Redesigning work in healthcare to fuel growth 

Healthcare systems are at a crossroads. While leaders are pursuing ambitious growth strategies — expanding facilities, opening outpatient centers, and introducing new care models — the workforce isn't keeping pace. Instead of fostering excitement, these initiatives often leave frontline staff feeling dejected. With more burnout, more roles to fill, cascading delays, and strained resources, growth has become a burden instead of an opportunity.

This dilemma played out vividly when a major health system launched a new outpatient center, positioning it as a cornerstone of its growth strategy. But instead of optimism, the effort exposed deeper cracks in workforce readiness: unfilled roles, increasing overtime, patient waiting lists stretching longer, and rising burnout among staff. What should have represented progress instead highlighted systemic vulnerabilities in outdated workforce planning.

Leaders quickly reframed the challenge. Solving the labor shortage alone wouldn't ensure growth. To realize their vision, leadership posed a bold imperative: What must be true about the workforce for this system to achieve its growth strategy? By taking this approach and focusing on redesigning work, it enabled systemic growth, rather than simply hiring to solve a labor crisis.

This is a foundational shift. It requires health systems to address workforce capacity and productivity through fundamentally new models for work delivery. The calling isn't to adapt to shortages but to grow through transformation: redesigning how care is delivered, leveraging smart automation, engaging staff to work at the top of their licenses, and embedding workforce resilience into systems and culture.

The future of healthcare requires a fundamental redesign of how work is delivered, deconstructing tasks to determine what can be automated, redeployed, or restructured. By taking this "work-backward" approach, health systems can bend the supply-demand curve, expand capacity, reduce burnout, and unlock scalable, sustainable productivity gains beyond what AI alone can deliver.

Mercer's framework for sustainable workforce transformation

Mercer has developed a scalable framework for work deconstruction and reconstruction that applies to both clinical and non-clinical roles. Cross-functional teams, spanning nursing, allied health, hospital operations, and HR, are collaborating to lead this transformation in leading healthcare organizations. A critical enabler is effective change management, ensuring redesigned models are adopted, sustained, and embedded across the organization. Equally important is knowledge transfer — we leave behind the approach, tools, templates, and technology so providers can quickly build this capability. As expectations shift, HR will increasingly be called on to facilitate this transformation.

Step 1: Build an evidence-based case for change

The framework begins by prioritizing roles for redesign using a change urgency score, which is a data-driven measure of workforce strain, operational importance, and organizational readiness. Roles that rank high on both urgency and readiness are prime candidates for immediate impact. Take, for example, a radiology technologist — a role in critically short supply. Recruiting is difficult, and the limited talent pool leaves current staff stretched to an unsustainable degree. Contrast that role with a hospital security officer, a position that is easier to fill but increasingly challenged by a rise in security incidents. These officers are highly mission-driven, dedicated to protecting patients and staff, and often receptive to adopting new approaches that strengthen their ability to safeguard the hospital community. 

The urgency score blends internal labor data (turnover, recruitment difficulty) with external labor market signals (talent availability, pay competitiveness). This allows leaders to pinpoint where redesign is both necessary and feasible; an excellent indication of where to start within a system.

Step 2: Redesign the work

Once roles are prioritized, redesign begins with a bottom-up approach. This involves:

• Deconstructing: Break down jobs into detailed tasks through focus groups, observations, and time-on-task analysis. This analysis uncovers hidden capacity and opportunities to improve utilization. For instance, studying the Certified Medical Assistant (CMA) role through manager interviews, focus groups, and employee surveys can reveal how tasks and time are distributed across the patient journey. Applying the same approach to the Patient Services Team makes sense, given their interdependence. Evaluating both roles together allows the organization to gauge automation potential better and uncover meaningful redesign opportunities.
• Redeploying: Evaluate each task to determine if it should be handled by people, automation, or alternative arrangements (e.g., gig workers, partnerships). This ensures clinicians and support staff work at the top of their license while opening new opportunities for reskilling and role evolution.
• Assessing ROIP (Return on Increased Performance): Once tasks are deconstructed and redeployment options explored, organizations must evaluate the Return on Increased Performance (ROIP) to prioritize redesign investments. Not all tasks create equal value, so understanding the performance-value curve is critical. Some tasks, like CMAs completing intake forms, carry minimal upside but high risk if done poorly, requiring strict consistency. Others, such as those responsible for prepping rooms or conducting follow-ups, deliver constant value where standardization reduces variance and saves time. Certain activities provide incremental value, with improvements, like expanding e-check-ins or accurate documentation for reimbursement, directly enhancing efficiency and outcomes. And in rare cases, tasks can generate exponential value, where frontline-driven innovations deliver outsized impact in areas like quality improvement or patient engagement.
• Reconstructing: Optimize the balance between human effort and automation. This may involve robotic process automation, AI, or cognitive automation, where each is aligned to task complexity and value. The goal is to increase capacity without adding cost or burdening staff.

Step 3: Embed change into systems and processes

Lasting transformation requires embedding new models into organizational culture and operations. This starts with leadership alignment to build a shared case for change among executives, clinicians, and HR. Clear communication and tailored training help overcome resistance rooted in fears of job loss or skill obsolescence.

Sustainable adoption comes from integrating redesign into related systems, reinforcing new behaviors, and fostering a culture of continuous improvement. By aligning workforce strategies with operational goals, health systems can expand capacity, reduce burnout, and achieve long-term resilience.