workforce. But essentially, really the difference between your local per diem and gig.
00:04:34:20 - 00:04:38:00
Speaker 2
Is how heavily is the agency.
00:04:38:00 - 00:04:48:04
Speaker 3
Involved in helping the hospital procure those resources? So on the gig, it's really a very much a technology play where the.
00:04:48:06 - 00:04:48:20
Speaker 2
Hospital.
00:04:48:20 - 00:05:07:21
Speaker 3
Can go into an app and they can look at the resources that are available to them, and they're often micro shifts. So what I mean by that is it could be a two hour shift, could be a four hour shift. So it really kind of breaks the mold of that 12 to 13 week model. It is again as needed.
00:05:07:21 - 00:05:10:10
Speaker 3
But it's the micro shifts.
00:05:10:12 - 00:05:33:17
Speaker 1
And you know, I can imagine with all these different types of tools that, you know, clients are innovating across all of them. Or maybe they are. Maybe there's hot topics. What what are you specifically seeing clients innovate or try something differently, like what types of pools are you seeing? Clients really push the envelope in in new, whether it's technology or process or strategy.
00:05:33:19 - 00:05:34:06
Speaker 2
I think.
00:05:34:06 - 00:05:35:22
Speaker 3
They're really attracted.
00:05:36:01 - 00:05:37:01
Speaker 2
To.
00:05:37:03 - 00:05:43:08
Speaker 3
The gig model. I think that clients see that as an opportunity for them to.
00:05:43:08 - 00:05:44:11
Speaker 2
Access.
00:05:44:13 - 00:05:45:14
Speaker 3
Community based.
00:05:45:14 - 00:05:47:10
Speaker 2
Resources in local.
00:05:47:10 - 00:06:15:21
Speaker 3
To their community and micro shifts. So it's very it's very small commitment. And I think the perception is that there's very little that that they have to do. But what we're seeing in the market is that some of the providers of Gig, they're really tech based, solutions. It's very manual on the client side. So oftentimes that client is having to provide the open shifts.
00:06:15:21 - 00:06:41:21
Speaker 3
They're having to manually enter it in there. And it's from the feedback that I've gotten some clients, it sounds really good. And I think there's other models that say Am and can provide that help alleviate some of the burden of the manual input, but they they are attracted by having resources readily available for micro shifts, and they feel like it should be hands free.
00:06:41:21 - 00:06:51:05
Speaker 3
It's really that simple model. But in practice, that model isn't as far along in the market is I think, where they'd hoped it would be.
00:06:51:07 - 00:06:51:22
Speaker 2
00:06:52:00 - 00:06:53:15
Speaker 3
And then I think we're seeing.
00:06:53:16 - 00:06:54:10
Speaker 2
Go ahead.
00:06:54:12 - 00:07:02:14
Speaker 1
I just going to say, what about on the client labor pool? So it's kind of that external labor pools. But what about the client labor pools? Anything popping up there?
00:07:02:16 - 00:07:03:08
Speaker 2
I think we're.
00:07:03:08 - 00:07:07:01
Speaker 3
Hearing a lot more about internal agency.
00:07:07:03 - 00:07:08:20
Speaker 2
I think that some some.
00:07:08:20 - 00:07:10:10
Speaker 3
Of the larger, larger, more.
00:07:10:10 - 00:07:12:01
Speaker 2
Sophisticated systems.
00:07:12:06 - 00:07:18:04
Speaker 3
Find that to be an attractive option. I think what they're finding, though, so what I've been hearing is.
00:07:18:04 - 00:07:20:04
Speaker 2
Some systems.
00:07:20:04 - 00:07:39:20
Speaker 3
Who have tried that, like during the pandemic, that was a good model for them to establish because it allowed them to control the supply of resources. Now they're looking ahead saying, gosh, there's such a compression between the average hourly wage rate of a traveler and of our core staff.
00:07:39:22 - 00:07:41:12
Speaker 2
There's also a lot of, I'll say.
00:07:41:13 - 00:07:46:16
Speaker 3
Administrative burden that they're having to take on with an internal agency model.
00:07:46:18 - 00:07:47:23
Speaker 2
That they're almost second.
00:07:47:23 - 00:08:03:03
Speaker 3
Guessing whether they should have that or not. Is they is there a more economic model that would benefit them better, that would serve serve their financial model in a little better way than what they've done traditionally?
00:08:03:03 - 00:08:06:21
Speaker 2
So it's talked about, but I think some clients.
00:08:06:21 - 00:08:24:17
Speaker 3
Often get to the point where they're feeling that that might not be the best model for them any longer. And in fact, I had a conversation with one client recently where they said, we've actually disbanded that because it was so burdensome for us to maintain, and it actually was more costly than some of the other options now available.
