The workplace environment of health care continues to experience volatility as the fee-for-service module for revenue is replaced by a managed-care module. This evolution has resulted in shortages across the spectrum of skilled healthcare professionals. Consequently, managers are facing major recruitment and retention issues. Understanding some of the driving forces behind this current shortage is the foundation for planning effective recruitment and retention strategies. Understanding this, and applying some basic management principles provide tools for staying on course during turbulence.

Many professionals agree that there are four major factors contributing to this shortage:

1. Higher than predicted hospital census and greater acuity.
2. Lower baccalaureate enrollment in healthcare fields.
3. A robust national economy.
4. Zealous reductions in staff in conjunction with short work-life careers.

Using the above factors as a basis for strategy development, incorporate these basic management principles:

• Base decisions on knowledge and information rather than hunches.
• Analyze and refine available information.
• Think long-term although the goal may be short-term.
• Select the best-fit candidate although additional training may be required. Ultimately, success is determined by character not credentials.
• Collaborate internally and externally.

Finally, healthcare managers can look at other industries for "lessons learned" during periods of volatility. Some apparent lessons are:

1. The rules for managing a full-employment workforce are different-command and control approaches are not effective.
2. Collaboration and alliances must replace competition.
3. Fail intelligently by learning from mistakes.