How Mercy Health 'Uberized' Its Nursing Staff

​If the pandemic taught Mercy Health's HR team anything, it was that the multistate organization had to change its workforce strategy and modernize its technology infrastructure to support the introduction of part-time contract "gig" nurses. Mercy executives called the move the "Uberization" of nursing staff.

Mercy is one of the 25 largest health systems in the U.S., with 900 physician practices and outpatient facilities, 3,400 Mercy clinic physicians and advanced practitioners, and 10,000 nurses who serve millions of patients across Arkansas, Kansas, Missouri and Oklahoma.

Mercy also has clinics, outpatient services and outreach ministries in Arkansas, Louisiana, Mississippi and Texas.

Like many health care organizations, Mercy struggled with a shortage of nurses before the pandemic. The problem became more acute when a surge in COVID-19 cases caused many nurses to quit after experiencing greater stress, burnout and a need to achieve a better work/life balance.    

The fallout from the pandemic sped up the organization's plans to add an additional layer of nurses to its workforce.

"We knew that nurses wanted to work differently because we were having a hard time recruiting into nursing across the nation, but when the pandemic came, we were certain that nurses who wanted to join our system wanted more flexibility. They didn't all want 12-hour shifts," said Betty Jo Rocchio, Mercy's senior vice president and system chief nursing officer.

To meet that need, Mercy designed a cloud-based platform called Mercy Works On Demand (MWOD), with an app that nurses download onto their smartphones. Credentialed nurses hired by Mercy can choose hospital shifts that last as long as eight hours or as short as four or even two hours.

Launched in April 2022, the platform manages 1,187 gig nurses, 50 percent of whom are rehires.

Gig Workers Want Control over Their Time

Mercy's effort to inspire former full-time nurses to rejoin as gig nurses reflects the need to give nurses more control over their careers.

According to data from management consulting firm Oliver Wyman, the number of nurses moving to gig labor grew 1,400 percent since the start of the pandemic. 

Additionally, the data shows that while lucrative financial opportunities are available to most health care workers in today's market, 20 percent to 30 percent of nursing and allied health professionals have accelerated their retirement plans.

Oliver Wyman's research also shows that 50 percent to 60 percent of nurses plan to change their career in some way, including a significant portion (15 percent to 30 percent) who said they are planning to work outside of health care all together.

"Nurses are predominantly female, and many crave opportunities to care for children and dependents in addition to their work," said Kathi Enderes, senior vice president, research and lead health care industry analyst at The Josh Bersin Co. "Having the flexibility to work on demand increases the engagement of these nurses."

Enderes added that while a major drawback for gig nurses is the lack of employer-provided benefits, being able to set their own schedules "helps them have more autonomy about their work, which is linked to engagement and performance."

Building the MWOD App

Mercy's HR and IT teams worked together to build a platform with tech tools that are user-friendly and help gig nurses engage with the health system.

The MWOD platform is built with text-messaging capabilities and driven by artificial intelligence, and its machine learning capabilities know the experience, competencies and qualifications each nurse possesses, such as who has an associate, bachelor's, master's or doctoral degree.

MWOD also tracks which nurses select particular shifts, how many hours they work, and what their specific specialty is, which helps the system accurately push alerts to the right nurse when shifts become available. 

"We have a profile in the platform for each nurse that allows us to know who can work in a specialty, and that's how we make sure that we only push the shifts that are right for that nurse," Rocchio said.

The platform integrates with iCIMS, Mercy's applicant tracking system, which processes gig workers' applications. The platform also integrates with Mercy's staffing and scheduling system, UKG Dimensions, which helps Mercy's HR team identify shift preferences and availability patterns. Mercy uses Workday as its HR system, providing the HR team with greater transparency into its contract workforce. Workday also automates administrative processes.

According to Tracey Grimshaw, Mercy's chief talent and organizational effectiveness officer, gig nurses can see their shift schedules on MWOD by logging in to the app; punch in or out of their shifts using the UKG Dimensions timekeeping, staffing and scheduling system; and get paid through Workday's payroll management system. 

"The systems are fully integrated," Grimshaw said, noting that technology requires standardization, and Mercy's nursing leaders had to agree on many different aspects of the platform before it was rolled out to staff.

"Behind the scenes, we needed to get all of our nursing leaders aligned around how we were going to think about pay rates for gig workers, standard definitions of what a gig nurse is, how we would leverage them and how they would work with us," she said. In addition, "getting Mercy's HR, IT and clinical staff to think about this platform in the same way took quite a bit of work."

According to Enderes, establishing a gig nursing workforce with the MWOD platform and app has made Mercy a stronger organization and "increased the attraction of hard-to-find nursing talent to the organization. Having the opportunity to work part-time and more flexible schedules makes it easier to compete in an incredibly tight labor pool."

Nicole Lewis is a freelance journalist based in Miami.