00:08:24:19 - 00:08:49:06
Speaker 1
You know, I think as you talk about all the different flavors of float and the various models, what what is a mix typically looking like, like are you seeing a client that has internal agency but also has gig or has, you know, a traditional PRN type float pool, but also does, you know, external per diem staffing, like what is what is the mix look like, or is everyone trying a little bit of everything?
00:08:49:08 - 00:08:53:04
Speaker 2
Yeah, it's all answered this way. It depends.
00:08:53:04 - 00:08:54:09
Speaker 3
And it's different.
00:08:54:10 - 00:08:55:11
Speaker 2
It depends on.
00:08:55:15 - 00:08:56:10
Speaker 3
How large.
00:08:56:10 - 00:08:57:18
Speaker 2
The system is, how.
00:08:57:18 - 00:09:06:07
Speaker 3
Disparate their hospitals are. Do they have rural hospitals? Are they more in a in a highly populated area.
00:09:06:07 - 00:09:09:07
Speaker 2
Where it's more easily access to.
00:09:09:07 - 00:09:11:08
Speaker 3
Different types of resources.
00:09:11:10 - 00:09:14:17
Speaker 2
But it really does depend. I would say most.
00:09:14:17 - 00:09:17:04
Speaker 3
Hospitals now are really going back to the.
00:09:17:04 - 00:09:17:17
Speaker 2
Basics.
00:09:17:23 - 00:09:34:23
Speaker 3
When I say going back to the basics, you have your your traditional internal float. Float pool full and part time staff. And they're layering that in with their internal per diem. So that could be local or hospital based. It could be regional based.
00:09:35:01 - 00:09:35:19
Speaker 2
And then some.
00:09:35:19 - 00:09:39:00
Speaker 3
Of the more sophisticated ones are really looking at.
00:09:39:01 - 00:09:40:07
Speaker 2
00:09:40:09 - 00:09:41:01
Speaker 3
When I look.
00:09:41:01 - 00:09:43:06
Speaker 2
At, access to local.
00:09:43:06 - 00:09:56:01
Speaker 3
Resources is can my agency help with that? Do we really need to explore internal agency? Maybe or maybe not. So it really depends. And when we work across our client base.
00:09:56:03 - 00:09:57:13
Speaker 2
It really spans the.
00:09:57:13 - 00:10:02:10
Speaker 3
Spectrum of all the different flavors.
00:10:02:12 - 00:10:21:07
Speaker 1
So it sounds like maybe number one is kind of availability of supply that determines what types of pool they're using. And then maybe the other sound like system complexities or what would you classify as like maybe that the 2 to 3 factors that you think impact what types of pools that they're selecting from?
00:10:21:09 - 00:10:23:11
Speaker 3
Yeah, I think you said it. I think one is.
00:10:23:11 - 00:10:25:20
Speaker 2
Access to resources, access.
00:10:25:20 - 00:10:41:17
Speaker 3
To supply. And you have to do two different spectrums you have. How easy is it for them as an employer to attract and retain resources? How easy is it for their agency partner to provide resources.
00:10:41:17 - 00:10:43:23
Speaker 2
At the lowest cost?
00:10:44:01 - 00:10:50:04
Speaker 3
I think the other thing is disparate. What do I want to say? It's like if you look at.
00:10:50:04 - 00:10:51:09
Speaker 2
How how.
00:10:51:14 - 00:10:51:21
Speaker 3
Are.
00:10:51:21 - 00:10:54:09
Speaker 2
They spaced between hospitals.
00:10:54:09 - 00:10:55:12
Speaker 3
If they have a rule.
00:10:55:12 - 00:10:58:13
Speaker 2
Based hospital, can they.
00:10:58:13 - 00:11:06:00
Speaker 3
Deploy a pool of resources across each of those? How easy is it for them to do that? Or do they have to have multiple.
00:11:06:00 - 00:11:11:20
Speaker 2
Pools to support each of those regions? So I think it's.
00:11:11:22 - 00:11:12:14
Speaker 3
Geographic.
00:11:12:14 - 00:11:15:08
Speaker 2
Dispersion. I think it's access to supply.
00:11:15:14 - 00:11:21:16
Speaker 3
I think the the rule based community is a is a big component. And then I think the other one is.
00:11:21:16 - 00:11:23:05
Speaker 2
Just appetite.
00:11:23:05 - 00:11:33:15
Speaker 3
To innovate. And so what I mean by that is do they want to explore different options that might be new and neat to what they've done before. Because it.
00:11:33:15 - 00:11:34:18
Speaker 2
Does take some.
00:11:34:18 - 00:11:35:11
Speaker 3
Effort.
00:11:35:13 - 00:11:40:17
Speaker 2
Regardless of which pool you opt for. But one of the success.
00:11:40:17 - 00:11:42:02
Speaker 3
Factors is.
00:11:42:04 - 00:11:44:12
Speaker 2
How consistent are your policies.
