The Executive Workforce Dashboard

Most healthcare workforce dashboards were built to answer operational questions: how many requisitions are open, how long they take to fill, how many candidates are in process, and how many offers were accepted.

Those measures are useful, but they do not tell an executive team whether the workforce is becoming more stable, capable, or financially sustainable. That distinction matters. Hospitals spent nearly $1 trillion on workforce costs in 2025, and labor remains the largest expense category for most health systems.7 At the same time, healthcare occupations are projected to generate approximately 1.9 million openings annually through 2034.4 Workforce performance is therefore not simply an HR concern — it is an operating, financial, and patient-care priority.

On The Mark Perspective

Healthcare leaders do not need more dashboards. They need better ones. An executive workforce dashboard should not function as a recruiting activity report. It should reveal whether the organization has the talent, stability, leadership capacity, and labor model required to deliver care.

The strongest dashboards connect workforce decisions to four outcomes:

• Patient access and quality
• Financial performance
• Workforce stability
• Organizational growth and resilience

The goal is not to eliminate traditional recruiting metrics. It is to place them inside a broader view of workforce health.

The 10 Metrics

Healthcare leaders do not need more dashboards. They need better ones — the ten measures below place traditional recruiting activity inside a broader view of workforce health.

1. Quality of Hire

What it measures: Whether newly hired employees become successful, productive, and retained contributors — not simply whether they were hired quickly. SHRM recommends measuring quality of hire through a combination of six- and 12-month performance, time to productivity, retention, and hiring-manager satisfaction.1

Suggested formula — a composite Quality-of-Hire Index: 30% first-year performance, 25% first-year retention, 20% hiring-manager confidence, 15% time to proficiency, 10% cultural or team contribution. Each element is scored 0–100.

Why executives should care: A fast hire who underperforms or leaves early can create additional recruitment cost, team disruption, manager burden, and patient-care risk. Quality of hire shifts the conversation from recruitment speed to workforce contribution.

Executive alert — flag: declines greater than five points; critical-role cohorts below target; high manager satisfaction paired with poor retention; strong retention paired with weak performance.

2. First-Year Retention

What it measures: The percentage of new hires who remain employed one year after starting — alongside 30-, 90-, and six-month retention, voluntary first-year turnover, and retention by recruiter, manager, facility, role and source.

The 2026 NSI healthcare retention report places national hospital turnover at 18.5% and RN turnover at 17.6%.2 Press Ganey’s 2026 research found that disengaged caregivers were 2.6 times more likely to leave, with turnover of roughly 24% in less-engaged systems versus 15% in highly engaged systems.3

Why executives should care: Early attrition often signals problems with hiring quality, role expectations, onboarding, manager effectiveness, scheduling, team culture, or compensation alignment. It should be treated as an organizational diagnostic, not merely a recruiting outcome.

Executive alert — flag: first-year retention below enterprise target; a unit with a sharp cohort decline; a manager whose new hires consistently leave early; a source channel producing high volume but low retention.

3. Vacancy Trend

What it measures: Whether workforce gaps are improving or worsening over time. A point-in-time vacancy rate can be misleading — executives should see the direction, duration and concentration of vacancies, including positions open more than 30, 60, 90 and 120 days, vacancy rate by critical role, and reopened positions.

The Bureau of Labor Statistics projects about 1.9 million healthcare openings each year through 2034.4 In mid-2026, healthcare and social assistance employers still reported more than 1.3 million job openings.5

Why executives should care: Vacancy rate is not just a recruiting measure. Persistent vacancies may affect patient access, bed capacity, appointment availability, overtime, contract labor, employee burnout, and service-line growth.

Better dashboard design: do not show only one enterprise vacancy rate. Display a heat map by facility, service line, role, shift, specialty, and business impact.

4. Internal Mobility

What it measures: The organization’s ability to fill roles through promotions, transfers, career pathways and internal redeployment — including SNE-to-GN conversion, GN-to-experienced nurse progression, and regrettable losses after unsuccessful internal applications.

LinkedIn found that employees who make internal moves are 40% more likely to remain at least three years, and organizations with high internal mobility see tenure roughly 53% longer than those with low mobility.6 Organizations with strong learning cultures also showed 23% greater internal mobility, 57% higher retention and 7% healthier management pipelines.6

Why executives should care: Internal mobility preserves institutional knowledge, reduces external recruiting dependency, supports succession, improves retention, and accelerates readiness for hard-to-fill roles.

Executive alert — watch for: low internal application rates; departments that rarely promote; high internal applicant rejection; employees leaving shortly after unsuccessful applications; critical roles with no internal feeder pathway.

5. Premium Labor Percentage

What it measures: The proportion of total labor expense devoted to overtime, contract labor, incentive pay, shift premiums and other above-base labor costs — reported separately by overtime, agency/contract labor, incentive shifts, critical staffing premiums, and internal resource pool expense.

AHA reported that hospital labor costs reached approximately $839 billion in 2023, nearly 60% of average hospital expenses, with about $51.1 billion spent on contracted staff that year.7 Earlier AHA analysis found contract labor expense increased 258% between 2019 and 2022, while contract labor FTEs rose 139%.8

Why executives should care: Premium labor is often a downstream symptom of vacancy, turnover, poor scheduling, inadequate pipelines, low internal flexibility, and delayed workforce planning — it should not be interpreted as a finance issue alone.

Executive alert — show: premium labor exceeding target; units with rising overtime and vacancies; agency use continuing after positions are filled; premium labor concentrated in particular shifts or specialties.

