Foreword

by Amanda Cage

President and CEO of Shift Work Forward

What if workforce development could stretch beyond just managing the crucial work of the talent pipeline? What if it could be a force for innovation and shared prosperity? For large healthcare systems and other anchor institutions, hiring for impact isn’t just a matter of human capital investment, it’s one of the most powerful ways to improve the health and wellbeing of individuals and families, strengthen local economies, and expand opportunity in low-income communities.

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At my organization, Shift Work Forward (formerly the National Fund for Workforce Solutions), our work centers on redefining what workforce systems can achieve to make them more inclusive, responsive, and effective for everyone. We believe that companies can bring the same level of intelligence and entrepreneurship to hiring for impact that they bring to designing products or services. In healthcare, that very much includes the patient experience. Employers can leverage their influence to create organizational and regional change where employers, workers, and communities thrive. This requires new approaches beyond traditional recruitment, hiring, and training practices, as well as new ways of thinking about job quality. 

We also unite a dynamic network of regional workforce leaders who work with us to test new ideas, learn from setbacks, and share what works in the field. Our Network Partners have deep knowledge of workforce issues in their local regions, and they collectively support thousands of employers nationwide in moving step-by-step towards a more inclusive economy. Through long-standing, trusted relationships, these partners work alongside employers, helping them make sense of local labor markets, incorporate community perspective, and strengthen promising practices over time. Some of these employers include members of the Healthcare Anchor Network.

Across both our network and that of HAN, we have seen plenty of employers do things that both defied conventional wisdom and made their workplaces and employees more successful. Health systems such as The Johns Hopkins Health System and Advocate Health pioneered the adoption of fair chance hiring. Others, such as Baystate Health and University of Vermont Health, created sustained, successful apprenticeship programs for roles such as Medical Assistants and Licensed Practical Nurses, which even a decade ago were widely seen as impossible. They did it by listening to their employees and their communities, taking small chances, measuring the results, and iterating over time.

These success stories are proof that intentional, outside-in recruitment and career advancement programs aren’t just good ideas in theory, they are practices that work. This toolkit was created to guide employers who want to make similar choices, to make their workplaces more successful, expand access to opportunity and mobility, and ultimately help their communities thrive. We invite you to explore the strategies within, experiment with new approaches, and join a growing movement to create a fairer and more inclusive workforce. The future of work is not just something we wait for — it’s something we create, together.

Preface

by David Zuckerman

President and Founder of the Healthcare Anchor Network

Every day, across neighborhoods that have long faced economic challenges, community members bring talent, determination, and deep commitment to their families and communities—yet too often remain disconnected from stable, well-paying careers in healthcare. When residents gain access to quality jobs with opportunities for growth, the impact is immediate and generational: families achieve greater financial security, communities experience renewed economic vitality, and health systems gain dedicated team members whose lived experience strengthens patient care. These are the people at the heart of this work, and their aspirations motivated the creation of the first Inclusive, Local Hiring Toolkit in 2016.

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At that time, the field of practice around building intentional, outside-in pathways into healthcare careers was still emerging. Only a small number of health systems had begun experimenting with new models that opened doors for local residents, especially those from communities most affected by health inequities. The network that would become the Healthcare Anchor Network (HAN) was in its early days, and the original toolkit drew on the insights of workforce pioneers who were testing new ideas, learning in real time, and often building their programs from the ground up. When the 2016 toolkit was released, workforce teams told us it finally provided a shared framework to efforts they had been trying to champion for years. As one member shared with us, “HAN gets you to start thinking in different ways…it just opens your eyes to what you can do that is much more impactful than what any one individual or organization could try to achieve.”

Nearly a decade later, the early seeds of that work have grown into a flourishing anchor mission movement across healthcare. Health systems have recognized more clearly the connection between workforce strategy, community well-being, and organizational sustainability.

This evolution has also expanded our understanding of what we now call Impact Workforce—a core anchor mission strategy alongside place-based investing and impact purchasing. Impact workforce includes outside-in pathways that connect community members to quality jobs, inside-up advancement strategies that support existing employees, and systems-level changes that foster equitable access to opportunity. At HAN, we believe deeply in the power of this strategy. With this updated toolkit, we aim to capture the most comprehensive set of learnings from this growing field, with profiles of 33 health systems, highlighting what has evolved since 2016 and why this moment calls for renewed focus and innovation.

