Taking a Data-Driven Approach to Workforce Optimization

Health systems across the country are facing workforce shortages in the coming decade, with demand for primary care physicians and surgeons, among other professions, projected to far outpace supply. The challenge is particularly acute for rural hospitals, most of which have smaller populations from which to attract and hire needed personnel.

To meet this emerging crisis effectively, health systems need to take a data-driven approach to evaluating their local markets for potential hires and assessing clinical staffing needs. For effective workforce strategies, health care leaders must understand how to collect and use accurate, real-time data to drive provider recruitment across their markets.

Shikha Parakh, the director of corporate strategy and planning at Sentara Health, and Jaclyn Zurawski, a consulting principal for SullivanCotter, a firm that partners with health care and other not-for-profit organizations to create tailored workforce strategies that enhance performance, spoke on the topic during a SHSMD Connections Conference session in October 2024. They shared their experiences developing a workforce strategy for Sentara Health that would help the health system meet future care demand across its diverse region.

“The pipeline of workforce is shrinking and becoming more specialized,” Parakh says. “And you can’t deliver health care without your health care team.”

Workforce Shortage

According to the Association of American Medical Colleges (AAMC), health care in the United States is going to experience a shortage of providers across all specialties by 2036. For example, the AAMC projects that there will be a deficit in available primary care providers of 20,000 to 40,000 (needed positions vs. trained professionals seeking employment) within the next 10 years. Other specialties are also expected to have significant shortfalls.

Sentara Health, an integrated (insurance plan and hospital system), not-for-profit health care delivery system, has already experienced difficulties identifying and recruiting staff to support its 12 urban and rural hospitals in Virginia and northeastern North Carolina. The organization, which has more than 30,000 team members, has two acute care facilities in the rural areas of these two states, meaning it has a limited local population from which to draw candidates. Demand for specific health care services or specialties in these areas also fluctuates based on the changing needs of the (relatively) small local population.

To optimize its workforce for the years ahead, Sentara Health is embarking on a 10-year, $350 million “upskilling ” initiative systemwide in keeping with its stated purpose, which is to “be the trusted partner to individuals and the community in their journey to health and well-being.”

“We cannot deliver on our mission unless we focus on our people,” Parakh notes.

The Sentara Solution

To assess staffing needs and identify ways to overcome potential shortfalls, Sentara Health has used a programmatic approach to workforce planning, collecting, and analyzing accurate, real-time data to drive its provider recruitment plans across its various markets.

Working with SullivanCotter, that approach began with a Provider Needs Assessment (PNA) to determine “the market supply minus the market demand,” Zurawski explains. “It tells you whether you have a surplus or deficit of providers in your specific community.”

Then, using SullivanCotter’s cloud-based market analysis application, Sentara Health was able to generate an accurate picture of the “supply” or number of providers practicing and offering care services in a health system’s local area. The PNA enabled the health system to determine the “number and type of providers … needed to optimize [its] workforce … to meet clinical needs,” Zurawski notes. “Being able to drill into those details is incredibly important as you’re making your strategies at an aggregate level or an individual hospital level.”

For example, one area that is often overlooked in workforce assessment—but was included in Sentara Health’s analysis—is “succession planning,” which takes into account provider age and likely retirement timeline. According to the AAMC, 47% of all physicians nationally are 55 years of age and older. Specifically at Sentara Health, one hospital has a roster in which 64% of its physicians are at least 60, Parakh notes.

This is important information to have because, as Zurawski says, knowing “how they are going to backfill” for retiring personnel is a key part of any health system’s workforce strategy.

Partnering with SullivanCotter enabled Sentara Health to map out the supply and demand of health care professionals in their various markets and project what care services would ultimately be needed by consumers, based on demographics and health trends, in these areas. With this information, the health system could staff up or down accordingly.

Adding Context to Data

However, an effective data-driven workforce strategy needs more than numbers. It also needs context.

Indeed, context—or what Zurawski calls “qualitative pieces”—augments the quantitative analysis and “supports prioritization and determines desired recruitment,” she says.

Context to consider along with key data includes specific service line goals, any quality-of-care issues in a specific service line, any market areas in which access to care is a challenge, and staff productivity. This context can be gleaned from leadership interviews, medical staff surveys, access studies, and productivity benchmarking, among other tools.

According to Zurawski, SullivanCotter’s workforce strategy application enabled Sentara Health to essentially map out care utilization trends across its region, which helped it distinguish areas where new hires could fill gaps. This also helped identify opportunities for future growth.

As an example, Parakh notes that Sentara Health made the “tough decision” to discontinue offering OB-GYN services at one of its locations following its market analysis, which revealed that there were multiple competitor providers in an area that had declining birth rates (an average of 265 births annually). As part of the process, Sentara Health prioritized the future needs of the community and decided to construct a new hospital to address future needs of the community and failing infrastructure.

“We ensured current OB patients were transitioned to another nearby Health facility,” Parakh says. “Everybody is fighting for the same market, and that’s not an effective use of resources.”

Instead, based on its analysis of care utilization trends in the area, Sentara Health launched an interventional cardiology practice in the region, which filled a clear clinical need for the local population. The SullivanCotter workforce strategy application also has a predictive model that enables health systems to project care service demand in a specific region five years into the future.

“I strongly believe care utilization is a function of disease prevalence, availability of health care services, and consumer preferences,” Parakh notes. “Having this data helps me identify workforce strategies that allow us to use resources most appropriately.”