Hiring processes at large institutions can be opaque and confusing. Another key piece of infrastructure for outside-in programs is a job hub or job center, which serves as a resource for residents interested in positions at the health system. Providing clear application instructions and descriptions of the process can help applicants who are already qualified get through the initial screening process. Moreover, the host of the job hub, usually an intermediary organization, can perform the initial task of sorting applicants and pairing them to job opportunities that best fit their skills, work experience, and interests, and providing interview training to help them succeed in the hiring process.

One of the value-adds that workforce development organizations can offer to health systems’ outside-in programs is providing soft skills or foundational skills training and practice. Studies have shown that adding this component to a pathway program can increase hiring of program graduates as well as increase retention of those who are hired. In addition, adding support services such as access to resources for housing stability, transportation, and childcare can add to the graduate’s ability to obtain and retain a job in the health system.

An additional component workforce organizations can provide that adds great value to the health system is coaching support to graduates of the program and supporting them through year-one of employment. This helps the new employee acclimate to the new job and work environment, and overcome “bumps” they may encounter in their new employment situation. By providing regular, “just-in-time” support, such as a bus ticket if a car breaks down, or talking through a conflict with a coworker or manager just as it occurs, a coach can help avert a corrective action—or even termination—as they help the employee navigate situations they face in both their professional and personal lives.

Another best practice is to connect training programs to broader economic development efforts. This can facilitate collaboration between multiple institutions, which in turn allows programs to reach more participants. Although workforce development is traditionally thought of as a competitive field, in reality there are many benefits that come from collaboration. Lurie Children’s and Rush are participants in West Side United (WSU), an anchor collaborative that coordinates training for positions such as certified nursing assistants, medical assistants, phlebotomists, and health IT professionals.58 WSU brings together Chicagoland-area health systems to identify common workforce needs, and in turn partners with several educational institutions to develop specialized courses that can prepare individuals to fill high-need roles. In addition, WSU provides wraparound support to training program participants. This yields a more efficient, structured approach for all participating employers. Since 2018, approximately 100 people have been hired into anchor institutions through WSU workforce programs. 59 

Publicly connecting organizational impact-workforce programs to city- or county-level economic development efforts is another strategy for scaling impact. In 2022, San Mateo County Health helped to spearhead the successful and unanimous adoption of a resolution committing the County of San Mateo in California to the anchor mission framework, making it the first county jurisdiction to formally approve of their role as an anchor institution. The resolution called for the development of a plan for inclusive staffing, procurement, and place-based investing in order to promote shared prosperity in the county.60 

Another health system partners with their regional anchor collaborative to develop intentional pathways to jobs at the health system and other large employers. Participating employers commit to recruiting from neighborhoods that are struggling economically, examining and revising hiring policies, and tracking data on employee retention, promotion rates, and the proportion of staff earning a living wage. If candidates to the health system are unsuccessful, they are referred to a partnering workforce intermediary for professional development support and for referral to other employers.

Collaboration is also a success factor in a similar effort in Ohio at the Health Careers Collaborative of Greater Cincinnati. Part of a larger, strategic initiative of United Way of Greater Cincinnati, the Collaborative is one of the career pathway programs of its Partners for a Competitive Workforce. The healthcare career pathway was initially developed in response to a nursing shortage in 2002. In order to fill open positions, competing health systems began raising wages to attract nursing talent. This strategy, however, primarily resulted in increased turnover as nurses moved between hospitals and failed to address the region’s overall nursing shortage. In response, the hospitals came together to develop training programs in partnership with the local community, career technical colleges, and the local workforce investment board. This collaboration helped address the nursing shortage and created a strong foundation for future workforce development efforts. “Part of [our] secret sauce is that we have a history of being collaborative and coming together, of dropping egos and individual agendas when it comes to creating good work,” explained Sharron DiMario, former senior manager of the collaborative.61