00:11:44:12 - 00:11:47:16
Speaker 3
And practices. So if you have a small resource.
00:11:47:18 - 00:11:48:05
Speaker 2
And you have.
00:11:48:05 - 00:11:53:15
Speaker 3
Inconsistency, not just from unit to unit, but from a.
00:11:53:17 - 00:11:54:08
Speaker 2
Hospital or.
00:11:54:08 - 00:12:07:02
Speaker 3
Region to region, that individual that you may want to deploy across that area, they're going to have to learn something different if there's lack of standardization. So that's an important.
00:12:07:02 - 00:12:08:21
Speaker 2
Component as well.
00:12:08:23 - 00:12:27:00
Speaker 1
That makes sense. And Jackie, are there any nuances around the skill set or type of clinician. Right. When we're talking about these different labor pools, are we mostly saying nursing's kind of the leading, you know, the leading or the allied space? Is it non-clinical? Is it physician like, where where are we seeing this adopted within the health systems?
00:12:27:02 - 00:12:34:04
Speaker 3
Well, I think traditionally it's been nursing. But now we're seeing more and more appetite for allied.
00:12:34:06 - 00:12:35:03
Speaker 2
And more are.
00:12:35:03 - 00:12:38:10
Speaker 3
Starting to see a greater appetite to.
00:12:38:10 - 00:12:40:18
Speaker 2
Explore. Physicians. So we're.
00:12:40:18 - 00:12:42:03
Speaker 3
Seeing it really open.
00:12:42:03 - 00:12:43:03
Speaker 2
Up to all.
00:12:43:03 - 00:12:45:20
Speaker 3
Skill mix, all specialties.
00:12:45:21 - 00:13:09:01
Speaker 1
Yeah, that makes sense. And it sounds like some of these tools are enabling that scale, right. If it seems like it was in one unit trying something out, the technology enablement is really helping with that, you know, scale beyond the R.N. space. So now that's great to hear. You know, Jackie, I know with your background, and for those who don't know, Jackie, you know, ran one of our large, technology divisions around scheduling and predictive scheduling analytics.
00:13:09:01 - 00:13:24:12
Speaker 1
And we'd love to hear a little bit, Jackie, about some of your experiences with your clients around impacts and lessons learned when a client is actually saying, okay, I want to start this journey right now. I only have kind of my core labor, and I use a bunch of travel nurses. So help me figure out a different way to do this.
00:13:24:13 - 00:13:34:17
Speaker 1
You know, what are what are some of those lessons learned that that you've gone through and experience with clients trying to embark on this journey? And how would you think about the best way to start that journey moving forward?
00:13:34:19 - 00:13:54:05
Speaker 3
Yeah, it's a great question. We always tell our customers, let's understand your current state. Let's understand what's creating the demand for contingency. And when I say contingency, I use that in the in the broadest of terms, meaning that that that shift is being filled by.
00:13:54:07 - 00:13:54:21
Speaker 2
Someone.
00:13:54:21 - 00:14:09:20
Speaker 3
Outside of their full time commitment. So it could be somebody in overtime or working extra. It could be agency staff. It could be what is your float world like? What is creating the demand for contingency? And the reason why that's important.
00:14:09:22 - 00:14:10:21
Speaker 2
Is that helps us.
00:14:10:21 - 00:14:15:21
Speaker 3
Understand what that backfill rate needs to be.
00:14:15:23 - 00:14:16:04
Speaker 2
So.
00:14:16:04 - 00:14:41:02
Speaker 3
Oftentimes will help our clients or will guide our clients through what we call a workforce assessment. And it's a very data rich, a very analytics rich assessment that utilizes their data. It examines the behavior of their core staff, and it looks at what's your frequency of PTO, FMLA, overtime meetings, orientation time.
00:14:41:07 - 00:14:43:03
Speaker 2
And it's all of those reasons.
00:14:43:03 - 00:14:47:02
Speaker 3
And aggregate that are taking your core staff away from the bedside.
00:14:47:04 - 00:14:48:08
Speaker 2
But it's also.
00:14:48:08 - 00:14:49:05
Speaker 3
That number.
00:14:49:05 - 00:14:53:18
Speaker 2
That helps us compute. How many resources.
00:14:53:18 - 00:14:55:13
Speaker 3
Do you need in your internal slope?
00:14:55:13 - 00:15:00:20
Speaker 2
What do you need to access the gig workforce? Is the use of.
00:15:00:20 - 00:15:07:00
Speaker 3
Agency at a higher level appropriate for your organization? Because maybe you have a.
00:15:07:00 - 00:15:10:11
Speaker 2
Unionized hospital, that this.
00:15:10:11 - 00:15:13:01
Speaker 3
Type of approach would be more beneficial to you.
00:15:13:07 - 00:15:15:01
Speaker 2
So it really is then taking.
