Jackie Larson, Executive Vice President of Aya Advisory Solutions, on Using Data to Maximize Results

David Folwell: Hello everyone. Thank you for joining us for another episode of The Staffing Show. Today I am extremely excited to be joined by Jackie Larson, who is the executive vice president of Aya Advisory [Solutions]. Jackie, thanks so much for being on the show today. To kick things off, could you tell us a little bit about who you are and how you got into staffing?

Jackie Larson: Yeah, absolutely. And thanks for having me this morning or this afternoon, depending on what time you’ll be listening to this. As you said, my name’s Jackie Larson. I’m the EVP of Advisory Solutions, which is actually a new division of Aya Healthcare, and really we’re focused on solving those broader workforce challenges facing our clients.

Over the last 15 years or so, I’ve been really fortunate to be on the forefront of building out innovative solutions via analytics, sound workforce optimization strategies. But I actually stumbled into the industry. I had a really successful career. I had a financial services firm. And as I left there, I’m like, “What do I want to do? What do I want to be when I grow up?” And what I landed on is I wanted to solve big problems that would transform the way our clients approach their work. And so I landed at a company who was wholly owned by a large health system, and it was really there that I found that passion for healthcare and how better staffing optimization could materially improve the clinical, financial, and operational goals.

Folwell: That’s incredible. And tell me a little bit about some of the things that you did with regards to staffing optimization?

Larson: Yeah, interestingly, the organization that I was at prior to coming to Aya, I was with a company called Avantas. I was there for 14 years, eight of those serving as their president. And at Avantas, it was really about helping organizations similarly solve those challenges. So things like, “How effectively are you utilizing the resources that you have available to you?” Because even if you look at what’s happening today, it’s all about effective utilization of resources. It’s driving down cost, it’s reducing reliance on contingent labor. And that’s really what we’re trying to do here at Aya is truly the innovative solution, true partners to our client and answering their call. They’re coming to us saying, “Gosh, we’re using too much of you,” and we’re like, “We know, we want to help you.”

Folwell: That’s amazing.

Larson: I thought it was really profound that Aya, being the number-one staffing firm in the country, is standing up a division that said, “We know you’re using too much of us. We are going to help you reduce your reliance on us, on contingent labor.” And truly giving them strategies and tools that create that nimble and flexible staffing model that helps them meet the ebbs and flows of patient demand.

Folwell: That’s really incredible to think about, you’re actually saying, “All right, we might keep taking more of your business as you grow, but we really want to be a partner and help you solve these problems from a different perspective.” I was going to ask you why you decided to join Aya. I’m sure some of this is part of that, but can you tell me a little bit about why you kind of chose Aya?

Larson: Yeah. I got a call. And having known several individuals within Aya and then having known the work that I’ve done previously, I said, “That sounds interesting, but tell me a little bit about the culture.” And I was fortunate to spend some time with a number of team members there and talk to them. And this probably sounds funny, but there is a heart and soul behind the logo. I continued to be impressed about the mission and vision of Aya. It’s really, we support our clinicians, but we’re here to solve a problem. We’re here to help our clients and we want to be there when they need us the most.

And the other thing that I really love about Aya is the culture of, “We are going to remove any barriers and any obstacles and unnecessary bureaucracy to get the work done.” Just take it away. We want to make sure that we get the work done. And so that’s kind of our job as leaders, too, is when we have team members that are really just trying to serve the clinician, serve the client, what’s getting in their way. And I really think that Aya leads with that and I was just drawn to that.

Folwell: That sounds like a great culture. And I think eliminating bureaucracy at any point is always good from my perspective. I mean, one of the things that I was excited to have you on the podcast for is seeing Aya’s growth rate. We just had Healthcare Staffing Summit a few weeks back, or maybe a month at this point. And hearing, I don’t remember the exact revenue numbers, but they’re significant and larger than any other healthcare staffing firm. I think you guys have grown to be the largest just in the last handful of years.

What is some of the drivers that have pushed you guys to be the number-one healthcare staffing agency in such a short amount of time?

Larson: Yeah, that’s a great question. I think one is the culture. It is, again, people-forward. It’s intent on removing those barriers. But second, kind of watching from afar and now being in it, I’ve just been blown away by our ability to innovate at a rapid pace. It’s crazy. Our technology platform and digital strategy, it’s really delivered that unmatched productivity for our teams. Interesting note, our recruiters are five times more productive when we compare to the SIA benchmarks.

