Achieving the transformative impact of a new impact workforce strategy requires laying the groundwork for long-term success. This section outlines key strategies for embedding these programs into the organization’s culture and operations. These strategies include: establishing clear metrics, building system-wide infrastructure, reviewing existing policies and and processes to remove barriers, leveraging community strengths, and ensuring longevity through stakeholder buy-in and ongoing education. By implementing these elements, your health system can ensure these initiatives become permanent, effective drivers of economic opportunity in your communities.  

Tracking impact is critical to making the long-term case for institutional investments in and maintaining community interest in impact workforce programs. By examining the demographic characteristics of the current workforce in the context of your goals and needs, you are better equipped to measure progress and identify successes and challenges as you implement these programs.

An important first step in establishing these programs is to ensure that you are collecting the right data, and that your data systems are able to track the information you want. In order to measure impact, variables should be tracked for both the general applicant pool (those who go through traditional channels when applying to jobs) and the talent pool from your focus geographies, which could include those who go through pathway programs, cohort training, internship programs, or local workforce-intermediary partnerships.

Variables To Measure

Evaluating the Hiring Process
  • Average number of applications per position posting
  • Average number of applications per month
  • Percentage interviewed
  • Percentage hired
  • Percentage of applicants that re-apply
  • Average days to hire
  • Location of applicants, by zip code
  • Location of successful applicants, by zip code
  • New hire starting wages
  • Demographics of applicant pool including city, zip code, percentage who reside in communities of focus
  • Staff time spent recruiting and hiring, by position category

 

Evaluating the New Hire Success and Retention
  • Retention rate after one year
  • Manager feedback on candidate performance
  • Employee satisfaction scores
  • Staff time spent on recruitment
  • Staff time spent on training and orientation
  • Administrative costs

 

Evaluating Career Ladder Success
  • Changes in wages of training participants
  • Retention rate of training participants
  • Employee satisfaction scores
  • Number of positions filled from internal candidates
  • Average cost of recruiting external candidates for positions requiring training
  • Location of employees taking advantage of training opportunities

How to Measure:

Identifying the metrics to measure is the easy part—the work begins when you set up the infrastructure necessary to collect and report on this data. This will involve agreements with the workforce intermediary around collecting applicant data, creating common metrics and measurement standards across organizations and departments, engaging the information technology department, and identifying a skilled analyst (internally or externally) to calculate the return on investment. This staff time, in addition to software upgrades and other data infrastructure investments, should be included in the budgeting process when beginning an impact workforce strategy.

Measure Your Current Workforce

Demographics

What is the demographic profile of your workforce and applicants?

  • By race, ethnicity, and gender identity
  • By position type (e.g., entry-level, mid-level, leadership)
  • By wage level

Location

Where does your workforce currently live?

  • By city or metro area
  • By zip code
  • Percentage of employees who reside in economically under-resourced zip codes

Turnover And Forecasting

What are your workforce needs?

  • Overall turnover rate
  • Positions with high turnover
  • Termination rate
  • Positions that will be affected by retirement or other workforce trends

Assess Data Infrastructure

  • How is the data about employee demographics stored?
  • What applications are used, and do multiple systems “talk” to each other?
  • Are these data systems maintained by human resources or at a department level?
  • Are there barriers to tracking this sort of employee data?
  • Is it easy to track when and where an employee moves within the institution (e.g., if they switch departments to move into a higher-paying job)? Is it possible to track the recruitment source or program a new hire came from?

UMass Memorial Health (UMMH) established its Workforce Development department following an internal assessment that revealed the need to create system-wide infrastructure and a dedicated budget to support multi-year workforce initiatives. The department is housed within the talent acquisition and workforce development division of human resources and overseen by the chief human resources officer, with clinical leaders partnering to help identify critical vacancies and implement quality programs. These “hot jobs” guided the department’s priorities to build new outside-in hiring streams, fill gaps in existing roles, and pilot new inside-up or “grow-your-own” career pathway programs for employees. In the department’s first full year of operation, UMMH established an anchor goal of launching three career-pathway programs for 50 employees and community members. Designed using an earn-and-learn program model, each program offers employees full salary and benefits while learning new skills. In addition, all tuition costs are paid for by the organization. Community-based organizations, colleges, and high schools were critical implementation partners.

