Data And Insights About The Missouri Hospital Workforce

Speaker A: Welcome to Policy Huddle. I'm your host, Dave Dillon. One of the top issues for hospital leaders in Missouri and nationally is the status of the workforce. Each year, MHA compiles data from the state's hospitals on vacancy and turnover and releases a workforce report to inform hospitals and workforce partners investments. The workforce report also supports advocacy efforts aimed at strengthening the pipeline of healthcare workers. In this episode, we'll be speaking with Angela Gibson, Human Resource Director at Cass Regional Medical center in Harrisonville, Missouri, and Jill Williams, Vice President of Workforce Development at mha, about the report and what they are seeing in hospitals as they innovate to strengthen their teams internally and the workforce pipeline overall. Angela, welcome to Policy Huddle. We appreciate you being here talking about what's going on at, uh, CAS Regional.

Speaker B: Thank you, Dave. I appreciate the invite.

Speaker A: Absolutely. Jill, pleasure to have you on again.

Speaker C: Thanks, Dave. Thanks for having me back.

Speaker A: Well, one of the reasons we have you back is because MHA just released the 2026 workforce report, and that provides a snapshot of, uh, what was going on in the workforce in 2025. Could you give us a sense of what some of the bigger issues are that came out of that report?

Speaker B: Yeah.

Speaker C: So I think there's really three key takeaways from the report. First, the workforce has become more stable than it was immediately following the pandemic, but we haven't returned to pre pandemic levels. We continue to see persistent shortages across many of our occupations, and the challenge has shifted from simply filling jobs to retaining and stabilizing the workforce over the long term. Secondly, we talk a lot about nursing, but our, uh, workforce challenges extend well beyond registered nurses. So some of our highest vacancy and turnover rates in the report are, uh, positions like physicians, MRI and CT, technologists, LPNs, environmental services, phlebotomists, nurse assistants. I think that just reiterates that every member of the care team M plays an essential role. Shortages that are anywhere in that team impact patient care. Finally, I think hospitals are adapting, and they're adapting across the board in many ways. So as the report shows, across the state, we're seeing hospitals using this multifaceted approach. Things like investing in career pathways to grow their own workforce, redesigning care teams, the use of AI and technology, creating safer work environments, and really focusing more intentionally on employee retention.

Speaker A: I know we always look at RNs because they are a huge portion of the hospital workforce. There seems to be a lot of churn in professions like environmental services and dietary. Is that a normal thing to see that churn?

Speaker C: Healthcare is truly a Team sport. Patients don't just experience care through a single profession. They interact with all different professions. Kind of, as you mentioned, Dave, you know, environmental services, lab therapy, food service workers. And some of these occupations require specialized training and education, and others are very entry level roles. But I would say either way, when hospitals struggle to recruit and retain those professionals, it just creates pressure across the organization. One that really comes to light in the report is the LPN occupation when it comes to the nursing pathway. You know, we have nurse assistants. It's kind of a way to get your foot in the door. And, uh, maybe those nurse assistants find out a career in healthcare is not for them, or they continue to advance their career, typically through a nursing pathway. But the LPN role specifically is one that falls consistently in both that high turnover and that high vacancy occupation. And we're hearing from hospitals that many LPNs then graduate and then they matriculate immediately over into an RN program. So they're not really staying LPNs for long. But an LPN is both a frontline caregiver, but it's also a path to a registered nurse. So I really think strengthening that LPN pipeline overall support nursing growth. And the other positions that are a little bit more entry level, they have labor market competition. So retailers, fast food, those other industries in a small community are looking to take that talent pool. And then we have those individuals that get their foot in the door and advance through other career paths through the hospital. So we do typically have some that we see in those high turnover or vacancy slots year after year. But, you know, typically there's a variety of reasons.

Speaker B: Jill, you hit on a good point. We at uh, Cass, we do the same thing. So one of the programs that we started implementing, it's called Ascend, but basically it's a grow your own program, but they're more energetic. So if I work with our EVS staff or dietary, I can easily grow them. So my education team and myself will have a conversation with them. They're like, oh, I'd like to maybe become a coder so we can easily grab hold those and then support their education goals. The LPNs, we have an LPN program here through CAST. We also have an MA program here through CAST that we actually pay for with a commitment, but we are doing it from within. And so we're taking these entry level courses, moving them on, but then that leaves us entry level courses again to, to turn over. So you're, you're absolutely right.

Speaker A: That is a strategy that we've heard of before, and it seems Like a very good one because it's grounded in place and attracting someone to help their family, friends and neighbors is a pretty strong pull.

