Mark Jackley | Content Strategist | March 16, 2023
In early 2020, when COVID-19 started spreading globally, healthcare HR teams found themselves in uncharted territory, responsible for keeping their hospitals running by maintaining enough workers to treat waves of infected patients. Among other responsibilities, they were called on to ensure the safety of employees, provide them with mental health assistance, and adjust policies on shift scheduling, remote work, and more.
While the dust has started to settle, COVID-19 still requires human resources teams to overcome a number of major challenges. Fortunately, HR managers have learned a lot in the past few years as they’ve faced the Great Resignation, a shrinking applicant pool, rising labor costs and strikes, and other tough issues.
As the pandemic unfolded, healthcare HR managers assumed greater responsibility for their organization’s people. HR doubled down on traditional tasks such as hiring employees and containing labor costs while taking on new roles, such as ensuring a sanitary workplace, one well stocked with cleaning materials amid global supply shortages.
Reduced applicant volume
Largely because of the stresses of COVID-19, healthcare employers face a shrinking number of job applicants. Applications for surgical technician and certified nurse assistant jobs, for example, declined 52% year over year, according to a 2021 report by HRO Today, while nursing applications decreased 45%. Even applications for nonclinical roles are down—those for dietary aides declined more than 30%. Similar trends continued in 2022, with recruitment experts SIA reporting that staffing firms rate their difficulty in filling healthcare jobs at 3.75 out of 5.
Although an HR team can’t solve nationwide talent shortages, HR managers are trying new ways to increase their applicant volume. Automated systems can help by simplifying the application process, for instance, letting people apply for jobs without creating accounts. Healthcare employers are competing harder for available talent, offering signing bonuses, relocation help, and for some employees, the option of working from home. One hospital in Colorado is taking another approach; it no longer requires a high school degree for certain hospital positions and is offering to fund additional learning after people are hired.
In late 2021, research firm Morning Consult reported that 18% of healthcare workers—nearly one in five—had quit their jobs during the pandemic, blaming COVID-19 itself, poor pay, and burnout. Among those who chose to stay, 31% said they had considered leaving.
Since then, healthcare employment levels have increased in step with rising COVID vaccination rates and sharp drops in infections. The Journal of the American Medical Association reports that by April 2022 the healthcare industry’s unemployment rate was down to 2.28%, compared with 3.18% at the pandemic’s height. Even though the Great Resignation has subsided among healthcare employers, they still face problems with chronic burnout, employee turnover, and the overall talent shortage. To prevent the next wave of resignations, healthcare HR managers must deliver competitive compensation and programs to combat burnout—for example, revamped time-off and scheduling policies.
A sanitary workplace has always been vital in healthcare, but in response to COVID-19, HR teams have reworked policies to prevent disease transmission. Working under guidelines set by the US Occupational Safety and Health Administration (OSHA) and Centers for Disease Control and Prevention (CDC), HR teams are helping facilities management upgrade cleaning procedures. These now include additional cleaning requirements for busy, high-touch areas such as waiting rooms, elevators, and restrooms, as well as workstations and employees’ personal property. They also include making ample supplies of hand sanitizer and wipes available and sometimes using physical barriers, such as plexiglass shields at reception desks. When there’s a suspected or confirmed COVID case at work, HR teams are requiring more-frequent cleaning and re-enforcing the requirement that employees and patients wash their hands, wear a mask, and maintain social distance.
Like other industries, healthcare organizations began expanding their virtual workforce programs when COVID appeared.
Tasks such as checking in patients, processing claims, and managing medical records can be done from anywhere, as long as HR provides guidelines on remote work etiquette, including security precautions. AltaMed, a Los Angeles-based provider of community health services, moved more than 1,000 call center, HR, IT, and compliance employees to a work-from-home model, even letting doctors and nurses work virtually at times under its “flexible walls” approach. And by not requiring certain new hires to relocate, health systems can plug staffing gaps more easily, especially in remote areas.
In a 2021 survey by the American Medical Association, half of the US healthcare workers who responded, including 56% of nurses, reported having symptoms of burnout, which is defined as physical or emotional exhaustion that also involves a reduced feeling of accomplishment. One-third reported high levels of anxiety or depression, and 25% of the physicians surveyed said they planned to leave their practice within two years.
In May 2022, the US Surgeon General, Dr. Vivek Murthy, issued an advisory on healthcare worker burnout and well-being, declaring the problem a national priority. Dr. Murthy offered the following prescription for alleviating burnout: “First, valuing and protecting health workers. That means ensuring that they receive a living wage, access to health insurance, and adequate sick leave. It also means health workers should never again go without adequate personal protective equipment as they have during the pandemic.” He also noted the need to expand employee access to mental health programs.
The coronavirus pandemic badly damaged healthcare worker morale. In a 2021 industry survey, 62% of respondents said COVID-related worry or stress was having a negative impact on their mental health, with 56% of frontline employees saying they were having trouble sleeping. As a hospital worker in Pennsylvania put it: “The staff was overwhelmed, the resources were running out, and our exposure to COVID was extremely high. It was terrible, honestly, and scary.” Though COVID-19 isn’t as rampant or severe as it was two years ago, the threat of workplace infection will never disappear.
Not all threats are from disease. OSHA reports that the risk of workplace assaults against healthcare staff is now four times higher than for employees in other industries. Relatively low pay, overscheduling, and burnout are other causes of low morale. To turn things around and improve healthcare retention, HR teams need to build employee well-being into their organization’s values and demonstrate that it’s a priority by offering competitive pay, more balanced scheduling, and programs that cultivate a more empathetic workplace culture, one where employees feel their needs are heard and addressed.