While filling critical positions is the short-term priority for UMMH, offering foundational support for employees interested in growing their careers is essential to creating equitable access to those jobs in the long run. Workplace English for Speakers of Other Languages (ESOL) and U.S. citizenship prep courses are now offered, along with career exploration and coaching. This work is supported by a five-person team, including four new full-time employees and one full-time role that transferred from talent acquisition. According to Kelly Aiken, director of the workforce development and planning department, “dedicated resources, senior leader support, and deep collaboration helped us to meet our first-year goal and laid the foundation for refining our system-wide workforce development plan.” This plan ensures that community members and caregivers receive the opportunities, support, education, and training needed to secure, retain, and grow in good jobs within the UMass Memorial Health System.90

Which policies and processes are working? Which are barriers to success?

Hiring Policies To Consider

Policies such as ban-the-box ensure that candidates with justice system involvement are not discriminated against during the hiring process and are an important step in connecting returning citizens to jobs. However, even with ban-the-box in place, barriers to entry can still exist. Evaluate whether there are policies that unnecessarily prevent individuals with justice system involvement in their backgrounds from working in specific positions. Although there is the perception that working in a hospital with such a background is not possible, for certain positions this is not necessarily codified in statute.

Some institutions require credit checks for positions that do not involve handling a significant amount of money or expensive goods. This ends up barring candidates with debt above a certain threshold or who may have written checks with insufficient funds in the past, regardless of their current financial status or the degree of the misdemeanor. This provision can end up being a major obstacle to strong local-hiring efforts, as many administrative positions have to handle smaller financial transactions. New Haven Works, a workforce intermediary based in New Haven, Connecticut, partnered with Yale University to reevaluate these thresholds and refine an overly broad policy so that they were no longer barring qualified applicants from these low-risk positions.91 Assessing these policies and determining more reasonable thresholds can help ensure that current practices do not discriminate unnecessarily against candidates with debt.

Hiring Practices To Consider

Where open positions are posted can make a huge difference in terms of whether individuals can access them. Therefore, it is important to post open position announcements in places that local community members are likely to see them. Having a job portal that is easy to navigate is also an important outreach step.

Changing the point at which a hiring manager engages with applicants is a significant step in linking candidates to job opportunities. When hiring managers assist with pre-employment training, conduct mock interviews, and meet with candidates, it can help them to forge personal connections that benefit both the candidate and the manager. Map your current hiring processes and determine whether there are any points at which hiring managers could meet with candidates from outside-in programs. Small adjustments to these processes can make investments and partnerships more effective and efficient.

Training Policies To Consider

Access to training opportunities soon after hire not only helps employees build job skills and strengthen performance, but can improve engagement and satisfaction. When are employees eligible for tuition assistance at your institution? Although employers frequently wait for a year to allow employees to access this benefit, opening up tuition assistance after three to six months can connect new employees to career pathways right away. Another important factor to consider is what programs are eligible. Ensure that your policies do not only cover degree-granting programs, as these programs are often not the trainings that entry-level workers can access right away. Tuition assistance policies that are only for degree-granting programs increase the bifurcation of opportunities between lower- and higher-wage employees.

Although tuition reimbursement is an important employer benefit, paying for training up-front can be a significant burden to the lowest wage employees that likely have limited savings. Policies such as direct pay, by which tuition is advanced rather than reimbursed, can help address these financial barriers. Some institutions have paired this with a requirement that the employee given a tuition advance commits to working at the institution for a certain amount of time after training. This requirement is designed to reduce the risk that trainings are not finished and to ensure the agreement benefits the institution. Other policy solutions can include: working out payment plans with employees, partnering with educational institutions that allow for delayed payment, or developing partnerships with local financial institutions that can provide short-term, low-interest loans.

Training Practices To Consider

Release time for training can also be critical for enabling entry-level workers to access career development opportunities. Employees might work multiple jobs or have other time constraints, such as childcare, which can create barriers to learn outside the work day. Allowing trainings to be completed on-the-job can help guarantee that they are truly accessible. Since release time is a cost burden, some institutions have used funds from training or human resource departments to pay for this time, or they have utilized internship programs to help fill the gap created by paid employee training.