Speaker B: Well, we have here at Cast in Harrisonville, so Harrisonville is, you know, 30 minutes south of Kansas City. So it's a real quick trip up the highway for somebody to want to work in the city. It's 20 minutes to lease Summit. So what's positive for us is a lot of the entry level positions are people who live right around here because it's convenient for them to drive back and forth. So that's how we capture them, is we capture people who are in this area because they're already coming because this is where they need to start out at. It's harder for us to recruit up north when they can go to the Kansas City or to Lee Summit. So if we can recruit in our own backyard, that's what has helped us most, is have people that are in this area and are staying here.

Speaker A: As a chief human resource officer at, uh, one of the hospitals in the state. Does this report reflect what you're seeing on the ground?

Speaker B: It absolutely does. What we use this report for is we look at what our strategic plan is going to be. So if we look at it just through what's going on here at cast. Yeah, that only gives us a small picture. Well, we're going to invest time, we're going to invest energy, money. We use this report to support that. It's a bigger picture. Like how big does our circle need to spread to make sure that we, we are recruiting in the right areas or, you know, if we see something on the report that we are or not seeing something on a report that we're seeing here, then we'll focus more on professional development, looking at the department itself before we start expanding our resources. But we use this as soon as it comes out, we do a, uh, data, uh, analysis and comparison to see if we're seeing the same trends. And that's how we decide to move forward on our succession plan, professional development and where we're going to spend our recruiting dollars.

Speaker A: Gotcha. So basically you get a sense of whether you have a problem that is a problem throughout the system or whether you can identify that you have outliers that you can then invest in 100%.

Speaker B: We're always looking for those outliers. If there's something that is strict to cast, then we can narrow our focus and look and see what we can support here internally. When we have our meetings, our MHA meetings, our HR meetings, then we can all talk about it so we can all kind of share those ideas of uh, hey, we're all seeing these trends. What are you doing that works? What are you doing that works? Is it internal issue or is it a statewide issue that we can work together as a team?

Speaker A: As you're looking at how your organization attracts talent at all levels, what are the elements that you focus on in culture?

Speaker B: It used to be where you could get a recruiter, we'd get them in the door, they want a job, you had a job and you can move on. Now it's about the employee experience. We include touch points. That's one of our biggest things. So we had a very high one year turnover. You know, there's different aspects of that. You're looking at generational, uh, mindsets. We have a generation all the way from generation Z all the way up to boomers, all working together. So we have to make sure that our patient or employee experience is hitting every one of those. So that is a huge challenge we have. So we did a whole program around one year turnovers and giving or seeing like the Gen Z generation want those feedback with our m new employees from day one we have a packet that says here's your career path. So if you stay with us, here's our pathway. Uh, we have taken almost every job in our hospital and created the pathway. So that's just part of our onboarding is already, hey, look, this is where you can go with us. So that's our biggest thing is going from recruiting that day one when we get that application all the way to retirement and making sure all the way through this process there's steps that we are doing, touch points, we are showing support, we're doing different items every month and hitting a different group of people to let them know that we appreciate them.

Speaker A: I want to transition back to Jill just for a moment. Um, where is the innovation taking place to reflect those different cultures that spanned 40 years in the workforce? And what kind of difference are you seeing relative to those changes?

Speaker C: I would say, you know, I'm seeing a lot of what Angela just spoke to hospitals increasingly realizing or recognizing that compensation alone is just not going to solve the workforce challenges. And you know, with burnout, workload demands, the overall employee experience, like you said, um, continues to drive turnover, whether that's increase or decrease of turnover. And I'm seeing a lot of hospitals investing, just as you said, leadership development, employee engagement, um, flexible work environments, safety culture. But I think one of the things that we're also seeing is beyond recruitment, how Are hospitals redesigning their care teams? Because that is a part of the work environment and the work culture too. And so are we asking every member of our team to work at the top of their license or certification? I think hospitals are also rethinking their workflows so that our highly skilled clinicians can focus on the work that requires their expertise so other qualified staff members can take on their appropriate responsibilities. I think we're seeing expanded use of interdisciplinary teams, care coordinators, navigators, community health workers. Some of these other innovative roles start to emerge. I also see that hospitals are expanding their models such as virtual nursing, taking nurses virtually, using them for patient education, admissions, discharge planning and doing documentation. These things that can be done remotely. Which gets to that point, Dave, that you were, that you kind of alluded to. But that really allows, you know, bedside nurses to spend more time delivering patient care, which is what gives them enjoyment and satisfaction in a long term career. All of these things create new career opportunities.

