4 guiding principles for creating a modern internal travel nurse program
Trinity Health built FirstChoice with job candidates’ desire for flexibility top of mind and a commitment to the internal buy-in that would be required for long-term success. Its approach was characterized by adherence to the following four guiding principles.
1 Build an internal team with an eye for long-term, cross-department alignment. “Trinity Health sought to make itself a destination employer for all clinicians and for non-clinician colleagues, including those who may need to take a month of the year to care for an elderly parent out of state,” Landstrom said.
That goal made it clear who would need to be part of the planning.
“Finance and human resources need to be locked at the hip with clinical leadership,” she said.
Landstrom and Trinity’s chief of human resources, Ed Hodge, were tapped as co-sponsors of the program, with a new cost center that reports to both of them and responsibility clearly defined as shared between clinical operations and HR. Pilot programs provided pro forma numbers for what promised to be an unprecedented process. The pilots also drove tight collaboration between Landstrom as operations owner and financial leadership to document early insights and anticipate the outcomes of various scenarios:
- An internal communication action plan ensured that strategy, operations and finance teams had all been informed about the pilot and its goals.
- The existing travel planning team was also brought in for input.
- The program was structured to allow for including other workforce lines, such as food service and environmental services, in the future.
Together, this team worked through pay structures, expectations for floating staff among facilities, staffing software to connect staff and make assignments, minimum competency and clinical experience requirements, and a balance of benefits that clarify the appeal for existing staff of remaining in a permanent position.
2 Connect with candidates. Trinity Health added technologies to modernize and speed up its hiring process. Reducing time-to-hire would require evolving legacy protocols and processes as phone tag and voicemails would not play well in a future-proofed hiring approach.b Trinity Health also would need to place a premium on talking with high-quality candidates instead of simply weeding through applications to vet candidates.
“Contract workers have many offers in front of them,” Landstrom said. “They weren’t going to tolerate an overly bureaucratic process. If we took even 24 to 48 hours to get back to them, that could be too long for hero nurses who are motivated to run to the fire and intolerant of delay.”
New automation capabilities, streamlined applications and text and mobile app capabilities were deployed to allow Trinity Health to vet candidate qualifications faster, and new chat capabilities gave them faster ways to reach and move forward with strong-match candidates.
“We needed to act like a very responsive external contract agency. We needed talent acquisition professionals to be jumping and using new, faster communication approaches to vet and bring in strong candidates,” Landstrom said.
3 Pilot and scale. For Trinity, bringing the CEOs of 90+ regional health systems and service lines on board was a much heavier lift than implementing a regional program. COVID-19 served as the impetus to move from an informed pilot to a cross-regional jobs marketplace. When the time came to move, pro forma data and a ready team helped them decide not just to move forward, but to do it quickly so they could maneuver as many as 100 colleagues into locations that previously didn’t use much contract labor.
The FirstChoice structure also helped redeploy staff who were not being called in because of postponed elective surgeries and other efforts to reduce hospital load. At the same time FirstChoice was ramping up, hiring leaders were adjusting regional scheduling and querying colleagues across Trinity Health’s
25 states to ask colleagues if they would be willing to serve temporarily at another ministry within the system.
4 Stay smart on compensation. A FirstChoice nurse receives a higher salary but lower benefits. With COVID-19 driving up compensation, Trinity Health realized it needed to closely monitor shifts in travel nursing compensation and respond to changes quickly.
“Nurses might be willing to work for us for a lower rate, but we had to stay on top of market rate changes and use new tools to track them in almost real time,” Landstrom said. This regular monitoring kept Trinity Health’s pay rates competitive, and the health system was able to ensure its internal resource pool was still more cost-effective than an external staffing agency.