Health systems today face unprecedented staffing shortages, rising burnout, and long-term gaps in critical roles. Meanwhile, communities continue to bear the weight of longstanding inequities that drive poor health outcomes. These challenges are interconnected—and they can be addressed together. By aligning long-term workforce investments with intentional strategies to reach residents of neighborhoods facing the greatest economic barriers, health systems can build sustainable talent pathways that advance both organizational stability and community health by addressing worker shortages, reducing recruitment times and turnover, and developing a staff that is well-prepared to serve patients and community.

This resource reflects the dedication, creativity, and persistence of the leadership of the health systems and the workforce professionals who contributed to it—and of those doing this work every day. We hope this toolkit supports your work, helps you make the case for continued investment, and equips you with practical insights and models you can adapt. At HAN, our goal is to provide resources that meet the challenges of the moment and help you continue expanding opportunity—for your workforce, your organization, and your community.

About this Toolkit

The Healthcare Anchor Network (HAN) is pleased to present the Impact Workforce Toolkit. As a core component of the anchor mission framework—a commitment to intentionally apply an institution’s place-based economic power in partnership with the community in order to mutually benefit the long-term well-being of both—impact workforce strategies represent one of several ways health systems can leverage their economic assets to intentionally drive positive, long-term impact and support the health and well-being of the communities they serve.

This toolkit builds upon the fundamental insights of the Inclusive, Local Hiring Toolkit, published in September 2016 by The Democracy Collaborative as part of the Hospitals Aligned for Healthy Communities toolkit series. Over the past decade, the original toolkit served as a foundational resource for health systems to build community wealth through inclusive, local hiring practices.

Since 2016, health systems have significantly advanced their workforce strategies, and the term Impact Workforce reflects this evolution. It expands the focus beyond inclusive, local hiring to encompass a comprehensive approach that also includes career development components and intentional systems change. HAN has been documenting and capturing these evolving learnings and new perspectives, and this Impact Workforce Toolkit provides the latest best-in-class workforce strategies that advance the anchor mission. It features recent case studies and examples illustrating how health systems have implemented and advanced impact workforce strategies over the past several years.

This Impact Workforce Toolkit is designed to serve as an up-to-date, core resource for health systems dedicated to embracing their role in driving positive, long-term impact in the communities they serve. It offers the most current information, tools, and resources available to guide these efforts.

We recognize that impact workforce strategies will be unique to each health system’s context and community. Therefore, this toolkit provides a breadth of resources and tools to support practitioners in identifying strategies that will be most impactful in their unique situations. Readers are encouraged to engage with the content in the way that best suits their needs—whether by reading chronologically or moving directly to sections of interest. This toolkit is intended for those who are new to, or seek to advance, their health systems’ efforts to embrace their roles as anchor institutions in their communities.

Acknowledgements

HAN extends gratitude to The Democracy Collaborative (TDC) for originating the Inclusive, Local Hiring Toolkit, made possible by generous support from the Robert Wood Johnson Foundation. TDC is a national leader in community wealth building and equitable, inclusive, and sustainable development. The original 2016 Toolkit was authored by David Zuckerman and Katie Parker, both of whom were staff members at TDC at the time.

HAN also extends sincere appreciation to the many leaders who generously shared their perspectives, stories, and insights to enrich and inform this updated version, which will benefit health systems working to advance equitable economic development through impactful workforce strategies.

The Impact Workforce Toolkit was authored by Lauren Worth, HAN’s senior manager for workforce & community engagement initiatives, and Debbi Perkul, impact workforce consultant. Lauren and Debbi lead HAN’s Impact Workforce Initiative Group, which comprises a network of more than 50 health systems that seek to learn and implement best-in-class strategies for connecting residents of economically disadvantaged neighborhoods to quality jobs and career pathways. David Zuckerman, president and founder of the Healthcare Anchor Network, was an author of the original toolkit and provided substantial support throughout the updating process. Bich Ha Pham, senior director of communications and policy, reviewed all content and assisted in toolkit finalization. Other HAN staff who supported the development of the toolkit include Sophie Hearn, research intern (former); Nora Hennessey, program associate (former); Hue Phung, senior associate, research and impact workforce; and Melissa Richmond, director, research.