Workforce Recruitment in the Safety Net

Safety net staffing is an important issue.

Safety-net providers often report challenges recruiting and retaining staff, particularly for high-cost, high-demand professions such as registered nurses and physicians. Rural providers face greater difficulty due to the relatively lower supply of health professionals in rural communities, and urban safety-net providers often face challenges paying competitive wages in their markets. As a result of shortfalls of supply, many safety-net providers report they rely heavily on contingent staff, which includes locum tenens, traveling agency, and temporary agency personnel. 

Several new companies have developed web-based marketplaces to facilitate the recruitment and placement of both permanent and contingent staff. These marketplaces may be of particularly high value to safety-net providers, in part because they often promise to reduce payments to temporary and locum tenens placement agencies. However, it is unclear whether safety-net providers have special needs with respect to their utilization of contingent personnel, whether safety-net providers would be willing to use technology-based marketplaces to meet their staffing needs, and whether such technologies might reduce costs and increase efficiency. 

In order to understand the potential value of technology-based marketplaces for safety-net staffing, we are studying the recruitment environment for registered nurses (RN) and physician workforce. Specifically:

  1. Review the literature on the factors associated with challenges in recruiting RNs and physicians in the safety net, and of factors that influence RN and physician decisions to work as contingent rather than permanent staff. 
  2. Conduct a landscape analysis of new technology models for recruitment of health care personnel, with a focus on RNs and physicians in both permanent and temporary positions. 
  3. Analyze secondary data from the California Office of Statewide Health Planning and Development (OSHPD) Hospital Annual Financial Disclosure Reports and Primary Care Clinic Annual Utilization Data, vacancy and turnover data collected by the Hospital Association of Southern California (HASC), data on perceptions of the RN labor market collected by the UCSF survey of hospital CNOs, and the California Board of Registered Nursing Biennial Surveys of RNs. 
  4. Interview human resources (HR) directors at 10 safety-net facilities and up to 4 new technology vendors in the nurse and/or physician recruitment space, and up to 20 nurses and 20 physicians employed as contingent staff and/or in safety-net facilities. 


For more information, please contact Joanne Spetz.