Retention Policies To Consider

A critical component to any sustainable impact workforce strategy is ensuring that there are affordable housing options near the hospital. This is especially critical in cities with high cost of living, or where neighborhoods immediately surrounding the hospital are being redeveloped and lower-wage employees face the risk of being displaced as property values rise. Employer-assisted housing programs are increasingly being used to draw investment to a particular place that will enable lower-wage employees to live closer to work and increase retention. For lower-wage employees, homeownership is a critical tool for building wealth and achieving economic well-being. Intentionally linking outside-in pathway programs to an employer-assisted housing program can ensure that a broader range of employees can take advantage of this type of benefit.

There are many strategies for structuring such a program, including forgivable loans, down payment assistance, or a mortgage buy-down.92 One of the most sustainable models for implementing this policy is a community land trust, which provides permanently affordable housing and ownership opportunities to low-income residents. Community development corporations and other affordable housing intermediaries are potential partners for implementing these strategies.93

Retention Practices To Consider

Practices such as connecting entry-level workers to a variety of supplemental skill development opportunities can help increase retention. Focusing on a wider array of skills can create a more inclusive working environment and can have a tremendous impact. One such example is financial education. On-site financial education programs provide important information to employees—about banking, home ownership, and general financial planning. Knowledge in these areas can help employees retain or build wealth, which in turn can help improve job stability. Other opportunities to offer could include English for Speakers of Other Languages (ESOL), and basic literacy and numeracy building classes. All these other courses could dramatically improve an employee’s chances of success on the job and in their career.

What Policies Might Help Make The Case?

Identify any existing policies and plans that are aligned with the goals of your impact workforce strategy. This can help to refine goals and make the case for investing in workforce programs.

Policy documents to draw from:

  • Strategic Plan
  • Sustainability Plan
  • Mission and Vision Statements
  • Community Health Needs Implementation Plan

You know your community needs jobs—but do you know the strengths it can offer?

The Applicant Pool

What skills are present in the community? Conduct focus groups or interviews to determine what types of jobs residents have skills for already or would like to train into. Local workforce intermediaries and job placement organizations might already have this data, and will have a good sense of community assets.

When beginning their local hiring planning process, University of Colorado Anschutz Medical Campus in Aurora conducted community focus groups to determine what the priorities were for local hiring programs. Through this process, and by working with local intermediaries, they discovered that within the local refugee population were people with skills from previous jobs in the healthcare industry in their home countries. However, they lacked the necessary U.S. credentials for working in the same positions here. The manager of the Hire Local program worked to find positions requiring similar skill sets that would provide opportunities for training and advancement into roles more closely aligned with the individual’s expertise and past experience. In one specific case, the manager found a position for a refugee candidate within an animal research laboratory; the candidate came in with the necessary skills to do the job and the institution did not have to pay to train anyone.94 

Mapping The Workforce Development Ecosystem

  • What organizations might residents looking for jobs already interact with? What do these organizations bring to the table? Meet with key stakeholders from your list of identified partners to see what trainings and skills they already offer, and what they might be interested in building out.
  • What are other nearby anchor institutions doing around workforce development? Are there any other local hospitals with similar workforce needs? Are there other employers with similar position categories in which hiring could be streamlined? Meet with workforce representatives to discuss areas of alignment and opportunities to partner.

In some cases, a new organization may need to be incubated based on the specific geographic or demographic focus of the local and inclusive hiring effort. Some examples include New Haven Works, a workforce intermediary in New Haven, Connecticut connecting local residents to Yale University and other local employers; University of Colorado Anschutz Medical Campus’ Local Hire Program; and the West Philadelphia Skills Initiative in Philadelphia, Pennsylvania. All these organizations were established or supported to provide effective workforce development services to health systems.  

How do you institutionalize programs and get the whole team on board?

Buy-in begins in the design stage. If you engage stakeholders from the beginning and understand their priorities, it becomes easier to link impact workforce goals with managers’ specific goals.

