Human Resources – Shortage

The Human Resources – Shortage risk relates to the shortage of human resources resulting from several factors.  These may include absenteeism, aging workforce, disability management practices, inconsistent assignment of staffing levels and the inability to recruit and retain competent resources. This risk can lead to adverse outcomes such as, staff burnout and fatigue, decreased staff morale, increased workplace injuries, inadequate care, reputational loss, financial loss (overtime/use of agency staff), longer patient/client wait time and potential patient/client harm. This document contains information entered by HIROC subscriber healthcare organizations (acute and non-acute) in the Risk Register application to help you in your assessment of this risk.

Key Controls / Mitigation Strategies

• Retention and recruitment
  • Dedicated resource(s) in place that handle active recruitment/retention efforts
  • Increase the number of placements for students/interns/residents with appropriate incentives
  • Comprehensive talent and leadership development program and opportunities for growth
  • Market analysis of salaries, benefits, employee assistance program
  • Incentive recruitment program
  • Physician recruitment program and locum backfill onboarding 
  • Student and new graduate recruitment program
  • Community partnerships with educational institutions to attract students
  • Increase staff engagement through various methods
  • Mentorship programs for staff and students
  • Wellness room and/or gym for staff to promote self-care 
  • Clarity in role, responsibilities, and accountability to reduce ambiguity and anxiety
  • Build on culture of caring, safety, innovation, respect, community, and progressive HR programs
  • Provide organizational development support in advancing team cohesion and conflict resolution
  • Attendance at career fairs and other targeted professional conferences/symposiums
  • Enhanced advertising and social media presence (e.g., LinkedIn career opportunity announcements)
  • Employee referral program
  • Nursing retention strategy and workforce planning initiative
  • Enhanced staffing pattern to attract new staff
  • Clinical extern program
  • International recruitment initiatives
  • Government funded programs for Personal Support Workers, Registered Practical Nurses, Registered Nurses retention

Note: Human resources shortage can result from the inability to recruit and retain resources. For more strategies related to recruitment and retention, please refer to the Risk Profile: Human Resources: Recruitment/Retention.

• Early identification and intervention
  • Review annual operating plan and number of changes to identify workload concerns as early as possible
  • Collaboration between managers and human resources for early anticipation of staffing needs and actions required to address gaps
  • Utilization of various methods to identify resource requirements (e.g., staffing request forms, surveys, algorithms, etc.), patient/client volumes and their needs
  • Annual identification of emergency replacement staff
  • Identification of high potential employees
  • Engage employees to ensure retention methods are meaningful
  • Regular communications with staff to share strategies
  • Implementation of robust systems that can help track and report on staffing level information by department/program
  • Review staffing requirements at daily bed meetings
  • Ability to update staffing levels and day to day staffing based on occupancy
  • Prioritization and re-prioritization of duties based on the staffing level
  • Regular review of absenteeism data to identify patterns and problem areas
  • Where necessary, use available casual and float pool staff to address immediate resource requirements
  • Review systems for back-up process when staff unable to be present (e.g., payroll requirements)
• Other human resources management strategies
  • Develop Board/Senior Management dashboard containing key indicators such as vacancy and staff shortage
  • Workplace injury prevention strategies and safe workplace standards implemented, monitored, and refreshed regularly
  • Attendance management program and process review with managers and staff
  • Strategies in place to manage sick leaves and disability
  • Contracts in place with third party care providers (e.g., agency) for temporary and permanent staffing solutions
  • Workforce optimization and master scheduling reviews
  • Staffing patterns awareness and process
  • Special scheduling arrangements to support attendance and retention for staff who cannot manage traditional schedules
  • Hybrid work modules where appropriate
  • Occupational Health and Safety policies, training modules, classroom training
  • Ability management and accommodation policies
  • Ergonomic assessments and interventions
  • Workplace specific hazard assessment
  • Staff positions for Occupational Health and Safety Nurse and manager
  • Joint Health and Safety committee
  • Monthly workplace inspections
  • Improve versatility of employees and build capabilities required for staff to move between programs to fill gaps 
  • Onboarding, orientation, and education for staff engaged in temporary positions
  • Appropriate backup plans for key resources (e.g., Anesthesiologist, Pathologist, etc.)
  • Appropriate number of casual staff to meet the needs of special projects, sick leaves, and holidays with oversight from leadership to address issues as they emerge
  • Health and Wellness programs and services
  • Confidential Employee Assistance Program
  • Education to managers and staff on sick time and effects of shortage of human resources
  • Proper succession planning in place
  • Encourage teamwork and sharing of tasks to avoid burnout

Monitoring / Indicators

• Management dashboard on vacancy and turnover indicators
• Incident and hazard reports
• Recruitment and retention rates
• Staff vacancy rates
• Length of time to fill key positions (e.g., management)
• Number of staff enrolled in leadership training program
• Number of staff accessing Learning Management System modules
• Shortages rate and number of unfilled shifts
• Overtime rates, sick leave rates
• Percentage of agency use and cost
• Daily staffing ratios
• Attendance program compliance
• Employee Assistance Program utilization data
• Retirement rate
• Work tenure and age and experience demographics
• Market salary adjustments
• Exit interviews
• Number of new employee recruitments
• Number workplace inspections, recommendations, and resolutions
• Number of workplace injuries
• Number of WSIB active claims and costs
• Employee engagement/satisfaction survey results