00:15:15:01 - 00:15:24:22
Speaker 3
All of that information, and we're able to populate it with real time wage information and provide back what is the cost benefit.
00:15:24:22 - 00:15:26:03
Speaker 2
Analysis, what is the.
00:15:26:03 - 00:15:29:02
Speaker 3
Layering of resources, including core.
00:15:29:02 - 00:15:30:17
Speaker 2
Staff, and what is that.
00:15:30:17 - 00:15:37:13
Speaker 3
Financial model and operational model look like? And that's really how we help them and how we guide them.
00:15:37:13 - 00:15:38:18
Speaker 2
To what's the.
00:15:38:18 - 00:15:45:00
Speaker 3
Right layering and what's the right sizing and numbers within each of those flavors of slope.
00:15:45:02 - 00:16:02:16
Speaker 1
Based on that, you know, looking at the initial analysis, where do you typically see clients get the greatest ROI? You know, it sounds like you're taking into account a lot of volume, a lot of expenses. Where are you seeing the ROI come from when a client really takes a step back to assess the size of the pools and what the goals should look like?
00:16:02:18 - 00:16:04:16
Speaker 3
Yeah, Janet, depends. It really.
00:16:04:16 - 00:16:11:01
Speaker 2
Does depend. If we've seen through the assessments that they typically can save.
00:16:11:01 - 00:16:12:07
Speaker 3
Anywhere from like.
00:16:12:07 - 00:16:16:01
Speaker 2
2 to 4 to 6% on overall.
00:16:16:01 - 00:16:22:14
Speaker 3
Labor savings and the underpinning of that is optimization.
00:16:22:16 - 00:16:23:09
Speaker 2
Of all.
00:16:23:09 - 00:16:26:14
Speaker 3
Sources of staff that they have the leverage that they.
00:16:26:14 - 00:16:27:21
Speaker 2
Use. So it.
00:16:27:21 - 00:16:29:01
Speaker 3
Means.
00:16:29:03 - 00:16:31:14
Speaker 2
One one probably consistent.
00:16:31:14 - 00:17:00:02
Speaker 3
Component is not to over utilized for staff because it creates a tremendous amount of burnout, burnout, and also creates turnover. So it's looking at are you utilizing the resources that you have appropriately. Are you working them into action over time, over what I call the tipping point. The tipping point would be at what point does it, Dan, create a burden on that clinician?
00:17:00:04 - 00:17:03:00
Speaker 3
And then it's looking at things like, are you.
00:17:03:02 - 00:17:03:05
Speaker 2
Are.
00:17:03:05 - 00:17:04:13
Speaker 3
You using premium pay?
00:17:04:13 - 00:17:07:21
Speaker 2
Do you pay incentives? And because the.
00:17:07:21 - 00:17:17:23
Speaker 3
Compression between the wage rates of travelers and core staff has shrunk, there's actually an appetite in some organizations.
00:17:18:01 - 00:17:19:17
Speaker 2
To use a higher.
00:17:19:17 - 00:17:32:10
Speaker 3
Level of travelers. But again, it depends on what their wage rates are, what the wage rates are for travelers and in that particular community or region. And then looking at all of the factors.
00:17:32:10 - 00:17:39:15
Speaker 2
Cost and time. So what we've seen is there could be in some instances also a shaving.
00:17:39:15 - 00:17:48:03
Speaker 3
Or reduction of reliance on travelers, but building up internal resources that they can draw.
00:17:48:05 - 00:18:05:02
Speaker 1
You brought up a really interesting point where on the surface level, as you're thinking about the pools and planning, you may just be thinking about, okay, how many resources do I have here and how many patient hours do I need to accommodate? Right. And you brought up some other metrics that I think are really critical to planning, right?
00:18:05:02 - 00:18:13:21
Speaker 1
So you're talking about burnout etc., like what are the some of the other underlying metrics or data points that you look at to help determine that optimal mix?
00:18:13:23 - 00:18:15:16
Speaker 2
Yeah, I mean, it would it is.
00:18:15:16 - 00:18:18:05
Speaker 3
Really looking at what is creating the demand for.
00:18:18:05 - 00:18:19:13
Speaker 2
Contingency.
00:18:19:15 - 00:18:33:00
Speaker 3
Why are they being pulled from the bedside and how are they currently filling those hours. And then there's been some studies that we've done and that will continue to refresh, to look at benchmarks.
00:18:33:02 - 00:18:33:17
Speaker 2
That are.
00:18:33:17 - 00:18:34:16
Speaker 3
Appropriate.
00:18:34:16 - 00:18:35:21
Speaker 2
For health systems.
00:18:35:21 - 00:18:48:22
Speaker 3
Today. What's the appropriate level of overtime? Slotting has been a big one. So when we talk about the characteristics of a core staff worker compared to a traveler, what they.
00:18:48:22 - 00:18:51:14
Speaker 2
Want is different.
