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Contingent Labor: A Health System's Story of Taking Back Control

Like many health systems, Franciscan Missionaries of Our Lady Health System faced many challenges related to contingent labor. From excessive agency costs to a decentralized hiring process across multiple markets, the health system realized it needed an innovative approach to filling its most difficult shifts. 

Annalee Starks, Staffing Director at Franciscan, recently shared her experience tackling this challenge for the health system which you can watch here.

As she put it: “Like many other health care organizations across the nation, we were struggling with contract labor – not just in nursing, throughout allied and non-clinical as well – but specifically in nursing at the time.” 

The discussion covered a lot of ground: from the establishment of the Flex Choice contingent labor program to the results the program has delivered to date, and to more nuanced topics like how relationships with their agency partners evolved. 

Here are some of the highlights: 

Centralizing the Contingent Staffing Function 

One critical step that Annalee and her team took early in the process was to centralize the contingent labor staffing function and process across the organization. “We are the centralized staffing department for our organization now,” said Starks, also referring to the department as a “super staffing center” and a “staffing command center.” 

By consolidating the contingent labor staffing function into a singular department, Franciscan has been able to gain more transparency over labor costs and trends to make better overall decisions for the organization. “We have fantastic transparency of what we are doing across the organization. In addition to that, I now know where we’re using contingent labor…where agency is being utilized, because that helps me in turn to focus on building our internal agency positions. It also helps to be able to share that information with our organization.” 

Getting the Buy-In to Make Important Changes 

With a vision in hand, one of the first steps Annalee took was getting all five markets on board with the mission for their centralized program, called Flex Choice. A core part of that vision was to “get back control of the market that was controlling us” according to Starks. She was able to secure buy-in from the CNOs across the five different markets served by the health system, communicating the need for the organization to embrace the “gig economy” to attract and retain quality nurses for the program. “We wanted to start meeting the staff where they were,” explained Starks. 

Impressive Results: 38% Cost Reduction, 400 Nurses Onboarded 

The results Annalee and her team have been able to deliver for the organization to date are impressive. After just a few months, Franciscan paid 38% less for contingent labor on average compared to agency market rates. 

Results: Contingent Labor Cost Savings Chart

Before rolling out any marketing campaigns for the Flex Choice program, it had grown to more than 400 nurses within the first few months. “(Nurses) are hearing about the programs that we’re building here at Franciscan and they’re excited,” explained Starks. She also attributes much of the program’s early success to its ability to accommodate nurses looking for more flexible working arrangements.

Results: Improved Nurse Recruitment with Flex Choice chart

Annalee was also impressed with how quickly she has been able to fill open shifts. “We’re getting applicants sometimes as soon as 3 or 4 hours after one of the orders is posted. We are making offers within 24-48 hours to agency nurses.” 

What About Existing Staffing Agency Relationships? 

“One of the most wonderful benefits of working with Hallmark is that they bring with them a plethora of vendors that they have great relationships with,” said Starks. “We went from working with four to five agencies consistently to a vendor panel of over forty. We have a powerful vendor panel now. And every vendor on that panel agrees to work under one singular agreement. And that creates efficiency and consistency. It also helps us to be competitive with our compensation packages.” 

The singular staffing agreement that Franciscan instituted was able to drive incredible efficiency, eliminate discrepancies (including multiple contracts with the same agency), and enable the program to scale quickly. Throughout the process, the organization only stopped working with one staffing agency. “It only strengthened the relationships that we had before. They want to work with us. They want to partner with Franciscan,” exclaimed Starks. “Vendor management alone has improved tenfold. It has been incredible.”

Managing Credentials 

One critical challenge that comes with managing a more robust contingent labor pool is credentialing. Annalee credits Hallmark with providing excellent support in this area. “On the vendor side, Hallmark comes with a credentialing department. We have a credentialing specialist that works hand in hand with my staffing coordinators on credentialing every agency employee.” 

“When I sit in meetings with our senior leadership that’s one thing that we get probably some of the most praise for in Flex Choice is how rigorous we are with the credentialing process,” said Starks. “Knowing that we have that credentialing team behind us helps me go to bed at night.” 

Charging into the Future, Including an Internal Agency 

While the program started with nursing, and then allied shortly thereafter, Annalee’s department is now supporting contract positions throughout the entire organization. The program's most recent evolution has been the creation of an internal agency – Flex Choice Internal Agency. “It grew so fast…that we find it a struggle sometimes to even keep caught up with all the applications that are coming through,” said Starks. “About 50 percent of your agency nurses become interested in moving over to your internal resource pool. And that (Hallmark) software alone helps my team identify that, it helps us to be so much more successful. Hallmark has been a great partner to help us prepare for what is coming.” 

Partnering with Hallmark 

Annalee was impressed with the level of support and partnership she has received from the Hallmark team. “They walk with you,” said Starks. “I remember saying, wait, they’re going to help me build my internal resource pool!” 

The Hallmark team worked with Annalee and her team to develop standard operating procedures and policies to ensure a smooth program implementation. Once the program was up and running, the Hallmark team conducted vendor panels and created vendor scorecards to help ensure that Franciscan was getting the right support from its partners. 

Her final assessment: “The (Hallmark) software is 110% worth it.” 

Listen to the entire conversation, which includes many more insights including Annalee’s lessons learned and best practices for organizations looking to do the same at their organization here.

If you're interested in learning more about Hallmark's Contingent Labor platform, request a demo to speak to our sales matter experts.