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What labor shortage?



Healthcare’s workforce crisis seems to be settling in for the long haul. A recent Kaufman Hall report finds that hospitals have vastly increased pay to compete, but all that is doing is driving up labor expenses rather than increasing staffing levels. Finding, hiring and retaining staff are major problems in nearly every part of the industry, as they are across other sectors around the world.


A service company such as Salud depends on talented, motivated employees to achieve exceptional results for clients, so you would think we would be subject to the same staffing challenges. And yet, as I have been reflecting on how the pandemic and other trends have impacted our company’s ability to source, retain and develop quality employees, I have come to a simple conclusion: They don’t.


According to the Bureau of Labor Statistics, workers have been quitting at a record rate for four months in a row. The U.S. overall turnover rate is 57.3%, a number that drops to 25% when considering only voluntary turnover. These number far exceed traditional rates that ranged less than 20%. Why is staffing a problem for some, and not all?


U.S. Labor Secretary Marty Walsh has identified three potential drivers of the turnover, all interrelated:

  • We’re living in unprecedented times

  • Fears over COVID

  • People are rethinking life and work


As I am not an expert on labor economics, I’ll defer to others’ expertise on national staffing problems. I do, however, recognize that companies like Salud will only overcome staffing pain when they recognize the following:


People want meaning in their work, to enjoy it, and to work when and where they want.


That sounds like a utopian ideal, and turning it into reality is unbelievably hard to carry out, especially amid a crisis like we are in today.


Luckily, Salud’s efforts to accommodate its employees have yielded high employee satisfaction without compromising quality. In our most recent employee survey, 100% of our staff participated anonymously and provided insight into our success in addressing their needs. Here are some of the results:

  • Sense of purpose: 98% of staff agree with the statement, “Salud does the right thing for patients.”

  • Overall satisfaction: 96% agree with the statement, “Overall, I am satisfied with my job.”

  • Flexibility: 96% agree with the statement, “I would recommend Salud to prospective employees.”


Today’s success results from a transformation we started in 2015. Prior to forming Salud, our leadership worked for years as healthcare administrators, so when we came together as Salud we quickly adopted policies that we used to enforce at health systems. This seemed normal, but we often heard complaints about staff not following the rules while complaining about managers applying them inconsistently. We initiated our bi-annual employee satisfaction survey, only to see the complaints in writing and associated with low scores.


We needed to change, like many companies need to change today.


According to Jennifer Swindle, our leader of quality and service excellence, the most important factors in job satisfaction are:

  • Feeling like I am making a difference

  • Being recognized for my accomplishments

  • Being trusted to work hard and smart

  • Knowing what’s expected of me

  • Feeling like my voice matters and is heard

Our key transformation came from being willing to throw out traditional approaches to management. We pulled out our policy manual, questioned why we needed each rule, and either revised or eliminated most of them. We chose to pursue a high-performance culture where leaders supported staff in achieving personal and client-centered goals instead of a culture that required managers to enforce rules. This journey has not been easy but it sure has been rewarding.


As a data-driven company, Salud is taking a scientific approach to our self-evaluation, and perhaps our research will benefit others in the industry. We are working with our clients and similar healthcare providers to understand their staffing challenges. We plan to share these results and our conclusions with participating providers. We look forward to achieving our goals together.


We know we aren’t perfect. Our company and employees struggle with the forces that are driving turnover throughout the world. We are fortunate to have started our transformation years ago, but we still need to continue to challenge our status quo.


Salud‘s values include service, integrity, respect, teamwork and quality. We’ve created a culture that rewards staff who live those values, and we do not sacrifice our values when hiring staff, even in a tight job market.

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