Our Vision on Reimagining the Workforce

Listen to KPMG executives discuss how leveraging innovative approaches and emerging technologies can help attract and retain talent

Video transcript

Dion Sheidy: (00:02) Thank you for joining us today as we dive into the challenges and opportunities related to workforce within the healthcare sector as part of our new video series, Re-imagining the Workforce in Healthcare. My name is Dion Sheidy. I'm a partner with KPMG and I service our US leader for our advisory healthcare practice. Joining me today are several of my colleagues. Kristine Coogan, a principal in our people strategy practice, focused on data enablement. Mike Fontaine and Michelle Pugh, two principals in our human capital advisory practice focused on workforce transformation. Ryan McDonald, the principal in our rewards practice and our US lead for employee benefits and last but not least, Jamie Sanchez Anderson, a managing director and registered nurse in our healthcare solutions practice focused on clinical operations. As we think about the workforce challenges facing healthcare today, many of these existed for some time including managing workforce and expectations within the cost constraints of operating within the sector. As we think about what's different today as we emerge from the global pandemic and we think about the economic challenges that exist today, many of these things just have exacerbated the issues impacting the sector.

(01:32) You think about the need to be able to match demand and capacity and service delivery around provision of healthcare across a much wider distributed network. You think about the ability of an organization to meet employee expectations in light of its organizational policies and procedures. We're going to dive into some of these issues today via discussion with my colleagues. Kristine, why don't you start us off? Can you give us a frame of the issues facing the sector?

Kristine Coogan: (02:02) Sure, Dion, and I think what's important to know is that when we talk about a workforce shortage in healthcare, we're not talking about something that's going to happen in the future. It's here right now. For example, for every three job postings nationwide for nurses, only one of them gets filled, which suggests that there's a lot of unmet demand in the market and when we look at studies across the industry, we are projecting around a half a million roles that we will be short over the next five years across all different positions that are affecting patient care, where healthcare is really in crisis today when it comes to workforce. You mentioned the pandemic, the increasing complexity of treatments, of chronic illnesses, patient care standards.

(02:45) These are all creating tremendous pressure on the workers who are at the front lines and so when we think about employees within healthcare, 50% of them are still trying to find and connect with that higher purpose within the industry and 20% of them tell us that they're looking outside healthcare for roles and opportunities and on top of that, 25% have said they're accelerating their retirement plans as a result of the pandemic.

Dion Sheidy: (03:14) Seems like a really difficult environment for hiring and retaining people. How do employers get their arms around this?

Kristine Coogan: (03:21) Yeah, one thing that I like to share with organizations is they should think of employees as the new customer. So, in a lot of the ways that we have used data to help us understand what customers want and need, build interest in product and services and measure satisfaction, we can deliver those same solutions around employees and use data to understand what they want and what they need and bring some really engaging experiences to them. Some good examples are we can use data to help us hire more efficiently, to connect people with jobs that meet their interests, the types of roles they want, the shifts they're looking for and the environments that they're most successful in and we know that when employees are in jobs that they like, they're up to 10 times more likely to stay and to be engaged within those roles. Another example is we've had clients who have a lot of turnover. For example, one specific client had a lot of turnover within the first 120 days and management would say things like, "These employees are not cut out for this type of work."

(04:19) But what actually was the case when we listened to the employees was that they didn't feel supported and the environment they were working in was complicated and so what we brought to the solution was more support, more training, and more guidance to help them be successful and really reduced turnover significantly in those first 120 days and improved employee morale at the same time. So, these are the types of ways that companies can use data to create better outcomes for employees.

Dion Sheidy: (04:48) Mike, Kristine talked a lot about the size of the issue, the importance of listening to the employees, the impact of turnover. What can organizational leadership do in the midst of these challenges?

Mike Fontaine: (05:00) That's a good question, Dion. The double disruption caused by both the pandemic and then the accelerating pace of digital transformation has really accelerated the way that leaders and organizations need to think about the workforce and how they are focused on the types of responsibilities and the level of agility that they've actually not driven into before. This is important because organizations now need to meet employees where they're at, right? They need to be thinking about social justice. They need to be thinking about ESG. They need to be thinking about DENI. They need to be thinking about how they meet their employees at a level where they feel as though their work and the work that they're involved in has a purpose. Changing cultures in an organization has become key for leaders as they've done that.

