Compass Staff |
On a typical Friday morning earlier this summer, a Midwestern healthcare system faced a staffing shortfall, as routine now as the coffee cart in the lobby. Only this particular personnel problem couldn't be solved with more overtime shifts or harried phone calls to float-pool workers.
There were no X-ray technicians available. None.
Machines sat idle, imaging appointments backed up, and by mid-afternoon the crisis had become a “CEO issue”. The lack of X-ray techs meant disruptions in essential patient services and lost revenue.
National v. local talent strategy:
A false dichotomy
When the HR leader of the healthcare system shared this story at a recent conference, heads nodded. Everyone recognized it. Each unstaffed role, each hour of lost capacity, is a reminder that today’s talent crisis is unfolding not in the national aggregate but in dozens of local labor markets all at once — city by city, county by county, each with its own set of challenges.
The next frontier of HR leadership means building systems that scale nationally while staying rooted in the realities of local markets.
And yet, expectations heaped on HR leaders (even from CEOs themselves) often run in the opposite direction: Think bigger, align with organizational priorities, standardize and centralize systems, and deliver scale across a national or large regional footprint. Therein lies the paradox: “One-strategy,” national talent playbooks are too slow to adapt to local constraints, while local fixes are too fragmented and inefficient.
The most effective path? Not national or local, but both at once.
Talent strategy works best when national scaffolding (corporate strategy, central resourcing) provides for necessary scale and efficiency, and local execution (partnerships with educational institutions, specialized skilling, coaching) adapts to local credentialing rules, training capacity, and employer demand. Talent and workforce leaders who hold both perspectives in balance will be the ones who close critical gaps and build resilient pipelines.
Before solving the paradox, leaders must consider the two forces at play:
1. National talent playbooks
Pros: Standardization at scale, repeatability, efficiency of measurement
Cons: Blunt to local realities (licensure rules, clinical seats, and provider readiness), slow to adapt
National talent playbooks create real advantages: a shared curriculum and common language for roles, skills, and career pathways aligned to top priorities; centralized demand and execution for learning goals; administrative efficiencies across markets; and — most important — the ability to replicate what works.
But one framework can’t solve a local shortage. External hiring has tightened to the point that “buying” talent isn’t viable; HR has to build from within. The question is who, where, and how: which employees in each local market can be identified, prepared, and moved into the hardest-to-fill roles — and how do we codify the playbook so it travels without starting from scratch?
2. Local execution
Pros: Direct-market fit, stronger pipelines
Cons: Resource-intensive, hard to scale
All talent crises are inherently local. HR leaders benefit from a close-up view of particular staffing shortages so they can respond quickly to particular needs and preferences. And many, for their part, have prioritized “hand-cranking” training programs with local community colleges, trade schools, and nonprofits to fill critical licensed roles. These programs, while developed with good intentions and limited resources, often depend on one person overseeing the progress and readiness of learners in real time, leaving HR and business leaders with scant insights to make decisions on backfill planning, clinical rotations, and targeted supports (childcare, transportation, tutoring). The result is a “leaky funnel”: Learners fall out of the pipeline when national scaffolding and local execution fail to connect.
The new balancing act for HR leaders
If neither national nor local approaches work in isolation (and we know they don’t), what does the solution look like in practice? The answer lies in strategies that borrow the strengths of both — scale where possible, customize locally where necessary — and grounding those strategies in principles that can guide HR leaders through the complexity.
Our experience and research point to a small set of no-regrets actions — simple to execute, seemingly obvious, yet consistently high-leverage when done with rigor — that leaders can start today.
1. Demystify and de-risk licensed roles.
The most resilient and operationally essential jobs — certified nursing assistants (CNAs), radiology technologists, commercial drivers, robotics technicians, and maintenance technicians — require licensed career pathways that many employees don’t yet understand or feel supported to pursue. These roles determine whether hospitals, factories, or logistics networks can operate at capacity.
Start by making these roles visible inside the business: Publish the top ten roles by local market, why they matter to the business, and make explicit the pay progression tied to licensure.
Then, provide guidance on the pathway with clear prerequisites, expectations on the role, journey-planning and management, timelines, and necessary commitments.
Finally, “walk the walk”: Fund exam fees, offer paid time to learn, secure clinical/seat availability in advance, train managers to coach learners on-shift, and commit to post-licensure placement windows with wage steps.
The signal to employees should be unmistakable — these roles are mission-critical, supported, and rewarded.
2. Standardize what you can; make local decisions portable.
Talent shortages are never solved in a vacuum. Many HR teams already run effective partnerships with colleges, technical schools, and state workforce boards; these homegrown efforts are the seeds of a durable talent supply. The challenge now is to scale — to shift from one-off, “hand-cranked” pilot programs to a repeatable system.
In our experience, this requires two things:
A centralized digital backbone: Automate admin, track progress in real time, standardize supports (think transportation and childcare stipends, licensed-exam prep and tutoring, and coaching).
Local decisions made with scale in mind. Codify local decisions — such as hiring strategies, learning outcomes, and terms of partner agreements with local colleges — so they can be more easily applied in every region.
How that looks in practice: A large regional health system partnered with a local college and made one pivotal choice — hire trainees on day one — that had the support of a centralized digital backbone that tracked progress and placements in real time. Learners split time between coursework and clinical rotations. Within months, the pipeline stabilized, and the model replicated at additional sites with only minor local adjustments.
3. Provide proactive support with end-to-end visibility.
Today, support for adults training into licensed roles can be fragmented: Schools track coursework, employers track participation, and learners navigate the rest on their own. What’s missing is line of sight. With real-time visibility into each learner’s progress, managers and coaches can intervene early — buy the laptop, add 1:1 coaching, troubleshoot childcare or transportation — before momentum breaks.
And it does more than triage. That same visibility gives talent and operations leaders foresight: Who will be job-ready, when, and where to place them. Leaders can pre-plan shifts, line up preceptors, stage equipment, and confirm offers ahead of completion, filling critical staffing gaps with confidence and speed. The result is fewer surprises at graduation, faster time-to-productivity, and smarter investments in your workforce.
As one healthcare HR leader noted to me recently: “We didn’t want to just send people to an external program and hope for the best. What kind of mentorship, what kind of training do we provide internally to support them through the journey?”
You can (and should have) both.
Talent and workforce leaders must embrace a paradox mindset: national and local at once. The next frontier of leadership is not only corporate stewardship. It is civic leadership — building systems that scale nationally while staying rooted in the realities of local markets — and equipping employees to navigate licensed career pathways into the ~10 roles that keep the business running in each community.
