Turnover, vacancies, and limited access to talent have challenged healthcare organizations for several years. It’s estimated that by 2033, the U.S. will need to hire at least 200,000 nurses per year to meet increased demand and replace retiring nurses. To tackle these issues, health systems are adopting flexible workforce strategies to manage costs, improve operating margins, and provide clinicians with the work life balance they are seeking.
LABOR DISRUPTION SOLUTIONS
The Ultimate Guide to Strike Contingency Planning Proactive Measures to Ensure Uninterrupted Patient Care
eBook: The Ultimate Guide to Strike Contingency Planning
The Reality of Today’s Labor Market Labor actions have emerged as a potent force capable of creating significant challenges in patient care, financial stability, and public reputation. Foresight and planning are key for healthcare leaders. Fortunately, you can prepare in advance with The Ultimate Guide to Strike Contingency Planning . In this guide, you will discover valuable insights and strategies for uninterrupted care and learn how to choose the ideal workforce partner to maintain operations. Healthcare labor actions are changing at an unprecedented pace—an acceleration supported by hard numbers. Data from the U.S. Bureau of Labor Statistics indicates an uptick in work stoppages: from 1993 through 2021, hospitals experienced 84 work stoppages, averaging one every 4.1 months. However, this frequency has intensified since 2022, with 15 stoppages in just 21 months through early October, decreasing the gap to an average of 1.4 months between each occurrence. 1 These are not ordinary fluctuations, and as leaders, we need to pay attention to this warning.
The COVID-19 Era: A Catalyst for Change The COVID-19 pandemic served as a tipping point for many healthcare workers – amplifying issues such as work hours, pay scales, conditions, challenges to their mental health, and the nurse-to-patient ratios. The Healthcare Financial Management Association (HFMA) echoed the sentiment, encouraging more efficiencies to improve employee relations. 2 Insight from our RN Survey underscores these issues, with 30% of nurses reporting that they plan to leave nursing due to strains from the pandemic. 3
eBook: The Ultimate Guide to Strike Contingency Planning
Strike Implications As reported by the Cornell-ILR Labor Action Tracker, the nation witnessed more than 120 healthcare workforce strikes between 2021 and 2023. 4 The rise of indefinite strikes poses a novel challenge—one that adds layers of complexity to contingency strategies. An indefinite strike does not have a defined end date specified when the union delivers the strike notice. Meaning, workers will be on strike until a settlement is reached. The protracted engagement at Robert Wood Johnson University Hospital in New Jersey, commencing in August 2023 and concluding only in December 2023, is testament to this trend’s disruptive potential. 5 With a growing national average of healthcare union Collective Bargaining Agreements set to expire annually, the message is transparent: the threat of a potential strikes is not going away, and healthcare organizations need to adapt and prepare to ensure continued care.
Crafting Your Contingency Blueprint
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1/3 of nurse leaders use contingent nurses to close gaps in labor agreements. “ - AMN Healthcare 2024 Survey of Nurse Leaders
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In recent years, nurse to patient ratios have been a point of contention in healthcare labor agreements. Contingency planning can help hospitals assess staffing gaps so you can focus on resolving your labor dispute and reaching a mutual agreement. When health systems do not have a strong contingency plan, they put themselves at risk of being unable to fill replacement worker needs and scrambling to provide continuity of care. Follow the steps below to achieve the best possible outcome in a strike.
eBook: The Ultimate Guide to Strike Contingency Planning
Key Steps for Contingency Workforce Planning:
1. Establish a partnership with an experienced labor disruption workforce supplier at least six months before the expiration of your Collective Bargaining Agreement (CBA). 2. Review and update your Contingency Planning Playbook. If applicable, review the resources utilized in a past work stoppage and analyze what worked well and what needs to be changed. If there isn’t a history of a past strike, create a playbook that will support your needs for the current event and beyond. 3. Determine your patient care model during a labor disruption event. This involves scenario-based planning to decide which services can still be offered during a strike, and possibly postponing certain services. Key things to outline include: a. Replacement staff needs based on patient care models. This involves determining the minimum labor force required to maintain critical operations, the clinical specialties needed, essential skills, certifications, and their quantities. b. Deciphering staffing coverage needs for continuity of patient care between “ideal” and absolute “must have.”
4. Prepare your order for contingent replacement staff 90 days before the expiration of the CBA. Securing your “insurance policy” with your workforce partner is paramount. 5. Assemble your “Workforce Stoppage Project Team.” This task force should include stakeholders from labor relations, executive clinical and operations leadership, employee health, human resources, security, and IT. Assign a project leader to act as a liaison between all stakeholders and the chosen workforce partner.