Dion Sheidy: (05:41) Thanks, Mike. Talk a little bit. Is there an approach that works better than others around this?

Mike Fontaine: (05:46) I don't think there's one approach that works better than others, Dion. But we've actually managed to take a look inside of KPMG and created a model called ALE or ALE, which stands for Adopt, Lead and Engage and as we started focusing on it, the adopt phase really takes a look at how leaders and organizations are adopting digital technologies to supplement and compliment the work of employees. The lead stage takes a look at how you would actually focus on how you reimagine the workforce of the future and the changing paradigms that are happening in new ways of working and the engaged phase takes a focus on how you're actually engaging employees around purpose and personalization. Now, if you go into that further, for adopt, many organizations are now currently putting new types of workflow technologies on top of the human capital management platform.

(06:33) So for example, we see many firms are now starting to put salesforce.com or ServiceNow, for example, on top of workday success factors or Oracle for their HCM systems to not only remove task processing, but to really improve the digital experience that's happening for employees and thinking through moments that matter as they move through that type of work and getting away from having all of us access different systems. We see that happens all the time. For the lead stage, we're really seeing that successful organizations are thinking about new ways of working, for example, right? Hybrid work. We've all talked about how we've changed to more of a hybrid economy during the pandemic and since. Some organizations have adopted remote working almost completely. There's a few that have, others are thinking as they bring people back into the office, how are they offering flexibility for the workday and for the work schedule? I think this is really important for the healthcare industry where you think about your frontline workers don't often have the ability to be remote or have the ability to be hybrid. Doctors and nurses are right there in front of patients.

(07:32) But you do have the ability to think about some improved scheduling and I think some of our team members will highlight that even more as we go forward and then finally, for the engage phase, we're really seeing that you need to pay much more attention to where employees are at and how you actually focus on them. So whether it's personalized career paths or even providing greater transparency to leadership decisions, we see a number of organizations, I wouldn't say bypassing the middle manager, but providing access to the employee on how the leadership team, how the board makes decisions, what is the process that they go through as they look at those and it's all about how you're really driving the moments that matter so that you can elevate and extend the employee experience journey.

Dion Sheidy: (08:11) Sounds like culture and experience are a big deal. Michelle, any insights? Talk about this from the employees' point of view.

Michelle Pugh: (08:19) Yeah, Dion, when I think about healthcare as a profession, I think about the caregiver and being a caregiver has always been a calling. I mean, we've heard from Kristine all of the stats that lead to these environmental and cultural challenges. So, caregivers who even have a calling need to have more than that to choose to stay or move into a healthcare profession. Part of that reason is really our clinical employees are experiencing unprecedented levels of abuse right now. Extreme work hours, a lack of support from more experienced professionals, leave them with inadequate support and this is leading to levels of depression, burnout, turnover that we've never seen before. So, in response, our healthcare organizations are focusing a lot of their effort on bringing in new people. But just as important, if not more important, is really retaining the employees that they already have.

(09:18) But in order to do that, you have to create an environment where they want to thrive, where they can thrive and this is done by evaluating the employee value proposition, creating a sense of purpose, understanding the unique needs of each of the employee and then designing a set of solutions that are fit for purpose and human centered and really help our employees engage, develop, and retain. By looking end to end at the talent cycle and figuring out the areas from recruit to retire that need the most effort, we're able to identify the most meaningful solutions to offer our employees. So, in doing this work, I've really identified three big areas in creating an employee value proposition. The first is really enhancing the talent programs that you already have or building new talent programs that you may not have and it's really in support of our employees' physical, their emotional, their financial wellbeing needs, better work life integration, a focus on job stability and career growth and advancement, putting together a total rewards package, compensation and a portfolio of benefits that really can be personalized to the needs of the employees.

