October 2025
When you meet someone who has been in the nursing trenches and helped lead a $2.5 billion turnaround of a major health system, you listen closely.
That’s why I was thrilled to sit down for a fireside chat with Paula Phillips, SVP of Operations Infrastructure at Ascension, during Hallmark’s recent Strategic Partner Summit.
Phillips joined Ascension—one of the nation’s leading non-profit and Catholic health systems—about three and a half years ago. At the time, the organization was losing billions annually. Labor represented 60% of operating costs, yet staffing was still managed through spreadsheets with little standardization across hospitals.
She knew that getting staffing right was essential to Ascension’s success. But financial recovery wasn’t the only goal. Ascension provides more than $1.7 billion in care of those living in poverty and other community benefit programs along with $1.8 billion of unreimbursed care for Medicare patients. Any turnaround plan had to support their mission of delivering care for all.
Some decisions, therefore, were non-negotiable. Supporting nurses, for example, was critical. As Phillips put it: “We will find another way to offset costs to ensure our patients have the nurses they need—that requires looking at everything.”
To truly “see everything,” Phillips needed better technology. That’s how Hallmark became part of her journey—by equipping Ascension with the workforce intelligence tools needed to connect staffing with strategy.
Here are three of my top takeaways from our conversation:
Insight #1: Matching resources to demand requires discipline
In a large healthcare system, change is constant—making workforce allocation incredibly complex. Phillips’ strategy involves enabling a flexible workforce, with a combination of full-time employees, supplemented with flexible float pools and (capped) contract labor. This balance gives Ascension the ability to flex staffing up or down as demand shifts.
She emphasized that it’s not just about nurses—it’s about getting the right blend across every role: “Whether it’s our nurses, ancillary staff, clinical specialists, or locums, we have to start by aligning and matching our resources to demand.”
Insight #2: Technology is the foundation of smart staffing decisions
When Phillips arrived, there was no system-wide visibility into labor costs—just disconnected spreadsheets. One of her first steps was to implement Hallmark’s workforce intelligence platform.
With a unified view, she could break down labor into key categories: CSP utilization, premium pay and overtime, contract labor, and average hourly rates. She could also benchmark Ascension against peers in the market.
Armed with this data, Phillips built a three-year efficiency plan and tracked progress in real time.
Insight #3: The right staffing mix reduces turnover
Turnover is one of the most expensive and disruptive challenges facing health systems today. Phillips tackles it by ensuring staff have balanced workloads—keeping overtime at or below 3% while avoiding canceled shifts. Both extremes, she noted, can drive burnout and attrition.
Looking ahead, she plans to standardize and optimize how Ascension uses locums. The need is urgent: a recent study found that 44% of physicians who changed jobs in 2024 moved into locum roles, up from 28% in 2022. As more providers seek flexibility, health systems will need comprehensive staffing data to adapt.
By Bharat Sundaram, CEO of Hallmark