6. Initiate operational and logistics planning. Leverage the expertise of your supplier partner across clinical, compliance, and regulatory support, enabling you to focus on execution once strike notice is received.
eBook: The Ultimate Guide to Strike Contingency Planning
QUICK LOOK: Strike Preparedness Timeline
1 YEAR 1 year prior to CBA expiration
Review your Collective Bargaining Agreement
6 MONTHS 6 months prior to CBA expiration
Establish workforce partnership
90+ DAYS 90+ days prior to CBA expiration
Determine patient care and staffing model
90 DAYS 90 days timestamp
Prepare order of contingent replacement staff
60-90 DAYS 60-90 days prior to CBA expiration
Assemble Workforce Stoppage Project Team
eBook: The Ultimate Guide to Strike Contingency Planning
How to Choose the Right Strike Workforce Partner
Selecting the right strike workforce partner is crucial for effective labor disruption management. It’s important to understand that not all staffing suppliers have the operational infrastructure and breadth of experience to plan, manage, and staff strikes. Many hospitals make the mistake of approaching strike events the same way as a rapid staffing event. This is a reactive approach that does not meet what is needed for a strike-controlled environment.
Steps to Choosing Your Ideal Strike Workforce Partner:
Look for a partner with proven expertise in supporting healthcare specific labor disruptions, including walk-outs and sympathy strikes. Ensure they have a breadth of experience in both planning and managing work stoppages, and scaling to your specific needs. They should have a robust recruitment engine with nationwide reach and an established network of clinicians who have strike experience or an interest in strike assignments. The partner should provide clinical leadership, regulatory expertise, and guidance on workforce needs and market conditions. Onsite support for healthcare professionals during work stoppages should be offered, including onsite clinical managers.
Onsite support should include clinician transportation and check-in, security protocols including singular points of entry/exit and other measures to support the safety of clinicians.
Non-clinical support for clinicians, such as payroll and lodging, should be provided. The partner should have credentialing and compliance expertise and be able to credential many clinicians in an expedited timeframe. The partner should have extensive experience to advise your facility on best practices for high volume clinician orientation, onboarding, badging, and system provisioning in a strike environment. When evaluating proposals from workforce suppliers, make sure to fully understand the terms, and watch out for hidden fees, and overly complex pricing models.
eBook: The Ultimate Guide to Strike Contingency Planning
Quick List to Strike Preparedness
Review your Collective Bargaining Agreements (CBAs) one year in advance. 1 Assess potential labor disruption workforce partners, considering the effectiveness of previous collaborations. 2 Compare offerings from different firms – not all provide the same services. 3 Don’t be overly confident – secure your insurance policy before you need it. 4 Have a workforce coverage solution ready – this strengthens your bargaining position and reduces the potential risk of a strike. 5
eBook: The Ultimate Guide to Strike Contingency Planning
About AMN Healthcare
AMN Healthcare brings together technology, a vast clinician network, and years of expertise to solve today’s workforce challenges. We provide our clients with a comprehensive set of workforce management technology
and talent solutions to meet workforce needs, optimize labor sources, improve operating margins, and enable care where and when it is needed.
Whether we are providing the transparency and tools to monitor and predict workforce needs, helping to prioritize and bring in talent to fill critical roles, or enabling real time language translation services, AMN’s capabilities are designed to support all workforce needs. We meet our clients where they are, and evolve with them, offering a full spectrum of technology and workforce solutions—all from one proven strategic partner.
Make the Connection with AMN Healthcare Labor disruptions in the healthcare industry can quickly disrupt your organization’s foundation. Our Ultimate Guide to Labor Disruption Workforce Contingency Planning equips you with the knowledge to navigate these challenges with strategic planning. AMN Healthcare is here to support you and your preparations. Implement your tailored contingency plan with confidence and turn uncertainty into a structured path to safety.
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References:
1 Bureau of Labor Statistics, Work stoppages in healthcare and social assistance. Read here . 2 Hut, N. (2023, October 16). Healthcare labor union activity gains steam: The consequences for hospitals and health systems. HFMA. Read here . 3 AMN Healthcare. (2023). 2023 AMN Healthcare Survey of Registered Nurses. Read here . 4 ILR Labor Action Tracker. (n.d.). Read here .
5 Striking nurses reach tentative deal with RWJUH after months on picket line. (n.d.). Healthcare Dive. Read here . 6 (2024). 2024 Survey of Hospital Nurse Leaders: Roles, Challenges, and Workforce Solutions. Read here .
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