The health care sector has tremendous challenges regarding staffing and workforce areas — that’s no secret. However, what is often forgotten is the deep history of innovation and progress made in health care over a single generation. Health care progresses and moves forward, and it is that same spirit of innovation that needs to take control of workforce areas.
The current staffing shortages in health care demand a brave rethinking of how leaders train, retain and optimize the health care workforce. This article reviews what’s not working in health care workforce development and proven real-world solutions to drive the industry forward.
What’s Not Working in Health Care Workforce Development
- Tuition reimbursement as a primary strategy.
Many health care organizations lean heavily on tuition reimbursement programs as a way to invest in their workforce. However, the uptake is often very low — rarely exceeding 14% in most systems. Part of the problem is that tuition reimbursement programs can be difficult for systems to control. Consequently, many non-profit health systems find their employees pursuing education at for-profit institutions with questionable outcomes and pay for programs and results that are not in the best interest of the system. In addition, while higher education is undoubtedly essential, today’s health care leaders are increasingly focused on skills and competencies, not just degrees. Unfortunately, human resources (HR) leaders often overestimate the efficacy of tuition reimbursement programs, despite clinical leaders having a far more skeptical view.
- Lack of centralized data.
One of the most glaring issues in workforce development is the absence of robust, centralized data. Even today, many residency programs and preceptors rely on archaic systems — think pen and paper — that are prone to loss and error. This inefficiency is a thorn in the side of nursing leaders, and it severely hampers workforce optimization efforts. Quality data is critical in understanding workforce trends, residency outcomes and skills gaps, yet health care systems still lag in creating centralized data hubs that could drive decision-making and improve care delivery.
- Inconsistent and fragmented delivery.
Another key issue is the inconsistency in workforce development programs across regions. Some systems may work with certain colleges or programs, while others rely on different partnerships or methods. This inconsistency can cause disjointed training outcomes and makes scalability nearly impossible. Unified, scalable delivery models are essential to ensuring quality training, yet they remain a rarity in the health care sector.
- A knowledge gap in training delivery.
There is often a significant disconnect between clinical educators and the actual logistics of delivering high-quality training programs. While many educators excel at curriculum development and teaching, they frequently lack expertise in delivering scalable, effective training across large, geographically dispersed systems. This includes managing online components, overseeing data collection and ensuring instructional design quality. The skill set required to manage such large-scale operations is very different from traditional programmatic knowledge, yet many health care organizations fail to recognize this gap.
- Lack of organizational alignment.
Perhaps the biggest issue is the lack of cohesive thinking about workforce development. HR departments often have well-intentioned plans, but clinicians find them ineffective. Meanwhile, CFOs want to track the return on investment but lack the trusted data to do so. This results in fragmented and inefficient development programs that fail to deliver meaningful results, and therefore, a corresponding loss of interest from executives.
What Works in Health Care Workforce Development
- A holistic approach to tuition reimbursement.
In contrast to the failures of traditional tuition reimbursement programs, when used as part of a broader strategy, these programs can be effective — particularly when they include support for both credit and non-credit, skills-based programs. This broader approach caters to the varied needs of health care staff and fosters a culture of learning without limiting development to degree-based education.
- Internal fill rates and workforce potential.
Some health care systems have succeeded by focusing on internal hiring and training. Organizations like MercyOne and Providence have launched initiatives that train internal candidates for roles like medical assistants (MAs), certified nursing assistants (CNAs) and patient care associates (PCAs). These programs are often oversubscribed and designed to allow employees to continue working while gaining new skills. This apprenticeship-style model has been immensely successful in filling critical roles while fostering workforce loyalty and engagement.
- Team-based training.
One of the most innovative strategies is training healthcare teams to work as cohesive units. Systems like UC Health in Colorado and CommonSpirit Health’s virtual nursing units have pioneered this approach. Training PCAs, CNAs and nurses together as a team — rather than simply training individuals to work in a team — creates a more collaborative and effective healthcare environment.
- Blended approaches and data hubs.
Dr. Kathy Sanford, CNO at CommonSpirit Health, has led efforts to blend various strategies into a comprehensive workforce development program. Her approach includes tuition reimbursement, new PCA residencies, bridge programs to transition post-acute staff into acute care environments and the implementation of large nursing strategies including a national nurse residency program and growing virtual nursing team. What sets this approach apart even further is the centralized data hub component, which tracks outcomes and continuously refines training programs based on real-world data. This has led to a 92% increase in new nurse retention.
- Pipeline planning and innovation.
One of the most forward-thinking initiatives is Northwell Health’s creation of a health care high school. This is pipeline planning at its finest — engaging young people in the healthcare field early while simultaneously contributing to the broader New York Community. By investing in the next generation of healthcare professionals, Northwell is building a long-term solution to the workforce shortage. This type of innovative thinking is exactly what the industry needs.
What’s Next: Setting a New Standard for Workforce Development
The health care workforce is at a crossroads, and traditional approaches to workforce development are not enough to solve the growing staffing shortages. While tuition reimbursement and degree programs have their place, the future lies in competency based, skills-driven training supported by centralized data, scalable delivery models and organizational alignment.
Pairing advancements like high-fidelity simulation technology with structured nurse residency and preceptor programs is playing a key role in strengthening workforce readiness. Integrating hands-on, real-world learning into comprehensive workforce development strategies is what will push the health care workforce forward, helping teams gain both technical skills and structured support that’s needed to transition into practice with confidence and competence. Those health care systems willing to embrace these innovations will not only survive but thrive in a health care landscape where staffing shortages threaten to undermine patient care.
The health care industry must move beyond fragmented, outdated approaches and invest in comprehensive, data-driven workforce development strategies that put skills and competencies at the forefront. The future of health care depends on it.