Folwell: Wow.

Larson: The majority manage over 100 clinicians.

Folwell: Wow.

Larson: I mean, it’s just, you kind of don’t believe it until you see it.

Folwell: That’s wild.

Larson: And it’s just amazing. But there’s still that human element. Even though we have this digital platform or this digital strategy, this fantastic technology platform, we still have nearly 1,000 individuals on the recruiting side of the house.

Folwell: That’s amazing. Yeah. You still have the human, there’s a huge human element as well. But I also, I don’t remember the numbers on this, but I think Alan said on stage there was like, I don’t know how many developers you guys have, but it’s significantly more than any other agency I’ve talked with, which is talking about the platform part of it. So you said that you have over how many recruiters, 1,000?

Larson: 1,000, yep.

Folwell: And how do you think their role differs compared to other agencies? Because you said that there is the human element, but that, what is it that makes it so they can do five times more?

Larson: Well, what’s interesting is Aya’s platform is the most visited site. And so we have really engaged clinicians that are coming to us that are looking to be placed where they’re needed versus if you flip the model, you’re not having to dial and recruit. So I think just all the touchpoints that occur with the clinician are engaging them in such a way where they’re saying, “I want to be part of the Aya team and I want to be part of that network versus having to reach out and physically recruit.” And I think that’s really a paradigm shift in what Aya’s created in the platform and the digital strategy. It really gives us the ability to use those resources to have more personal touch with those clinicians in a more meaningful way versus always just trying to do the recruiting side of it and pulling people in because they’re already there.

Folwell: Yup, so it sounds like they’re not having to do outbound recruiting. The candidates are there.

Larson: Yeah.

Folwell: It’s all inbound or they’re teed up for them. And then I imagine based off of just knowing where you guys are at from a development side, that you guys are probably automated, a lot of everybody that I talk to in staffing, I mean, I think it’s common knowledge that it’s automate the meaningless tasks and focus on the human relationship side of it. Sounds like you guys have maybe nailed that aspect of it as well.

Larson: Yeah.

Folwell: Are there any other kinds of major components, do you think, what have been key drivers to the success? I think that’s a great answer so far.

Larson: Yeah. You know, kind of alluded to it. I think the number of developers, and just based on my past experience, and you probably have experienced this, or touched on this as well, as sometimes technology can be a bottleneck. And this has really been an enabler to be able to put that many developers to continue to improve and innovate and get rid of the waste and really have the people-side of it focus on the things that are most meaningful. It’s been impressive to watch because a lot of times it’s trying to keep pace with what’s happening in the market. And I think Alan’s vision and strategy, he’s really done a phenomenal job at creating an environment where we are ahead of it and we’re continuing to innovate ahead of the group.

Folwell: Yeah, I can see that. And I think your growth shows that he’s got the right vision in place.

Larson: That’s right.

Folwell: What are some of the biggest challenges that you’re facing at Aya right now?

Larson: I don’t know that this is necessarily or solely an Aya challenge, but just a challenge for healthcare staffing as a whole. We know that a lot of healthcare systems are looking to drive labor costs down and one of those areas is contingent labor, and contingent is just one of those tools.

I think the real problem is workforce shortages. And there’s a systematic workforce challenge that needs to be addressed. And I think one of the things that we’re trying to do is help our clients rebuild their workforce by creating more flexibility, creating a more nimble, gapping model, and then also providing varied employment options and opportunities to address how different workers want to work.

So one example would be really creating on the Aya side an avenue for travelers who are getting burnt out. We hear this in the industry, to be able to offer them a permanent home and to be able to use that huge platform in digital strategy to really allow that recruiting engine to work. So we might have a health system that says, “I want to draw down my premium labor, my reliance on travelers, but we don’t have a great means to recruit for permanent staff. Aya can you help?” “Yes, we can absolutely help you. We can help post your jobs because we can cast a much wider net and because of the traffic that is drawn to our site, you’re going to have a much better chance of being able to fill those open positions.”

Folwell: So with that, and that sounds like you’re talking about some of the advisory services that you offer. I also know, and I don’t know, do you guys have an RPO division separate from that? Or is that similar to what you guys are giving a little kind of a landscape of how these things work together?

