3 health systems bet on internal displacement programs


Amid the COVID-19 pandemic, American hospitals and healthcare systems have been tasked with addressing exacerbated clinician shortages. Many organizations have turned to third-party recruitment agencies and travelers to fill labor gaps. Today, some health systems meet their need for qualified clinicians through internal travel programs.

Health systems with internal travel programs said they viewed the initiatives as an effective strategy and an opportunity to address staffing issues internally rather than through an outside agency.

“We need to make sure we have staff available now, not just for COVID and ICU units, but across the spectrum,” said EJ Kuiper, CEO of Omaha, Neb-based CHI Health. Becker’s in February. “Building an internal [staffing program] makes sense on many levels. »

Right here, Becker’s dives deeper into the trend, including the progression of internal travel programs and the details involved.

Christus Health

At Christus Health, based in Irving, Texas, discussions about an internal travel program had been underway for years, but came to the fore during the pandemic. Texas used federal money during the pandemic to pay temporary healthcare workers.

Christus saw an opportunity once the state began demobilizing temporary workers, according to Debi Pasley, MSN, RN, senior vice president and chief nursing officer at the Catholic nonprofit, which has about 45,000 employees around the world.

“They had been provided to us for a while…and we said, ‘Why would we want them to go, especially the ones that seem compatible with our mission? ‘” Ms. Pasley said.

Christus offered the program to temporary nurses who needed to leave the healthcare system, especially those in South Texas. Initially, about 96 nurses accepted the offer to stay with Christus, where they had been placed by the state. Of those 96 workers, some left the program because they no longer wanted to travel, but others joined the program later, Ms Pasley said. Christus predicts that the total number of nurses and other workers, such as respiratory therapists, in his program will soon exceed 100.

“We’re about to hit 100 people, and a lot of them are people who live near some of our departments,” Ms Pasley said. “So we think we’ll be able to sustain them for a longer period of time.”

Christus program workers generally accept 12-week assignments, although assignments can be modified based on travel nurse and facility needs. The health system pays for the travel costs of the workers and those who participate in the program have access to health benefits from Christus.

Christus program workers receive a similar amount to what someone traveling for an outside agency would receive, Ms Pasley said.

“For the nurse, there is no benefit to bringing in an outside agency, especially if they are already oriented and working with us,” she said. “Our goal is to make the nurse whole. If they’re willing to travel and be away from home, we want to make them whole if they’re doing it for us rather than an outside agency.”

The pandemic has exposed the gap between full-time worker pay and lucrative temporary contracts.

During the pandemic, hospitals and health systems have offered bonuses, raised salaries, and made other investments in employee retention for their employees. Yet the pay gap between nurses working in hospitals and travel or agency nurses has continued.

As the amount paid by outside agencies decreases, pay will fluctuate for those who participate in Christus’ internal program, Ms. Pasley said.

Outside of salary, she said Christus offers workers in its internal program flexibility with schedules.

“We have people adjusting their schedules with their boss so they can have a better lifestyle,” Ms Pasley said. “We try to accommodate the needs of every clinician who comes to us, but we understand that’s not always the case with our colleagues, our competitors, or they may not be able to have that flexibility. We can have a relationship with our traveling nurses so it’s more of a give and take.”


Pittsburgh-based UPMC launched an internal travel program for its 40-hospital system in December.

John Galley, director of human resources at UPMC, said Becker’s in January that the health system launched the initiative not only to address the shortage of nurses – and attract nurses that the health system has lost to outside travel agencies – but to cope with the increase in the prices of external travel agencies.

Nurses and surgical technicians who qualify for the UPMC program will earn $85 per hour and $63 per hour, respectively, in addition to a $2,880 stipend at the start of each six-month assignment. weeks.

Pay for travel nurses at UPMC is always higher than that of full-time employees because the job comes with its own set of challenges. While full-time nurses get to know their facilities and have a more regular schedule, traveling nurses are constantly on the go.

“They’re going to have assignments for a few weeks at a time at a particular location, and then we’re going to pick them up and move them somewhere else, so they’re going to be constantly traveling, living out of a suitcase, and that’s what external travelers do, we so want to be like the market, create roles like that, and pay like that,” Galley said. “I think our employees understand the difference between that kind of lifestyle that comes with higher pay. “

In a statement shared with Becker’s On April 19, Holly Lorenz, DNP, RN, UPMC’s chief nursing officer, said the health system has onboarded 207 nurses into its travel program since the start of the year.

“We are delighted to see so many nurses joining our team who are new to UPMC, and we are especially delighted to welcome back many nurses who have left our team to work for external travel agencies and have helped us. joined,” Dr. Lorenz said. .

CHI Health

Most recently, Omaha, Neb.-based CHI Health, part of Chicago-based CommonSpirit Health, launched an internal travel program in April for qualified clinicians from Iowa, Nebraska, Minnesota and Dakota. North.

CHI Health Midwest’s internal travel program allows nurses, technicians, pharmacists and other workers to be full-time employees of CHI Health, receiving full-time salary, traveler rate, stipend, vacation hours, insurance and a 401(k), the health system says.

Under the program, workers would move through CHI Health’s 28 hospitals with assignments of six to 12 weeks, depending on where the need is greatest.

Timothy Plante, vice president of the patient care division at CHI Health, said the program involves one tier for people who prefer to work only in hospitals in Nebraska and southwestern Iowa and another for individuals wishing to work at CHI Health hospitals in Minnesota and North Dakota, according to the Lincoln Journal Star.

He also said CHI Health can provide staff travel nurses with the same salary they would get from an agency, but without having to pay recruitment agency fees, according to the newspaper.

As of April 20, CHI Health estimated that more than 50 workers were participating in the program and about 60 more were in the process of applying.

Long term strategy

With CHI Health and other health systems creating in-house travel programs, Ms Pasley of Christus said the trend is here to stay. She said the reason is that many organizations need increased flexibility to meet the shortage of clinical professionals.

“I believe strategies like this will become commonplace…until we can increase the number of clinicians we need to care for our communities,” Ms. Pasley said.

She also said that Christus sees its internal program as a long-term strategy.

“We know that at some point – it may not be in the next 10 years, or maybe – but at some point we may not need the number of people traveling today today because the numbers are improving,” she said. “At this point, we think we can still keep people on this [internal travel] team, maybe not at the same rates, but at a differential that would compensate them for staying flexible. We also have hurricanes. We need to move nurses to areas affected by hurricanes or other natural disasters. We have a lot of experience with that, and we see that these are people we could mobilize… I don’t plan to dissolve [the program] for the foreseeable future.”


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