As the economy rebounds – however slowly – many workers will look elsewhere for new opportunities. Patel says there is already some evidence of that. "That's especially true for what we would consider pivotal roles that are absolutely critical to keeping the doors open, and also with high performers," she says. "People are still a bit uncomfortable about testing the waters and seeing what is out there but if you know you are good or you know you are in a role that is in high demand, you are more willing to look at what is out there."
"When you don't have the budget, you don't have the resources to dedicate to that," Patel says. "That is not to say that is the way it is at all hospitals. Some hospitals are very effective in outsourcing more of the administrative components so that the dollars remaining are spent on more strategic elements. But the reality is that most are not there."
It is possible that some of hospital HR costs are hidden in what Patel calls "shadow HR spend" on services that might be performed by nurse supervisors and mentors during the on-boarding process. "Some hospitals have a particular function that focuses on retention. That may or may not fit within HR," she says. "The question becomes, is there cross collaboration so that the organization is effective in managing the workforce? I have clients who say every hospital in their system can do whatever they want for anything HR oriented. That creates a lot of fragmentation and redundancy and expense, where if certain things were centralized that could help the organization."