00:18:51:16 - 00:19:00:14
Speaker 3
For staff. Workers tend to want the stability of going to a employer. They want to show up at their unit.
00:19:00:17 - 00:19:03:03
Speaker 2
Whether it's seven, eight A, £0.07.
00:19:03:09 - 00:19:09:00
Speaker 3
And they want to work on that for they want to work in that unit where travelers.
00:19:09:02 - 00:19:09:18
Speaker 2
Love.
00:19:09:22 - 00:19:12:17
Speaker 3
The variety. They want to be all over the place.
00:19:12:17 - 00:19:14:17
Speaker 2
All the time. Well, if you.
00:19:14:17 - 00:19:23:11
Speaker 3
Start imposing a traveler model on top of a core staff worker, that creates a lot of staff dissatisfaction.
00:19:23:11 - 00:19:23:23
Speaker 2
So one of the.
00:19:23:23 - 00:19:24:23
Speaker 3
Metrics we look at.
00:19:24:23 - 00:19:27:11
Speaker 2
Is what is the occurrence of flow.
00:19:27:11 - 00:19:32:13
Speaker 3
Outside of their home unit? Was that an expectation that was set when they were hired?
00:19:32:13 - 00:19:33:22
Speaker 2
So some of the.
00:19:33:22 - 00:19:35:20
Speaker 3
Things that we talk about with our clients.
00:19:35:20 - 00:19:36:06
Speaker 2
Is.
00:19:36:08 - 00:19:45:05
Speaker 3
Maybe part of the transition is that you're hiring to a store of units, not a unit.
00:19:45:07 - 00:19:46:05
Speaker 2
So the.
00:19:46:07 - 00:19:47:08
Speaker 1
Expectations at the.
00:19:47:13 - 00:19:53:03
Speaker 2
Setting, different expectations, exactly. And it's interesting because it helps.
00:19:53:05 - 00:19:58:16
Speaker 3
That they don't have the perception or the expectation. I'm going to one unit. So the occurrence.
00:19:58:16 - 00:19:59:11
Speaker 2
Of flow.
00:19:59:13 - 00:20:04:21
Speaker 3
We also look at how were they back selling. Where they have gaps are they can.
00:20:05:03 - 00:20:06:02
Speaker 2
Consistently.
00:20:06:02 - 00:20:10:03
Speaker 3
Asking those core staff workers to pick up an extra.
00:20:10:03 - 00:20:10:13
Speaker 2
Shift.
00:20:10:13 - 00:20:18:13
Speaker 3
To work into over time. And we look at all of those factors in conjunction with one another. It's really clinicians fatigue, because.
00:20:18:13 - 00:20:19:12
Speaker 2
We have also.
00:20:19:12 - 00:20:23:03
Speaker 3
Heard it is more difficult now.
00:20:23:06 - 00:20:26:05
Speaker 2
For hospitals to.
00:20:26:07 - 00:20:34:21
Speaker 3
Get new team members in the door. And when we get the new team members in the door, you want to make sure that they keep them. So it's providing the insights.
00:20:34:23 - 00:20:35:09
Speaker 2
To help.
00:20:35:09 - 00:20:47:06
Speaker 3
Them understand. Are there areas that could unintentionally create some burden on that, or staff that could eventually turn into turnover.
00:20:47:08 - 00:20:48:03
Speaker 2
00:20:48:13 - 00:21:08:13
Speaker 1
Interesting. Yeah. Many different factors to figure out the different float pools. And you know I think going back to your conversation in the very beginning we talked about you know, where, where are we seeing innovation and investment. And you mentioned the gig models and the per diem models. So let's pivot back to that external labor pool for a second.
00:21:08:15 - 00:21:26:11
Speaker 1
What are you seeing in the technology space there. And maybe why is that becoming. You know, I know you mentioned that hospitals are still seeing it as being burdensome. And health systems are still seeing it as manual. But what type of investments are you seeing on the tech side that are making gig more interesting? Like, why is it the shiny object right now?
00:21:26:11 - 00:21:27:18
Speaker 2
Yeah, I mean, I think.
00:21:27:18 - 00:21:33:02
Speaker 3
Even when you look at at our organization, when you look at Amazon, we want to make sure.
00:21:33:02 - 00:21:35:08
Speaker 2
That it is seamless.
00:21:35:08 - 00:21:36:09
Speaker 3
From a technology.
00:21:36:09 - 00:21:37:20
Speaker 2
Perspective that.
00:21:37:20 - 00:21:42:04
Speaker 3
We can integrate with a scheduling solution that gives.
00:21:42:04 - 00:21:44:02
Speaker 2
Us access to open shifts.
00:21:44:04 - 00:21:53:14
Speaker 3
When you think about it, what we're trying to solve for is how do we, in the most economic way, in the most financially prudent way.
00:21:53:16 - 00:21:55:17
Speaker 2
Position those open shifts.
