Advocate Aurora Health, 2023 Workforce Report

Flexible, Data-driven Programs to Optimally Recruit, Retain and Deploy Nurses

As the national nursing shortage continued to make headlines in 2022, Advocate Aurora Health expanded its multi-pronged response to this complex problem. Our approach included several innovative elements, such as a student loan forgiveness program; a protocol for reassigning nurses who work in non-patient-facing roles to the bedside to help with staffing needs; and an internal staffing agency. 

At a foundational level, our leaders have long understood that competitive compensation is simply table stakes—a minimum requirement in the current staffing environment and a clear indicator of the value our organization places on nursing. That’s why we implemented a temporary supplemental pay program designed to enhance nursing pay rates from January through October 2022, in addition to continuing annual merit increases, bonuses and market and compression pay adjustments. To help us further stand out as an employer of choice, Advocate Aurora also implemented a student loan forgiveness program in 2022 that cancels up to $20,000 in educational debt for nurses who meet certain qualifications, including working in patient-facing or patient-supporting roles.  

On a higher level, we continued to refine our sophisticated, data-driven approach to ensure that our nurses were optimally matched to clinical demand throughout 2022. In one example, we rolled out our NASCAR (Non-Acute Support—Corporate and Remote) program to reassign nurses who currently work in non-patient-facing roles to meet hospital needs. 

Created by our system’s labor pool team with experts from HR, HR analytics and nursing, NASCAR defined clear protocols to leverage these nurses’ individual experience and temporarily place them in both clinical and non-clinical roles at our hospitals. NASCAR also implemented guidance around onboarding, communication pathways and other administrative elements to smooth the reassignments. As a result, more than 180 Advocate Aurora Health team members redeployed and covered more than 6,500 shifts at our hospitals during six weeks from January to March 2022, when COVID inpatients surged. 

This experience inspired yet another new program set to launch in 2023, our Nursing Reserves Program. The Nursing Reserves is a pre-identified team of non-patient facing nurses with current bedside competence who have agreed to be potentially “called up” to staff inpatient care units for assignments as long as six weeks. The program gives these nurses the opportunity to maintain their skills and be quickly redeployed in the event of another staffing crisis. 

In another innovative investment, we developed an internal nursing agency as a cost-effective alternative to relying on extremely expensive agencies to supply temp and travel nurses to meet our staffing needs. Modeled after our successful Wisconsin Float Pool—a program that sends registered nurses, nursing assistants, health unit coordinators, nurse externs and nursing students to assignments ranging from two to 12 weeks at our hospitals across Wisconsin—our internal agency also deploys team members who are willing to travel. By creating our own agency, we are able to retain nurses in our system who may otherwise have left for a travel agency role.  

Improved retention offers tremendous benefits: Not only do our patients benefit from our tenured nurses’ expertise, but we are also able to lessen our own reliance on outside nursing agencies to fill departed team members’ roles and therefore save significantly on agency fees. To date, our agency has created $12.7 million in savings while retaining hundreds of nurses. In light of this success, we are expanding our agency to include respiratory therapists and surgical technicians.