(10:40) The second area is really to implement technologies that reduce that manual effort. Our employees spend upwards of 5% of their day doing administrative activities that interfere with the more valuable things they should be doing as they're facing off with our patients and last, more importantly probably than even the other two is really providing our employees with a sense of safety, of belonging, of purpose and underpinning that whole employee value proposition with diversity, equity, and inclusion.

Dion Sheidy: (11:16) Jamie, we've heard a lot of great perspectives. Talk a little bit about operationalizing this.

Jamie Sanchez A...: (11:21) Yeah, absolutely. Coming out of the pandemic, many organizations are focused on hiring and rebuilding their workforce. They're really focused on filling those gaps. I really think that we need to challenge ourselves instead to think about how we're redesigning patient care and really leveraging technology to think about how we deliver care in different ways to sustain the future of work and encourage more generations to enter it. We have no immediate answer to solve the nursing shortage today, but here at KPMG have developed several tactics: to focus on the now and filling those gaps and then also to focus on the near and far term to think about new strategies to deliver care in different ways that will ultimately reduce the burden on the direct caregiver. We are creating new staff scheduling and flexibility models, leveraging advanced scheduling technologies and tools to really forecast and predict the staffing needs. We're thinking about ways that we can re-skill and up-skill our staff so that we're leveraging those trained individuals at their highest potential. From there, we really need to think about how we can empower and support our workforce, not only for today, but those for tomorrow.

(12:27) We need to focus on retaining them ultimately and we need to think about the shortages that we have now, not only are going to continue to exist. But statistics are showing that many people don't want to enter the workforce. They're hearing about that burnout. They're hearing about the stress. So, we really need to think about how we can transform it so that we encourage our future generations to continue to enter it and fulfill that calling that Michelle mentioned earlier.

Dion Sheidy: (12:51) Jamie, how about a few examples of some of the work we're doing with our clients around this?

Jamie Sanchez A...: (12:55) Yeah, absolutely. Healthcare organizations have really thought about how we can transform that staffing model. So, we've started to implement centralized scheduling and we've also started to focus about self-scheduling. People want to have a say about how and when and where they work. We need to empower them to be able to do so. Many organizations have a lot of misconceptions around centralized scheduling and self-scheduling. They think that's actually going to increase the gaps. But we've actually found in many cases, we're able to fill 90% of our shifts through self-scheduling. They're concerned about the weekend coverage, the off-shift coverage. But many individuals look for that work-life balance and they're able and want to fulfill some of those needs. So, I would encourage you to look at the centralized scheduling and self-scheduling options within your organization. Not only in addition to that, we've been looking at job sharing. So, we've been looking at not just those department-based scheduling, but how we can help people. As you can imagine, those fast-paced environments, the ED, the ICU, they increase stress. They increase burnout.

(13:54) It's actually is what's causing some of our turnover and having people leave the profession. So, through this job-sharing model, we're able to alleviate some of that stress by not only having people work in the ED and ICU, but offset some of that time with job sharing and primary care and urgent care. While that disrupts the way that we think people should work in their 12 hour shifts and where they work in an individual department, we have seen a reduction in turnover. We've seen a reduction, an incentive and overtime by balancing that schedule between those different areas and look, 1% of our RN turnover can save over $200,000 a year per employee. We need to focus on the retention, and not only do we need to transform how we deliver care, we need to leverage some of those patient monitoring capabilities or telehealth and remote capabilities to deliver work differently. We need to reduce the burden, the administrative burden that Michelle talked about on our caregivers, and we need to focus how we can allow people to work when and how they want to.

Dion Sheidy: (14:52) Great. Ryan, lots of considerations here. Talk a little bit about what employers are thinking about in terms of rewards.

Ryan McDonald: (15:00) Sure. We spoke about the organizational challenges that contribute to burnout and some of the solutions to help address. But there are a lot of personal challenges that healthcare workers are bringing to the workplace that are contributing to that burnout and that intersection between the professional and personal has never been more interwoven than it is today. So, for employers to really target wellbeing, they need to focus on whole person support, not just professional, but also in their personal lives. When we think about where to start, our recommendation would be to target behavioral health. We know our employees are struggling. We know they've been struggling for several years. So, is our domestic EAP sufficient to really support our employees where and when they need support? If not, there are virtual solutions in the market that we would really recommend organizations consider that allow shift-based workers to either talk to a therapist during their break or pre or post shift that can meet them where and when they need support.