00:21:55:19 - 00:21:59:22
Speaker 3
In the right order? So what I mean by that is the open shifts.
00:21:59:22 - 00:22:00:16
Speaker 2
Let's let's.
00:22:00:16 - 00:22:04:12
Speaker 3
Say that our internal core staff is the lowest wage rate will.
00:22:04:12 - 00:22:05:17
Speaker 2
Be there should.
00:22:05:17 - 00:22:20:17
Speaker 3
Be an opportunity to make sure that they're working up to their full commitment. If they still have an unmet need, maybe it's their internal flow pool, then that has the opportunity. If there's still an unmet need, we want to be able to.
00:22:20:23 - 00:22:21:19
Speaker 2
Push those.
00:22:21:19 - 00:22:44:15
Speaker 3
Open shifts out to the local market. So whether you call it local per diem, whether you call it gig, it's making sure that they're they have the ability to access the local market and then really has that final deployment or positioning of open shares. If they still have an unmet need, then maybe it is travelers again, every market could be different.
00:22:44:15 - 00:22:45:06
Speaker 2
So that.
00:22:45:10 - 00:22:47:03
Speaker 3
Theory.
00:22:47:05 - 00:22:48:22
Speaker 2
Would be customized to what's.
00:22:48:22 - 00:22:50:21
Speaker 3
Occurring within that particular.
00:22:50:21 - 00:22:52:21
Speaker 2
System. But I would say.
00:22:52:21 - 00:22:56:02
Speaker 3
The innovation absolutely has to be.
00:22:56:04 - 00:22:56:19
Speaker 2
Seamless.
00:22:56:19 - 00:22:57:22
Speaker 3
Integration to make.
00:22:57:22 - 00:23:02:09
Speaker 2
It easy for the hospital to fill those open shifts. They shouldn't.
00:23:02:09 - 00:23:05:15
Speaker 3
Have to do a lot of manual input.
00:23:05:17 - 00:23:06:17
Speaker 2
Of information.
00:23:06:17 - 00:23:08:16
Speaker 3
That's already available within NetFlow.
00:23:08:16 - 00:23:30:07
Speaker 1
What's interesting. So so you're saying, hey, the investment in the technology right now is more around the integrated, holistic approach across scheduling and HDFs and the EMS and Gig, and to make that seamless. So I think that's really interesting. If if you were to look at it from the clinician perspective, let me throw out an analogy that's probably not a great one to you.
00:23:30:11 - 00:23:49:14
Speaker 1
But, you know, at the end of the day, taking a taxi or an Uber is still you getting a ride somewhere, right? And when you call it on an app and when you go on a corner and, you know, try to hail someone. So at the end of the day, it sounds like you're saying the pool for gig and per diem local per diem are sort of the same people.
00:23:49:14 - 00:24:00:16
Speaker 1
It's the same workers. Maybe they're just accessing shifts different. Like, is that is that a fair way to put it, or how would you describe what's being invested on in the technology side from the clinician's perspective?
00:24:00:17 - 00:24:02:08
Speaker 2
Yeah, I mean, I think so.
00:24:02:08 - 00:24:04:23
Speaker 3
And you can really, you know, weigh in on this as well.
00:24:04:23 - 00:24:06:09
Speaker 2
It's like from the clinician.
00:24:06:09 - 00:24:08:04
Speaker 3
Perspective, they want easy.
00:24:08:04 - 00:24:09:21
Speaker 2
Access to open shifts.
00:24:09:23 - 00:24:19:12
Speaker 3
They want to know that what they're being shown is what they are capable and competent of working, that they've already had gone through the orientation.
00:24:19:12 - 00:24:20:20
Speaker 2
So if there is a shift.
00:24:20:20 - 00:24:33:16
Speaker 3
Presented to them and they pick it up, that they can work that shift with no problem. I think, I think that there is a continuum between gig.
00:24:33:18 - 00:24:33:22
Speaker 2
And.
00:24:33:22 - 00:24:38:12
Speaker 3
Local and per diem that is really based on the preference of.
00:24:38:12 - 00:24:39:12
Speaker 2
The system.
00:24:39:14 - 00:24:45:18
Speaker 3
And I believe that depending on where they're at, like, it's not all about meeting the customer where they're at.
00:24:45:23 - 00:24:47:23
Speaker 2
So if they still have some.
00:24:47:23 - 00:24:55:09
Speaker 3
Reservations with a newer technology play, hey, we'll help you do that. Our goal is to make sure that you have.
00:24:55:09 - 00:25:01:16
Speaker 2
Access to supply, where you can get that shift filled, and that also means access.
00:25:01:16 - 00:25:05:12
Speaker 3
To your local community, access to your local supplier.
00:25:05:12 - 00:25:07:22
Speaker 2
Staff. If you know a system.
