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Melissa Turner

Staffing Up for a Hospital Expansion or Replacement


Expanding your unit or relocating to a new tower will require additional staffing. Determining when to begin recruiting and onboarding new staff members can be challenging. There are several factors to consider when establishing your hiring timeline. Ask yourself the following questions:


Are there local or national shortages for the types of positions you will be filling?

The answer is a resounding YES for Respiratory Therapy Specialists, Echocardiology Technicians, Sonographers, and Pharmacists, as they are in short supply across the country. As a result, many hospitals find themselves competing for the same talent pool. This combined with an ongoing national shortage across many specialties, filling existing vacancies is difficult. Staffing up to meet the demands of a larger hospital footprint and increased patient population will require a longer lead time and dedicated HR resources.

Are multiple units within your organization recruiting from the same hiring pool?

Consider the necessary education and experience required for some of the more entry level positions that support the larger hospital such as patient transport, parking attendants, security, dietary/kitchen staff. Does the local market of the hospital have a robust applicant pool that could fill these positions? If not, different departments may be competing for the same applicants. If there are enough applicants for entry level positions, you may not have difficulty hiring as candidates interested in food service positions may not be interested in maintenance or valet services.


Is your organization waiting for a newly graduating class to join the workforce?

As the national shortage continues for registered nurses, it is important to take into consideration graduation schedules to recruit candidates to fill new positions required for a hospital expansion or replacement. In markets that have nursing programs, reach out early to establish a relationship with student placement personnel, as competition among local and regional hospitals is becoming fierce for these new graduates.


Have you factored normal attrition into your hiring plans?

In addition to the anticipated number of newly hired staff needed to support this increased footprint or patient population, remember to account for attrition and retirement of existing staff. According to the American Nurses Association, approximately 500,000 registered nurses are set to retire in 2022 resulting in a need for over 1.1 million new RNs to avoid a nursing shortage.

Have you considered creating an onboarding timeline?

With so many factors to consider, it will be important to make your assessment and onboarding timeline well in advance. Many of these questions and factors will impact nursing units, clinical support positions, and the support services across a hospital system. Each are populations which are integral to the success of opening a new hospital. The timing for when recruitment begins will be important to ensure everyone is trained and ready for day-one in the new facility.


Are there specialty areas that require longer training timelines?

While many of these questions and answers are well known to the recruiting units, it is important to tie it back to the timing of the Go-Live date and activation of the new facility. For example, specialty areas such as Pharmacy, Laboratory, Supply Chain, EVS, and Physical Plant may need to be up and running prior to Go Live dates. For a successful transition to a new facility, these teams need to begin working in the new building prior to patients being seen. Therefore, it will be important for these positions to begin recruiting, hiring, and training to meet an earlier deadline than nursing units.


For example, additional lab techs may be required to validate equipment in a new building. Pharmacy will have stocking and medication dispensers to fill prior to occupancy of the new facility. For a new space to be “ready” for patients, supply chain staffing may have an increased workload stocking supply rooms and carts, and EVS will have additional spaces to service. The Physical Plant team will need time for training on how to maintain new building systems and changes in building technology. These teams may have activities beginning as early as 3-6 months prior to the new facility’s Go Live date and often include responsibilities associated with different state inspections. Therefore, the hiring and onboarding timeline for some teams may need to begin as early as one year prior to opening a new facility.


HBS’s transition planners and facility activation staff work closely with healthcare leadership to understand these challenges and can develop an achievable plan and timeline for each service and unit, resulting in a smooth Go Live for your next project.


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