6. Agency Spend

What it measures: Total external staffing expense and the degree to which core operations depend on contingent labor — spend per occupied bed, spend by service line, average agency rate versus employed rate, agency conversion to employed status, and assignments longer than 90 or 180 days.

Premium labor shows total excess cost; agency spend shows structural dependence on external staffing. A unit can reduce overtime while remaining heavily dependent on agency labor — executives need both views. AHA reports that hospitals continue to use costly contract labor to maintain access and fill gaps, representing tens of billions of dollars in annual expense.7

Executive alert — flag: agency use increasing despite improved hiring; long-duration assignments; high-spend units without a reduction plan; agency workers filling predictable, recurring demand with no internal resource-pool strategy.

7. Pipeline Health

What it measures: Whether the organization has enough qualified, engaged talent to meet near- and medium-term demand — qualified candidates per critical vacancy, interview-ready candidates, offer-acceptance rate, candidate withdrawal rate, and provider searches with viable finalists.

AAPPR’s 2025 benchmark included nearly 150 organizations and more than 12,000 active searches. Physician searches averaged nearly four months to signing, with some specialty searches extending to a year or longer, and an average offer-acceptance rate of approximately 83%.9

Why executives should care: Open requisitions are a lagging indicator. Pipeline health reveals whether future vacancies are likely to be filled before they become operational problems.

Executive alert — flag: critical roles without qualified prospects; pipeline volume rising while conversion falls; excessive stage delays; low offer acceptance; provider searches with no finalist after defined milestones.

8. Leadership Bench Strength

What it measures: Whether the organization has ready-now and ready-later internal candidates for critical leadership positions — successors identified, ready-now coverage, high-potential retention, interim leader duration, and promotion success after 12 months.

Formula — Leadership Coverage Ratio = critical leadership positions with at least one viable successor ÷ total critical leadership positions × 100.

LinkedIn found that organizations with strong learning cultures had 7% healthier management pipelines and significantly stronger retention and mobility outcomes.6 Gallup reports that organizations making strategic investments in employee development achieve 11% greater profitability and are twice as likely to retain employees.10

Why executives should care: Leadership vacancies can destabilize clinical teams, operational performance, culture, retention, and strategic initiatives. A strong bench reduces reliance on prolonged interim appointments and expensive external searches.

Executive alert — flag: critical roles with no successor; high-potential turnover; successor slates unchanged in years; departments with repeated external leadership hires.

9. Workforce Stability

What it measures: The overall reliability and resilience of the workforce — not one isolated element of it. This can become a proprietary On The Mark Workforce Stability Index, weighting first-year retention (20%), overall turnover (15%), critical-role vacancy (15%), agency dependency (15%), premium labor (10%), internal mobility (10%), engagement or intent to stay (10%), and leadership stability (5%).

Why executives should care: No single metric adequately captures workforce health. Vacancy may fall while turnover rises; hiring may increase while agency dependence remains unchanged; retention may improve while leadership vacancies grow. A composite score makes those tradeoffs visible.

Press Ganey’s research connects workforce engagement with retention, safety and patient experience — hospitals in the top quartile for engagement were 4.2 times more likely to achieve top-quartile patient-experience performance.3

Executive alert — display: current index score, prior month, prior year, forecast, top three positive drivers, and top three risks.

10. Business Impact

What it measures: The relationship between workforce performance and the organization’s clinical, operational and financial outcomes — patient access, closed or constrained beds, appointment lag, length of stay, safety events, readmissions, labor cost per adjusted discharge, and contribution margin.

AHRQ notes that inadequate nurse staffing can contribute to missed care, patient dissatisfaction, longer stays, readmissions and mortality risk.11 Research summarized by the National Institute of Nursing Research found that each additional patient assigned per nurse was associated with higher mortality, longer length of stay and increased readmission likelihood.12

Why executives should care: This is the metric category that transforms workforce reporting into workforce intelligence — allowing leaders to examine whether lower vacancy improves appointment availability, whether lower agency use improves margin, and whether leadership instability precedes employee turnover. Correlation does not automatically prove causation, but it identifies where executives should investigate and intervene.

Recommended Executive Dashboard Layout

Bottom panel — Risk and action: three emerging risks, three positive trends, three required executive actions, the accountable leader, and a target completion date.

The dashboard should answer three questions within 60 seconds: Where are we stable? Where are we vulnerable? What decision is required?

Evidence at a Glance

• Hospitals spent nearly $1 trillion on workforce costs in 2025.7
• Healthcare is projected to produce approximately 1.9 million openings annually through 2034.4
• National hospital turnover was reported at 18.5%, with RN turnover at 17.6%.2
• Hospitals spent approximately $51.1 billion on contracted staff in 2023.7
• Employees making internal moves are 40% more likely to remain for at least three years.6
• Highly engaged hospitals are 4.2 times more likely to achieve top-quartile patient-experience performance.3

Executive Reflection

At your next executive workforce review, consider asking:

• Which metric on our current dashboard is primarily an activity measure?
• Can we connect workforce performance to patient access, quality or margin?
• Which critical roles represent the greatest operational risk?
• Are we solving vacancies — or repeatedly refilling the same positions?
• Where are we relying on premium labor instead of building permanent capability?
• Do we know whether recent hires are becoming successful employees?
• Which leadership roles have no credible internal successor?
• What workforce issue requires an executive decision this month?