(15:55) The next recommendation would be to target some of the personal challenges that contribute to burnout, so financial stress, fertility, parental and child caregiver, DEI, and some other lifestyle challenges. There are rewards in place that can help address many of these challenges and we spoke a lot about showing our employees that we truly value their perspective and offering these benefits to meet their needs will go a long way to showing them that we truly care, that we're investing in them, that we're allowing them to be the best versions of themselves, which in turn will allow them to bring the best version into the workplace and we know that's critical within healthcare.

Dion Sheidy: (16:30) Yeah, I think that makes a lot of sense. We spoke a little bit about ongoing cost constraints within the sector. Talk a little bit about the ability to kind of tweak the reward packages in light of these constraints.

Ryan McDonald: (16:47) Sure. Cost is always a focus and typically the main obstacle to enhancing your benefit program, especially with the compensation increases that took place over the past two years. But there typically are opportunities to take a holistic review of your program and identify areas. One example is we reviewed vendor relationships of an organization that had not gone to market in over five years. We saved them $6 million per year, which allowed them to invest back in enhanced fertility coverage, enhanced employee advocacy, some DEI benefits and reducing their medical premiums. So, they were able to, by taking a holistic review of their current program, utilize some of those savings to invest back in the program and actually retain some for themselves.

Dion Sheidy: (17:30) Great. Well, as we wrap up, I'd like to get the key takeaway from each of you as we ask our clients to kind of continue to think about these challenges. So why don't we start with you, Kristine?

Kristine Coogan: (17:43) Yeah. I would encourage organizations to use data to understand where their employees are at, what they want and what they need and then apply that to developing solutions that really work and that the employees value and that make their working lives better.

Dion Sheidy: (17:59) Jamie?

Jamie Sanchez A...: (18:00) Yeah. I would really challenge healthcare leaders to redesign how patient care is delivered and to rethink how and when and where staff work so that we can ultimately enable the future of work and more generations to enter it.

Dion Sheidy: (18:16) Mike.

Mike Fontaine: (18:16) I would say that as a leader and even a leader in HR, that now is the time and there's likely no better time to really challenge yourself and challenge your organization to think bigger and broader and to really start to think about how you are adopting digital technologies to support your workforce, how you are leading them through new ways of working and how you're engaging them where you need to meet them so that you can attract and retain talent for the long term.

Dion Sheidy: (18:38) Ryan?

Ryan McDonald: (18:39) Yeah. We know our employees need support. So, my recommendation would be to be strategic, aggressive, and targeted in understanding what our employees need and providing the resources that can best support them.

Dion Sheidy: (18:50) And finally, Michelle.

Michelle Pugh: (18:51) I think it's important for us all to remember that employees decide to join an organization just once. But their decision to stay happens every single day. So, we need to create an employee value proposition and a set of solutions and programs that reinforce that desire to stay every day.

Dion Sheidy: (19:09) Great. Well, thank you all for joining us today. As you can see, there's a significant opportunity as we think about reimagining workforce and healthcare, and this is clearly an imperative for our clients or should be an imperative for our clients. I invite you to look at the additional videos within our series that do a deeper dive into things like talent and culture and operationalizing this within the care delivery setting. Thank you again.

Contact us

Dion Sheidy

Dion Sheidy

Partner, Healthcare Advisory, KPMG US

+1 412-480-3167
Kristine Coogan

Kristine Coogan

Principal, Advisory, Strategy, KPMG US

+1 312-665-2641
Mike Fontaine

Mike Fontaine

Principal Advisory, Human Capital Advisory, KPMG, US

+1 201-307-7357
Michelle Pugh

Michelle Pugh

Principal Advisory, Human Capital Advisory , KPMG US

+1 612-305-5000
Ryan McDonald

Ryan McDonald

Principal, KPMG Benefits Services, KPMG U.S.

+1 585-263-4098
Jamie Sanchez-Anderson

Jamie Sanchez-Anderson

Advisory Managing Director, C&O Health & Government, KPMG US