00:25:07:22 - 00:25:09:09
Speaker 3
Where you're like, oh my gosh, I.
00:25:09:09 - 00:25:14:13
Speaker 2
Love this, this 100% tech play.
00:25:14:15 - 00:25:16:18
Speaker 3
Okay, absolutely. Let's help you configure.
00:25:16:18 - 00:25:17:18
Speaker 2
The systems so that.
00:25:17:18 - 00:25:20:04
Speaker 3
It is adaptable to your organization.
00:25:20:09 - 00:25:22:16
Speaker 2
And it is also seamless where it takes.
00:25:22:16 - 00:25:28:05
Speaker 3
Away that administrative burden of having to manually enter open shifts.
00:25:28:07 - 00:25:35:19
Speaker 2
So I think it is one in the same. I think it depends on the client preference in terms of how.
00:25:35:19 - 00:25:36:04
Speaker 3
They want to.
00:25:36:04 - 00:25:36:20
Speaker 2
Access.
00:25:36:20 - 00:25:38:07
Speaker 3
And how they want to interact with.
00:25:38:07 - 00:25:39:15
Speaker 2
The system. So I'm like.
00:25:39:21 - 00:25:41:23
Speaker 3
I don't really want to we we really don't want to use.
00:25:41:23 - 00:25:45:22
Speaker 2
This system, but we want access to the supply. Perfect.
00:25:46:00 - 00:25:52:09
Speaker 3
We can do that. There's some out there that would say, oh yeah, we're very comfortable interfacing.
00:25:52:09 - 00:25:53:11
Speaker 2
With the system.
00:25:53:13 - 00:26:02:04
Speaker 3
We probably don't need to call on you, but we know you're there. If we need you, great. Let's set that up. Let's configure that for you so you can do that seamlessly.
00:26:02:05 - 00:26:29:15
Speaker 1
You know I know you're talking about the spectrum on the health system side. But I do think from the clinician side too, there is a vast difference in user base. And I think you have an incoming generation of clinicians that don't want to pick up the phone and call someone, and then you have an existing generation of clinicians that are used to calling in a central staffing, central scheduling, central staffing office and saying, hey, I need to call off for this shift, right?
00:26:29:19 - 00:26:49:09
Speaker 1
Or switch shifts are available. So it sounds like we're still in that transition phase. But, you know, I think if you had a crystal ball and you were trying to look out 12 to 18 months and say, hey, I think this trend or this, this change is going to look vastly different. Is there anything out there that you think we should all keep an eye out or, you know, what's your prediction?
00:26:49:11 - 00:26:50:12
Speaker 2
I think it I.
00:26:50:12 - 00:27:00:03
Speaker 3
Think it is that that sweet spot of being able to leverage the technology to offload much of the administrative burden that hospitals.
00:27:00:03 - 00:27:00:17
Speaker 2
Are faced with.
00:27:00:17 - 00:27:05:22
Speaker 3
Today and mirroring that with the preferences of the clinician that it.
00:27:05:22 - 00:27:08:05
Speaker 2
Brings into this, I'll call.
00:27:08:05 - 00:27:14:03
Speaker 3
It marketplace, like the transparency of cost and wage so that there's no surprises.
00:27:14:03 - 00:27:17:01
Speaker 2
To the hospital. They see what they see.
00:27:17:01 - 00:27:20:14
Speaker 3
Who they're getting, they see how much they're paying, and they have the.
00:27:20:14 - 00:27:22:05
Speaker 2
Choice.
00:27:22:07 - 00:27:35:00
Speaker 3
So I think it really when I when I work out, it really is the evolution of the technology with the services wrap around and it's very fluid. And I think it's.
00:27:35:00 - 00:27:38:16
Speaker 2
Both on the clinician side and on the client side.
00:27:38:18 - 00:27:50:10
Speaker 1
So do you see here's a follow up question. Do you see these float pools. Is flexible pools getting bigger. Do you see more stuff looking less traditional. Like why do you see that actually that mix change?
00:27:50:12 - 00:27:53:14
Speaker 2
Well I think the mix change is going to a is going.
00:27:53:14 - 00:28:03:14
Speaker 3
To naturally occur because you're bringing in different generations of talent and they're wanting something different than what we've seen even five years.
00:28:03:14 - 00:28:12:21
Speaker 2
Ago. So I do see that. I don't see wholesale changes, meaning I but I see that.
00:28:12:21 - 00:28:14:18
Speaker 3
Over the next many.
00:28:14:18 - 00:28:16:21
Speaker 2
Months, we're going to start to see some.
00:28:16:21 - 00:28:21:08
Speaker 3
Incremental change that when you do an 18 month look back, you're.
00:28:21:08 - 00:28:22:23
Speaker 2
Going to say, oh, wow.
00:28:23:00 - 00:28:26:08
Speaker 3
We used to do that. I think what we're going to find.