Speaker B: Yeah, and you're right. When I first got here four years ago, we had like 152 job, different job titles. We have now due to what you exactly said, we have 179 different job titles because people wanted to stay in their area. So, so we took their expertise and went out instead of up to create newer jobs or give them some passion that maybe they feel like they've lost.

Speaker A: Have there been any critical insights that as those couple years have passed, say post pandemic where you said, wait a minute, this is how we need to change to become an organization that, uh, people will select for a career or the kind of satisfaction they're looking for in their daily work. Have, uh, there been those moments?

Speaker B: Everybody else is going through the same struggles. That was our all home moment. It's like we're not in this alone. It makes such a difference in these conversations and how we approach recruitment and how we approach building our culture. The mindset shift that our leadership is willing to do to help out and say, hey, let's see if this will work and use that data to support that has been a game changer for us because if we don't change our mindset, it's going to be really hard to move forward. So we've been very lucky.

Speaker A: I always think in terms of opportunity cost, which is to say the investment in people who want to work there and want to spend a career there. Yeah, there's absolute investment there, but the cost of turnover is also huge.

Speaker B: It is.

Speaker A: And you have to balance those two things.

Speaker B: Another thing that Chris has Supported, we are finding are we doing the best for interviews. So if we get people in the door, are we interviewing them correctly? We did a whole day with every director, every manager of how to interview correctly. Like that's a lot of money sitting in one room. But understanding the importance of behind how to interview for a right candidate. We created our own preceptor classes where we are taking our best nurses and employees and making sure that they have the skills that they need to be preceptors. But that also is cost efficient on one end, hoping that it will pay off in another end. So those are things that we've been doing is that development of even from the start, to make sure we have the right people training our new employees.

Speaker C: I think it's important, like Angela said, that realizing uh, that long term stability really depends on creating a workplace where people want to stay and they want to grow and addressing those workforce challenges through a comprehensive strategy, like you have mentioned, that recognizes that interconnectedness along the employees entire workforce, their entire career journey.

Speaker A: I, uh, do want to talk about the fact that we did it very differently this year. Data is now publicly, uh, accessible and easier to drill down on.

Speaker C: So we've been working over the past year to create an electronic system to capture workforce data with our Heidi analytics team to develop our first interactive dashboard. So the dashboard contains workforce turnover and vacancy data for the last five years. You can go into our interactive dashboard and run various reports via, uh, workforce, region, occupation, um, you can see trends, graphs, maps, all kinds of information. And we really hope that this will help our hospitals with benchmarking policy and advocacy initiatives, our educational partners as they determine which uh, educational programs around healthcare to invest in, in or to grow. Don't look at this workforce report as just a collection of statistics. It's a roadmap. So it's a roadmap that we're giving hospitals, educators, policymakers to understand kind of where the trends are at today to help us make informed decisions and investments going forward in the future. Now more than ever, all of those stakeholders that I just mentioned are working together and are focused on moving healthcare forward. So they're seeing the challenges, the change that's ahead. And I think that this data that is in, uh, our workforce report and now this interactive dashboard is just this great tool in the tool belt again that kind of gives us a roadmap for the future, for innovation and for funding and investment.

Speaker B: I want people to use Jill's data. Okay? Those are the conversations we need to have. They have a ton of Data, a ton of information. Now what? And I think that's what we get stuck. We look at all this information and go, well, that's a lot of good information. Uh, we agree with that. But hospitals should be looking at the now what? We have this. How do we use it? How do we pull what we need from that to move forward? Jill's. Jill and her team are saying, okay, guys, we see our areas. Now what are you going to do about it? I think those are the conversations that need to be starting head.

Speaker A: Right. I think we're at the beginning of a very transformational period about the future of work. And this is one tool of many, uh, that I think helps begin that conversation. Um, and then we have in the past, Jill and I and others have talked about where the innovation is occurring. So the more MHA can get engaged in helping understand where the real levers that make a difference are, that can be replicated, whether you're at large scale or not. To make a difference in your workforce is transformational. Push backwards to that patient bedside to get the right people in the right place at the right time to make care better and make communities healthier. Angela, thank you so much for giving us some perspective on, uh, how these data end, uh, up being used on the ground in communities. And thanks for being here, Dave.

Speaker B: Ah, thank you so much again for inviting me and Jill, thank you to you and your team for all the hard work you've put on this survey and getting that live dashboard on our website. Website. Thank you.

Speaker C: Thank you so much, Angela, for being here and thank you, Dave, for having us.

Speaker A: Thanks for joining us on Policy Huddle. Please remember to hit subscribe.