As health systems are considering which positions to focus on for their impact workforce programs, it would serve them well to focus on positions that are in-demand and/or have high turnover. Aligning business needs with impact workforce programs serves the dual purpose of benefiting the institution as well as individuals. This strategy garners more buy-in, gains more champions, and ensures greater sustainability. One example of an institution aligning investments in workforce development with business needs can be found in Kaiser Permanente’s effort to support the implementation and scaling of non-degreed healthcare and behavioral health pathways for youth and young adults in its Colorado region. In partnership with Jobs for the Future and the Colorado Health Institute, Kaiser Permanente is helping to strengthen the healthcare apprenticeship pathway by expanding current infrastructure, filling programming gaps, and building capacity. This is done through the development of comprehensive career pathway maps, technical assistance to support the implementation and utilization of the pathway maps, capacity building to strengthen the regional career navigation supports for young people, engagement of employer networks to expand youth career pathways, and strengthening regional workforce programs to enhance accessibility and scale. By building workforce pathways that are broad and inclusive, Kaiser Permanente not only addresses workforce shortages in high-demand clinical and nonclinical positions but also creates a sustainable workforce that meets the needs of the patient population being served in the area. 94b

Public goals are an important way for leadership to demonstrate that the impact workforce strategy is a priority. They serve not only as a tool to publicize efforts and generate interest in impact workforce programs, but also to hold the institution accountable for its efforts. The Johns Hopkins University and Health System has local hire initiatives under its HopkinsLocal program where it publicizes goals and progress. In 2023, health systems that signed onto HAN’s Impact Workforce Commitment set public goals to reach at least 10% of new hires annually as impact hires by the end of 2027.

Even after just one year, impact workforce programs can have a tremendous positive effect. But high quality data needs to be consistently tracked in order to tell this story. By investing time into establishing your workforce baseline and setting up data infrastructure systems, it will be easier to report back to stakeholders on the success of programs.

“It can be a challenge to get the data you need and may take time to define the right metrics,” says Seanna Ruvkun, Workforce Planning Consultant. “But think early about what success would look like and [understand] what you can measure.”95

Although it’s easy to think of hiring as just a human resources function, in reality, the success of an impact workforce effort crosses all departments: administrative staff may need to shift payroll practices, department managers may need to change release time policy, etc. Dedicating resources to training all staff on the effort can significantly increase the program’s long-term impact. Best practices include doing presentations at monthly departmental staff meetings, or requiring that mandatory professional development training hours be dedicated to the effort.

It is important to ensure that there are processes for all stakeholders—job applicants, new employees, managers, intermediaries—to provide feedback. This is not only essential in ensuring that the program is effective, but it will also help generate narratives about the program’s achievements. Often it is the individual stories that are the most compelling. Creating mechanisms to solicit qualitative feedback will help you gather evidence on the various ways in which these initiatives matter.

 

 

90.

 Kelly Aiken, Crystal Roberts-Gilbert, and Chris Lee, “Laying the Foundations for Impact Workforce Strategies” (presentation from the Healthcare Anchor Network, Los Angeles, October 3, 2023).

91.

 Boris Sigal, interview by David Zuckerman and Katie Parker, New Haven, CT, April 1, 2016, notes.

92.

 For a chart describing strategies for employer-assisted housing, see: Anna Afshar, New Arguments for Employer-Assisted Housing (New England Community Developments: Federal Reserve Bank of Boston, 2006), page #3, https://share.google/getfqdQiIwvvsWB4Z.

93.

 “Community Land Trusts,” Grounded Solutions Network, accessed 12/01/2024, http://community-wealth.org/strategies/panel/clts/index.html.

94.

 Robert McGranaghan, interview by David Zuckerman and Katie Parker, April 7, 2016, transcript.

94b.

Jasmine Brar emailed Hue Phung and Lauren Worth updated impact numbers, Kaiser Permanente, September 25, 2025, Healthcare Anchor Network.

95.

 Seanna Ruvkun and Kristin Driscoll, “Getting Started with Impact Workforce Strategies” (presentation, Healthcare Anchor Network Convening, Los Angeles, October 4, 2023.