To meet personnel needs at the onset of COVID, healthcare organizations ramped up partnerships with staffing agencies. Jackson Healthcare in Georgia, for example, teamed up with Healthcare Workforce Logistics to add 570 workers, while the Liacouras Center in Philadelphia worked with General Healthcare Resources to handle their COVID surge. Rural areas especially have benefited from such partnerships, though they can add significant costs.
One creative public-private partnership, Community Care of North Carolina, which is sponsored by state agencies, comprises 14 regional networks of doctors, nurses, pharmacies, social service workers, and others to extend quality care far beyond urban centers. Although staffing shortages aren’t as severe as they were two years ago, projected shortages in the years to come will make partnership models a useful option.
Healthcare industry HR teams have made widespread policy changes to address COVID-related challenges. Among them are revised policies for keeping employees and patients safe, cleaning the workplace, wearing masks, and getting tested. HR is the main source of accurate, up-to-date information on workplace safety in the COVID era.
As needed, HR management should also review and enhance policies in the following areas: shift scheduling; taking time off from work; allowing remote work; hiring and onboarding; adjusting pay and benefits, including adding new perks; and seeking and acting on employee feedback. Indeed, one of COVID’s silver linings has been a top-to-bottom policy refresh, spearheaded by HR.
Healthcare labor costs have increased by more than a third since the onset of COVID-19, according to a report by Kaufman Hall. While contract labor is a major reason for that increase, salaries for full-time employees are also on the rise to compensate them for having to work under grueling conditions and the threat of COVID infection. When one staffing firm surveyed nurses, more than a third said they plan to leave their job soon, with better pay cited as a primary motive. Peterson-KFF reports that healthcare employers have responded by increasing average wages 17% since the pandemic started.
Some healthcare organizations have explored raising prices to offset higher salaries for nurses and other employees, claiming that federal programs such as Medicare have underestimated hospital labor costs when adjusting payments. Other health systems have contained costs by closely watching contract labor expenses as well as overtime and premium pay.
HR departments generally aren’t responsible for procuring medical supplies, but with overseeing COVID safety and sanitation added to their duties, HR teams must help make sure their organizations have ample quantities of hand sanitizer, protective masks, COVID testing swabs, and more. When a New York hospital ran low on swabs, its HR department found a supplier that came through using 3D printing. HR must also help employees cope with supply shortages. For example, when some hospitals postponed surgeries because of a lack of supplies, HR teams had to rearrange shift schedules on the fly while ensuring clinicians were available when surgeries resumed.
The pandemic has been extremely hard on healthcare workers, causing many of them to bargain for better pay, benefits, and working conditions. Some unionized workers have gone on strike, including nurses at two New York hospitals who went on strike for three days at the beginning of 2023. Over the course of 2022, at least 30,000 healthcare workers went on strike, with nearly twice as many threatening to do so before agreements were reached, according to Healthcare Dive. In California alone, workers at three major health systems—Stanford University Hospital, Cedars-Sinai, and Kaiser Permanente—went on strike in 2022.
COVID-19 created a state of emergency in the healthcare industry. To help their organizations cope, HR managers went beyond the call of duty, sometimes managing emergency relief and response. HR suddenly played a bigger role in protecting employee safety, creating and enforcing stricter cleaning protocols, implementing COVID testing policies, and setting social distancing and mask mandates. HR also had the sensitive job of encouraging—sometimes demanding—that frontline workers get vaccinated. More than anything, HR teams were the main source for reliable COVID information as conditions rapidly changed and health systems responded with new policies and procedures.
One important lesson healthcare employers will take into the future is the importance of building flexible and supportive work processes. Both the organization and its workers must be ready to pivot when the next public health emergency happens. Remote work for certain jobs and the growth of virtual care will require new technologies, plus guidance from HR on the dos and don’ts of dealing with people on-screen versus in person. As HR teams help to fashion the next healthcare workplace, the C-suite must embrace HR as a strategic partner.
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COVID-19 has challenged healthcare HR organizations to reexamine their role. Coming up with creative ways to recruit new employees, share employees with other health networks, partner with agencies to augment their existing workforces, and create new programs and processes to retain existing employees is a bigger HR priority than ever before. So too are safety concerns in the wake of a pandemic that by January 2023 had killed 1.1 million Americans. For many HR managers in hospitals and clinics, handwashing, mask-wearing, and vaccinations have become permanent concerns.
As the industry emerges from the pandemic, HR must continue to use everything in its toolkit, including data and technology, to improve employees’ lives while watching the bottom line—containing labor costs, avoiding lawsuits from injured or disgruntled employees, and complying with regulations to avoid fines. The end goal remains the same: Serve patients better and improve health outcomes.
What challenges has healthcare HR faced since COVID?
Since the pandemic began, healthcare HR has faced severe staffing shortages, rising burnout and employee turnover rates, and employee fears of contracting the virus. HR teams have also had to change policies on shift scheduling and remote work, as well as explore using staffing firms to meet personnel needs.
How did the COVID-19 pandemic affect healthcare workers?
The pandemic led to more cases of employee burnout and lower morale, leading many to resign and accept jobs elsewhere.
What is the single greatest challenge facing healthcare HR professionals today?
Although industry staffing levels have rebounded since dropping sharply in 2020, healthcare HR organizations are challenged to hire and retain sufficient numbers of doctors, nurses, and other personnel. Anticipated staffing shortages challenge HR teams to create a workplace environment that’s more positive and rewarding.