Larson: Yeah, it is separate, but one of the things that we do within advisory is using the client’s data to understand how effectively are you utilizing all the resources you have available? So that is their full and part-time firm staff as well as anything that they’re using to supplement those open shifts or open vacancies. And really what we’re able to do is analyze that in such a way that aggregates all of their information so we can pull their census information, HR, payroll, time and attendance, and really provide them insights to tell them, “Why are you using overtime? Are you over-utilizing travel resources? Do you have the opportunity to create a more robust internal flow pool?” Oftentimes healthcare organizations don’t, they under resource there. And then be able to turn back to them a strategic roadmap and have it plotted on an effort and impact graph, meaning, okay, here’s some low-hanging fruit….

Folwell: Love it.

Larson: …tackle that first, but then let’s look out 6, 12, 18 months. And what are the different strategies that you really could implement that could help you draw down that travel usage, really creating more balance structure within your organization? Because we also know that retention is a key initiative, and to be able to retain staff once you get them is so hugely important to our clients right now.

Folwell: So it sounds like a key part of what you guys are doing is just helping them utilize their data to be more strategic with their efforts and actions to make sure that they’re actually maximizing what they can do with what they have.

Larson: That’s exactly right. Yeah.

Folwell: Okay. And how are you partnering, and this might be on the nerdy side of this, but I just imagine getting access to the data, normalizing the data, having that working with different hospital systems is, and that has to be a project for each hospital that you start working with? Or how do you approach that?

Larson: Yeah, the first step really is: “Let’s get their understanding of what they think the challenges are. What are they feeling and what are the clinicians feeling on the floor? And what’s the financials telling them? Where do they have open shifts or open vacancies? What’s their turnover?”

And then essentially what we do is we do a huge data intake with all of the different data feeds that I mentioned, and we make sure that we’re normalizing the data, that we’re cleaning the data, that we’re mapping it in the right way, that by the time we create the output, it makes sense. And they’re not saying, “Hmm, this one,” we try to take care of that ahead of time. But then we have pretty impressive needs to be able to do some predictions on the census.

We want to be able to futurecast what their staffing needs to look like because we don’t want to give them something that’s retrospective, it’s already old by the time they get it, but then do the modeling to say, “There is a perfect mix between core and contingency, and there’s a way that we can align those resources, according to the emerging patient demand.” That really creates the sweet spot that draws down that premium pay, reduces reliance on travelers, but also creates this balance within the system where they have better clinician engagement and higher retention because they’re not being overworked.

We’re helping them embed different strategies that really create more of that work-life balance and give those clinicians better options in terms of where they work and when they work.

Folwell: That sounds really incredible. And it leads to the next question I was going to ask you. What advice that, as hospitals are moving out of this post-acute phase of the pandemic, what is some guidance that would help them move forward and prepare for the next unknown crisis?

Larson: It’s funny, you hit on a key point because we can’t predict what’s never occurred before, but they can be planful. So I think the big thing is have them utilize the data aggregated in a way that gives them meaningful insights, but then start to ask the questions and seek answers to those through the data. Is there an over-reliance on overtime? Is there a high premium pay? Is it trending in the wrong direction? Are your core staff picking up extra shifts? Again, is that above normal? Is it trending up? Do they have a disproportionate number of traveler resources? And then there’s other things.Are there things that are creating strain on the clinicians that might be creating a downstream impact of either burnout or turnover? 

So it’s creating this data pool and creating these queries that give them some of the answers to these data so that the next step is, “Okay, what are the different strategies that can help us curb some of these trends that we’re seeing that needs to be reversed?”

Folwell: Yeah, that’s incredible. And are you seeing hospitals, this might be a little bit in the weeds, but using things like the employee NPS, are you starting to dig into what actual culture fit and having strategies to help reduce the burnout and the turnover feel like that’s something that frequently, it feels like hospitals aren’t paying attention to culture as much as maybe other organizations?

Larson: Yeah. Yeah, that’s an excellent question. I think what we’re seeing is that systems are acknowledging that what’s occurred over the last several years is creating a condition within the clinician that’s creating dissatisfaction, burnout. I mean, the clinicians are leaving the profession. And so it’s this wake-up call, “Oh my gosh, we need to look at all things. We need to look at culture. What’s creating this dissatisfaction and this burnout? What are the things within our control that we can start to flip?” And one of the things that we focus on specifically is how can we give them better models that align all of their resources to the emerging patient demand and not overuse any one source of staff.