00:28:26:08 - 00:28:28:12
Speaker 2
Is building.
00:28:28:12 - 00:28:30:15
Speaker 3
Credibility and trust.
00:28:30:17 - 00:28:31:22
Speaker 2
With health systems.
00:28:31:22 - 00:28:39:12
Speaker 3
Is going to be very important as we leverage more technology, as we leverage AI, as we continue to leverage predictive.
00:28:39:12 - 00:28:40:12
Speaker 2
Analytics.
00:28:40:14 - 00:28:53:23
Speaker 3
I remember doing a talk a couple of years ago, and I remember standing there saying I would have never imagined ten years later, I would still be talking about trusting predictive analytics.
00:28:54:01 - 00:28:55:02
Speaker 2
And I think that's just.
00:28:55:02 - 00:28:59:15
Speaker 3
Something that we have to be mindful of, is we need to continue to show proof.
00:28:59:15 - 00:29:06:16
Speaker 2
Points that you should trust the system. You should we should be showing.
00:29:06:16 - 00:29:11:05
Speaker 3
Them proof points to drive credibility in the platforms that will be presenting to our.
00:29:11:05 - 00:29:13:05
Speaker 2
Clients. Yeah.
00:29:13:07 - 00:29:31:19
Speaker 1
That is interesting that predictive analytics is still the hot topic ten years later. Now we're just sprinkling a little eye on it. You know, a little extra AI for decision making, right? Embedded decision making with the predictive analytics. But I'm sure we'll still be talking about it in a couple of years from now. So I think, Jackie, to, to close out and thank you so much for the dialog.
00:29:31:19 - 00:29:53:08
Speaker 1
I know there's so many nuances we can get into with float pool and all the different flavors, but, you know, if I'm a listener or a health system, what advice do you have for clinical leaders that are looking to move from maybe thinking about these as short term solutions to longer term, like sustainable workforce strategies, like, what does that look like from your perspective?
00:29:53:10 - 00:30:03:13
Speaker 3
I to me, I think it's one be open minded. Like there are some nuances to what they might have been used to. And I think there's.
00:30:03:13 - 00:30:08:16
Speaker 2
Access to pure hospitals that can give some.
00:30:08:16 - 00:30:11:07
Speaker 3
Some guidance and credibility to.
00:30:11:09 - 00:30:15:04
Speaker 2
The different flavors. I think the next big thing is.
00:30:15:06 - 00:30:17:15
Speaker 3
Take the time to do the analysis.
00:30:17:17 - 00:30:19:10
Speaker 2
Just don't don't just.
00:30:19:10 - 00:30:21:19
Speaker 3
Throw a model or bodies.
00:30:21:21 - 00:30:22:17
Speaker 2
At something.
00:30:22:17 - 00:30:27:03
Speaker 3
Without understanding what do you need? Why do you need it?
00:30:27:05 - 00:30:33:20
Speaker 2
Is your system set up for success? Meaning do you have process standardization?
00:30:33:22 - 00:30:40:11
Speaker 3
Do you have the same policy in practice relative to scheduling and staffing that give you a greater chance.
00:30:40:11 - 00:30:41:05
Speaker 2
Of success.
00:30:41:05 - 00:30:43:00
Speaker 3
With any one of these models?
00:30:43:02 - 00:30:43:23
Speaker 2
So I think it's.
00:30:44:04 - 00:30:47:06
Speaker 3
Do the work to analyze current state.
00:30:47:08 - 00:30:48:08
Speaker 2
And what do you need.
00:30:48:08 - 00:30:54:02
Speaker 3
To do to get to your desired future state? I think those are some critical elements there.
00:30:54:04 - 00:31:17:17
Speaker 1
Yeah, the pre-planning and leveraging the data seems seems foundational. So thank you for that, Jackie. And thank you in general for joining me today. I'm super excited to keep talking about the different flavors of floating and how they evolve. And just wanted to say thank you, everyone for joining us today on Elevate Care. If you found this episode valuable, please consider sharing it with a colleague.
00:31:17:19 - 00:31:19:21
Speaker 1
Colleague. I'll start over.
00:31:19:23 - 00:31:20:18
Speaker 2
And.
00:31:20:20 - 00:31:42:07
Speaker 1
Thank you for joining us today on Elevate Care. If you found this episode valuable, please consider sharing it with a colleague and subscribing to our show on your favorite podcast platform. You can also learn more about this episode and our flavors afloat on our website at AMN healthcare.com, and follow us on social media. Special thanks to AMN healthcare for making the show possible.
00:31:42:09 - 00:32:03:03
Speaker 4
Thank you for joining us today on Elevate Care. If you found this episode valuable, please consider sharing it with a colleague and subscribing to our show on your favorite podcast platform. You can learn more about this episode in our show on our website at AMN healthcare.com, and follow us on social media to stay updated on new episodes and the ever changing world of healthcare.
