Inclusive, local hiring: Building the pipeline to a healthy community

Every day, we learn more about how patients’ health outcomes are tied not only to the healthcare they receive but also to the conditions in the communities where they live. Social and economic inequities, amplified by race, often emerge as the leading factors explaining differences in health outcomes and life expectancies.

Through local and inclusive hiring, health systems can invest in an ecosystem of success that lifts up local residents; helps create career pathways for low-income, minority, and hard-to-employ populations; and begins to transform neighborhoods. In the process, health systems can develop a more efficient workforce pipeline, meet sustainability and inclusion goals, and ultimately improve the health of their communities. Establishing a local and inclusive hiring strategy is an important first step towards rethinking your health system’s role in the community. This toolkit can help you get started.

Making the case for inclusive, local hiring

Case Studies

Learning from leaders in the field

University Hospitals

In Cleveland, Ohio, University Hospitals is working in partnership with community- based organizations to connect diverse residents from high-poverty neighborhoods to available frontline positions, and then intentionally to internal career development...

West Philadelphia Skills Initiative

In Philadelphia, Pennsylvania, the West Philadelphia Skills Initiative is building the local workforce capacity to meet anchor institutions’ (including health systems’) hiring needs, and connecting diverse residents from high- poverty neighborhoods to ...

Emergency Medical Services Corps

In Alameda County, California, EMS Corps is increasing the number of underrepresented emergency medical technicians by connecting young men of color to mentorship and job training opportunities.

Partners HealthCare

In Boston, Massachusetts, Partners HealthCare is offering paid internship programs with pathways to hire and providing coaching and tuition assistance for internal advancement for frontline employees.

University of Colorado Anschutz Medical Campus

In Aurora, Colorado, University of Colorado Anschutz Medical Campus is prioritizing community engagement and partnering with local workforce intermediaries to provide training to diverse, local residents for high-need, high-turnover jobs.

Johns Hopkins University & Health System

In Baltimore, Maryland, Johns Hopkins University & Health System is connecting forecasting, training, and hiring departments to create a workforce strategy that prioritizes hiring diverse, local residents, and then providing intentional internal career...

Key Strategies


Expanding employment opportunities for local residents by tackling barriers to employment

Health systems that equip local residents for high-demand jobs through training and skills development, and connect these candidates to pipelines that provide entry points to the institution, improve the efficiency of their own recruiting and hiring processes and expand employment opportunities for residents. Learn more about outside-in strategies



Local hiring initiatives do not end at the moment of hire. The success of programs lies in connecting frontline workers to pathways for career advancement within the institution—ensuring a sustainable, effective program and a pipeline to opportunity for local communities.  Learn more about inside-up strategies


Diving In

Small projects with big impact

Simple Policy Fixes

  • Adjust tuition reimbursement programs to allow for tuition advancement
  • Change policies that prevent hiring individuals with criminal records
  • Make diverse, inclusive, local hiring an explicit goal in the strategic p...

Quick Practice Upgrades

  • Communicate with workforce partners and intermediaries about forecasted job needs
  • Tweak job descriptions to eliminate unnecessary requirements
  • Evaluate recruiters, hiring managers, and department heads on local hiring...

Readiness Checklist

Do a basic assessment of where your institution is at, and identify the steps you need to take to implement a local and inclusive hiring program.

The Big Questions

Getting clarity on Your Goals and Priorities

What does “local” mean to your institution?

What does “community” mean to your institution?

Which institutional priorities would be met if your hiring was more inclusive and local?

Learn how to ask — and answer — the big questions

Laying the Foundations

Setting the stage for transformative impact

Measure your workforce baseline

Key ways to assess your current workforce and existing commitments

Survey your workforce policies and practices

Which policies and processes are working? Which are barriers to success?

Map your community's assets

You know your community needs jobs—but do you know the strengths it can offer?

Identify your partners

A workforce pipeline doesn't have to be built alone—who will be on your team?

Design around data and metrics

What are you going to measure to assess success, and how are you going to measure it?

Plan for sustainability

How do you institutionalize programs and get the whole team on board?

The Return on Investment

How inclusive hiring benefits your institution, and how to measure impact


Key benefits to your bottomline

  • Reduce job turnover rates
  • Make the recruitment process more efficient
  • Reduce time spent filling positions
  • Save internal training and orientation costs

Additional Benefits

A more expansive notion of ROI

  • Address issues of health equity and identified community health needs
  • Create a more diverse workforce
  • Improve employee morale
  • Improve the institution’s reputation in the community
  • Reduce carbon footprint with more employees living closer to work
  • Increase the number of residents with access to health insurance

Overcoming Barriers

Promising solutions to common challenges
  • High volume of applications…
  • Blanket policies prevent the hire of formerly incarcerated applicants…
  • Staff are unable to take advantage of training opportunities…
  • Employee demographics do not match the demographics of the surrounding community…
  • Staff are unable to take advantage of tuition reimbursement because of the upfront costs…
  • Healthcare system or hospital is too small to warrant a local hiring pipeline effort…

More resources

Additional templates and tools plus further reading and research

More about this toolkit

The partners, sources, team members, advisors, and practitioners behind this project.

Can Hospitals Heal America's Communities?

Tyler Norris, Vice President of Total Health Partnerships, Kaiser Permanente and Ted Howard, President and co-founder, The Democracy Collaborative, make the case for a new anchor mission for healthcare institutions.

Hospitals Building Healthier Communities

In this research report, David Zuckerman of The Democracy Collaborative offers an in-depth exploration of the leading edge of hospitals innovating to build community wealth.

The Anchor Dashboard

The Democracy Collaborative's set of indicators designed to help institutions reflect and assess broadly the long-term impact of their anchor-mission activities—particularly their impact on low-income communities.

EMS Corps: Additional tools and templates

Key documents illustrating the strategies used by EMS Corps to build an inclusive workforce.

Project REACH: Additional tools and templates

Key documents illustrating the strategies used by Johns Hopkins Health System's Project R.E.A.C.H to build an inclusive workforce.

West Philadelphia Skills Initiative: Additional tools and templates

Key documents illustrating the strategies used by West Philadelphia Skills Initiative (University City District) to build an inclusive workforce.

University Hospitals: Additional material

A presentation from University Hospitals of their strategies to build an inclusive workforce.


A network of healthcare leaders formed to champion the business case for investing in frontline workers.

Aspen Workforce Strategies Initiative

Improving access to quality training and employment for low-income adults.

Employer-Assisted Housing Resources

Resources to help design employer-assisted housing programs that can help facilitate building a more inclusive, local workforce.

Atlanta CareerRise: Additional Material

An overview of the Atlanta Beltline Workforce Partnership in Healthcare.