Folwell: Got it. So it might be more flexible schedules, lighter schedules, not relying on overtime and trying to push each employee as heavily, so larger workforce, fewer hours potentially, something along those lines?

Larson: That’s right. And even as I mentioned, internal resource pools, we’re hearing a lot about that, but interestingly enough, it’s we’ve developed some algorithms to help them calculate and quantify the right sizing of an internal resource pool because oftentimes it’s so under-resourced that the only lever that they have to fill those open shifts is either overworking existing staff or using agency to cover off on that.

Folwell: Got it. I mean, you just mentioned that you have an algorithm for this, but I was going to ask how hospitals can identify the ideal mix of contingent versus core staff?

Larson: Yeah, so we’ve developed a lot of these proprietary algorithms, but one thing that they can do is look at what is the occurrence or the amount of time that core staff can’t take a patient for whatever reason. It could be PTO, FMLA, overtime, meetings, and that could be a good first step in identifying what the back bill rate needs to be, or an initial swag at what’s the hiring target for an internal flow pool? There’s a lot that goes into it, but this could be a simple first step to identifying, “Are they close or are you a little bit further off in your thoughts on what that hiring target needs to be for that internal flow pool.”

Folwell: Got it. Got it. And with that, I mean, all of the stuff you’re doing sounds incredible. How big is — it sounds like you must have a team of data scientists or a fairly large team to do this type of analysis — how big is the group that you have working on this?

Larson: It’s interesting. We’re very cross-functional, and so we draw on a number of different individuals throughout the organization to help us do the modeling, to help us provide insights in the data. So we’re really leveraging the team at Aya in different pockets, but we’re also growing the team, so we’re getting quite a bit of demand for this type of work, as you can imagine.

Folwell: Yeah, I feel like every hospital right now is probably asking for this. I mean, it seems like something they would all want the answers for.

Larson: So we’re continuing to grow as well. So if you know anybody….

Folwell: That’s perfect. With that, are you seeing hospitals themselves take action? It sounds like you guys are doing this as an outside saying, “Hey, we’re coming in with these services.” And I know for a lot of staffing agencies listening to this, they’re probably like, “Oh, that would be great to do. What’s the scale and effort and impact? How can we get to a spot where we could offer service like that?” 

But are you seeing hospital systems themselves go out and starting to build teams of data scientists and trying to solve these internally as well?

Larson: Yeah, and it’s interesting. We’re seeing that some of the larger, maybe more sophisticated, large IBNs, healthcare systems are starting to bring some of this in house. It’s a little bit of a lift, I think. And so we’re seeing that because we’re getting the demand. I think as we move downstream, we’ll probably see more and more of those hires go to the health systems and they’ll try to do this in-house as well. But I think the thing to notice there is some benefit in having teams that this is all they do, all they specialize in, to create these models for them. So I think that’s what we’re also trying to do, is this is a great way to supplement or augment their existing teams. If they do have some analysts in house, we can certainly help augment that with some of the work that we’re doing.

Folwell: And I’d also imagine just the benchmarking data alone, the data set that Aya has with the number of contingent labor that you place across the country and RPO as well, that would be a huge benefit as well. 

Do you have any specific examples of how Aya has helped the hospital with workforce planning? I know we’ve gone through a bunch of hypotheticals of different areas where you’re like, “Here’s things like this.” Do you have any specific examples of where you went in and worked with the hospital system and what the outcome looked like?

Larson: Yeah, it’s interesting. In the work that we’ve done with health systems across the country, what we’re seeing is, on average, health systems can save anywhere from 4 to 6% of their total labor spend, not just off contingent labor spent, total labor spend, because there are so many different levers that they have to pull to create that nimble, flexible workforce. One example, and it’s small, but we had done some work with a large academic medical hospital and we did a smaller engagement, and we were able to uncover 90 FTE of what we would call a hidden capacity. It wasn’t saying, “Hey, you need to hire 90 more people….”

Folwell: It was like, you have this here.

Larson: “You have this here. And you didn’t realize it just based on some small tweaks.” And I’m underselling this, but it really was creating awareness around what they were able to see in the data and how they were scheduling those resources against the staffing plan.

Folwell: That’s incredible. And you estimate that most hospitals that aren’t doing this type of workforce planning could say 4 to 6% just by more strategic planning of the resources?

