Engaging Employees in a Buyer's Market

Engaging Employees in a Buyer's Market

By adapting to employee expectations and needs, this hospital reduced staff turnover by a third.

Children’s hospitals across the country are feeling the sting of increased labor costs. Johns Hopkins All Children’s Hospital in St. Petersburg, Florida, is no different—according to the Florida Hospital Association, overall workforce costs in the state rose 45% from 2019 to 2022, despite patient admissions remaining essentially flat over that period. Further, costs associated with extraordinary measures, including overtime and premium pay, have skyrocketed more than 245%.

To address these soaring costs, leaders at Johns Hopkins All Children’s began by looking to answer a fundamental question: “What are the things that need to be present in the organizational environment for someone to feel like they belong?” says Nicki Hancock, FACHE, MBA, SPHR, vice president of human resources and occupational health at Johns Hopkins All Children’s.

To find the answer, Hancock and her team went straight to the source—the hospital’s employees—to measure engagement and determine how best to recruit and retain talent in this new “buyer’s market” for workers. Johns Hopkins All Children’s conducts engagement surveys of its teams twice a year. The data from these surveys is analyzed and used to form focus groups to further drill down into employee attitudes and opinions.

Hancock says recent feedback from two departments struggling with staffing—pharmacy and respiratory therapy—revealed some common themes.


Workers crave the ability to have more leeway in setting work schedules and, where appropriate, work remotely. In addition to leveraging existing technology to allow some remote work options, the hospital also rolled out a pilot program with flexible scheduling for its respiratory therapists.

“There was a time when that was considered a ‘casual labor’ mindset, but the reality is that the flexibility we've been able to provide in some of these areas completely debunks that myth,” Hancock says. “It’s not a casual labor mindset, it's flexible working—when those folks are here, they're 100% committed to their work and there's a reason they've chosen to be here during that time.”


Team members are eager to receive more consistency and direction in their day-to-day work and in plotting career paths. The hospital hired a new manager and clinical supervisor to enhance support in the department as well as career guidance staff to help all employees better understand their prospects within the Johns Hopkins organization. Additionally, the hospital launched a program to help interested employees gain their pharmacy technician certification.


Employees want a wider array of benefit offerings that align with their needs and lifestyles. Although childcare or tuition loan forgiveness programs might be popular, employees who don’t need those services are seeking benefits they can use. “That's not a wrong thought; it's an equitable thought,” Hancock says. “It has created a lot of energy and become a catalyst for us to go back and conduct a full assessment of our benefit plans to ensure we create that level of equity in utilization of benefits.”

Workforce coming full circle

The approach appears to be working. In addition to significant consecutive gains in the biannual employee engagement surveys, Johns Hopkins All Children’s is seeing reductions in staff turnover. Hancock says overall hospital turnover has dropped from about 30% to 21% and turnover among nurses has fallen from 27% a year ago to 19% today—compared to a 32% turnover rate statewide.

Although many of these programs were borne out of a COVID-fueled “buyer’s market” for workers, Hancock expects the learnings to prevail through the next employment market shift. And she sees an employee population embracing an “old-fashioned” mindset of loyalty—as long as employers are willing to evolve with them.

“There was a time when people only worked for one or two organizations in their entire career, and then it shifted to wherever they could get the best deal,” Hancock says. “But I see it coming back to wanting that consistency and feeling like they’ve found a place where they belong. They might want an organization to take care of them throughout their life cycle—if so, how do we create flexibility as an organization to do that?”

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