The Challenge
Minnesota’s healthcare sector is facing a talent supply crisis. According to Stratasight, the healthcare industry is facing the greatest worker shortage in the state, and has been for many years. Across the nine employers in the Stratasight-led Minnesota’s Older Adult Services TPM Collaborative, 5,398 Certified Nursing Assistant (CNA) jobs would need to be filled over a two-year period. CNAs are responsible for critical tasks such as assisting patients with daily living, documenting patient condition, and providing patient support. Yet employers struggle to fill these important roles because of misalignments between varying employer expectations and healthcare workforce readiness.
The Solution
To address the CNA talent pipeline, Stratasight organized the Minnesota’s Older Adult Services TPM Collaborative. Stratasight first brought nine employers in the Twin Cities region together to identify common pain points experienced by each organization: attracting entry-level talent, retaining talent, and sustaining the internal talent pipeline through upskilling.
Leveraging the TPM framework’s guidance on assessing hiring requirements, Stratasight dissected the job postings used by employer collaborative members and found significant educational misalignments. Over half of the collaborative’s employers required a high school diploma for CNAs; however, the state of Minnesota allows people to obtain CNA licenses starting at age 16. They thus revised hiring requirements to prioritize CNA training and certification over a high school diploma.
With Stratasight's guidance, employers also worked to develop a consistent approach to supporting unlicensed, newly hired CNAs with credential achievement within a four-month period. Furthermore, Stratasight pinpointed differences in preferred credentials between skilled nursing facilities and residential care facilities, to better guide jobseekers towards roles they will be successful in.
Building Partnerships
To better understand employer hiring challenges, Stratasight analyzed how participating organizations were sourcing and preparing CNA talent. The analysis showed that employers were struggling to fill and retain CNA roles, with turnover rates exceeding 100% among some collaborative members. It also revealed an opportunity to better align employers, training partners, and community organizations around a more direct path from training to employment.
To address this challenge, Stratasight worked with employers and community organizations like the Hmong American Partnership, Hired, Healthy Helpful Insight Healthcare Institute, and the International Institute to build a targeted hiring pipeline with regional training providers. Through this model, students could register for Nursing Assistant Training, interview with employer collaborative members, and receive job offers contingent upon passing their Nursing Assistant test. This coordinated approach helped increase CNA hires while reducing unnecessary costs and creating a more sustainable hiring process.
Implementation and Impact
Stratasight developed a nuanced understanding of employer challenges. Deb Broberg, executive director at Stratasight, recalled that, before TPM, “Everyone was asking what 'the employers' need, when she started in her role — as if 'employers' are a single entity. The amount of one-off, duplicated efforts (and related investments) with no proven outcomes that benefit employers (and in turn workers) was shocking.”
The pilot program ultimately saw employer return on investment (ROI) achieve a high of 74% return for CNA hiring; the new solution identified by the employers decreased employer costs associated with CNA hiring from as much as $11,700 per hire to $3,000 per hire by paying their training partners directly for tuition and support services. The pilot demonstrated a compelling business case and highlighted the need to embed ROI tracking and data collection into the design of future co-designed talent pipeline solutions from the outset. The solution also provided the added benefit of reduced reliance on grant funding for the training partners.
Lessons Learned
A key takeaway for employers was that, when lowering education and credential requirements, the priorities and expectations of the hiring team must shift as well. Stratasight stressed that leadership must support and communicate with the hiring managers to ensure effective implementation of the workforce solutions. Broberg noted, “[Employers have] got to educate [their] hiring managers on the benefits of changing job qualifications and requirements. You've got to make sure everybody in your decision tree that makes hiring decisions and job offers is aware and aligned around the changes agreed upon by the collaborative.”
Moreover, Stratasight stressed that the employer's buy-in must be companywide. To implement changes in hiring strategy, employers must commit to the solutions both at the C-suite level and at the hiring manager level. Furthermore, they must be willing to leverage the time, expertise, and advice of their HR, finance, and other teams within the company to assess the data needed to evaluate the viability of the proposed solution.
Scalability and Future Potential
One important element of Stratasight’s TPM collaborative was that the employers truly came together to advocate in the best interests of all older adult service and long-term healthcare collaborative members. During collective outreach efforts, when employers visited schools to advertise the CNA hiring opportunities, they built joint recruitment materials. During presentations, Broberg exclaimed that, “They talked about the kinds of career lattice options that exist if you start as a CNA, but they didn't go individually and talk about their own companies.” Instead, they focused their efforts on attracting kind-hearted, capable, and employable talent to the healthcare industry, understanding that widening the talent pool would benefit everyone.
The CNA worker shortage is national and growing. The need for a scaled solution is more pertinent than ever. Stratasight’s solution is replicable for any group of employers willing to work together and build up their industry’s workforce collaboratively. Workforce intermediaries struggling to fill regional CNA job openings can view Stratasight’s pilot as an example of what can be done when employers, educators, and community organizations come together in partnership.
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