Larson: Absolutely.

Folwell: That’s amazing. That’s really cool. With that, we’re going to jump into the personal and kind of fun questions that I have for you, but did you have any closing thoughts or anything else that you’d like to share around hospital workforce planning or how the hospitals are using data?

Larson: No, I mean, I think we covered a lot of ground. There’s so much opportunity, and I know that just talking to CNOs, COOs, CFOs, CEOs around the country, there is margin fatigue. It’s almost like we need to do something different and we need help. And I think they’re rich with data. Just aligning with the right partner that can help guide them through all of the insights that they might have at their fingertips they just might not have the right way at this point in time to aggregate it. And I think that’s what we’re really trying to do is provide them the means to get at that.

Folwell: That’s really incredible. I think it’s a very cool initiative that you guys have in place, so I’m excited to see where it goes. All right. So with that, we’ll jump over to the personal questions. What advice do you wish you were given before entering the staffing industry?

Larson: What I learned is this isn’t a business of transactions. So I remember being new to the industry, it was, you get an order, you fill an order. And I learned that this is a human business, like we’re providing clinicians to hospitals when they’re most needed. They provide relief to already overworked staff. They’re filling gaps so patients can be adequately cared for. I think it’s a really easy mission to align with and find passion for. So I think it wasn’t so much the advice, but I wish that more people would realize that this business, it’s a people business. It’s a human business versus transactional.

Folwell: I love that. And in the last five years, what new belief, behavior, or habit has most improved your life?

Larson: So for me, actually it’s been running. It’s kind of my form of meditation, relaxation, reflection. Although one thing that I do is I put my earbuds in, I crank the music up, and sometimes I have been known to sing loudly no matter where I’m at. I have found that I’ve done that in the hotel fitness rooms, like, “Oh, shoot, is there anybody in here?” But my kids have told me, “Keep your day job. Recording’s not in your future.”

Folwell: That’s awesome. And what is one of the best or most worthwhile investments you’ve ever made? Could be an investment of money, time, energy, et cetera.

Larson: Yeah, that’s a good question. You know what? I think it’s the investment of time. Gosh, I’ve been blessed with two kids. I’ve had the pleasure of leading some awesome teams, and I think I found that when you give your time and attention to…I truly listen, guide, mentor, help, those moments have such a lasting impact. And I’ve been surprised by the people that I have come to know over the years, and they will come back and they’ll say, “Remember when you said or did?” It just warms your heart to know that you could have such an impact. But I would say it’s made me a better parent, a better leader, because I have a different understanding and a different perspective listening to different viewpoints, just giving you the ability to engage in a whole different way. So I think it’s the investment of time in people.

Folwell: Couldn’t agree more. What is the book or books you’ve given most as a gift and why?

Larson: Mine is, “Oh, the Places You’ll Go!” by Dr. Seuss. I just, and that’s for, that’s oddly, I look at that as a business book and a kids book. So if my team members are having kids, I’ll give that book. And I also give it as a business book because if you think about the message, it’s about trying new things. It’s about seizing new opportunities. It’s about taking risks and just getting after it. So one of my favorite quotes, and there’s many in there, but it’s, “Kid, you’ll move mountains. Today is your day. Your mountain is waiting. So get on your way.” If you think about what we’re doing in the industry, it’s like, “Man, we’re going to move mountains. We’re going to move mountains. So let’s get after it.”

Folwell: That is great. First time that anybody’s answered with a Dr. Seuss reference.

Larson: There you go.

Folwell: So relevant and great. Last question I have for you is, what is an unusual habit or absurd thing that you love?

Larson: So if any of my colleagues will listen to this later, they will know the answer to this. My guilty pleasure is gas station hot dogs.

Folwell: Oh.

Larson: That’s probably why I have to run. Even if there’s no sneeze guard on the condiments, I don’t even mind.

Folwell: You just go for it. You’re just getting that. You’re getting the hot dog.

Larson: That’s right?

Folwell: All right.

Larson: Try it. You have to try it.

Folwell: I’ve had them. They’re not bad, but I think I’ve had them more in the college years after some drinks, so it’s been a while. Maybe I need to get back out there. Awesome. Jackie, thank you so much for joining me today. Really enjoyed this conversation and really excited about what you and Aya are doing.

Larson: I appreciate it. Again, thank you for the time.