You feel the impact of early turnover every time a nurse leaves before day ninety. Staffing plans break, clinical leaders scramble, and patient experience suffers. When you rely only on traditional tools, healthcare recruiting software helps you push requisitions live and move applicants, yet it does not always tell you who will stay.
A predictive hiring approach changes that equation. When you combine healthcare recruiting software with data from performance, tenure, and candidate behaviour, you move from filling shifts to building teams that hold. According to Bucketlist Rewards, hospital registered nurse turnover reached 18.4 percent in 2023, which keeps workforce risk front and centre for clinical leaders. A report highlighted by Becker’s Hospital Review notes that hospitals spend around 56,300 dollars for each registered nurse replacement, which means even modest reductions in 90-day attrition protect millions.
This case study shows how a multi-hospital healthcare system used Cadient SmartSuite™ as healthcare recruiting software with predictive hiring to reduce 90-day attrition for frontline nurses and clinical support roles.
Why 90-Day Attrition Hits Healthcare Hard
Short tenure leaves a mark across care quality, finances, and team morale. You feel strain at the bedside first, then see it in reports.
Early Turnover Multiplies Cost And Disruption
When nurses and clinical staff leave within ninety days, you pay twice. You pay for acquisition, onboarding, and orientation. Then you pay again for agency cover, overtime, and another recruitment round.
According to NurseRegistry, healthcare facilities spend between 40,000 and 64,000 dollars to replace a single nurse, which consumes up to 5.8 percent of operating budgets and represents roughly 6.5 billion dollars in annual costs nationwide. Bucketlist Rewards notes that the total cost of nurse turnover in many hospital settings reaches more than 50,000 dollars per nurse, once you include overtime and burnout-driven exits among remaining staff.
When a large health system loses hundreds of nurses each year before day ninety, those unit-level disruptions roll up into board-level financial risk.
Patient Outcomes Depend On Stable Teams
Early turnover does not only hit budgets. It also affects outcomes. Frequent changes in staff reduce continuity, increase reliance on temporary workers, and raise the load on the nurses who stay.
A release from The BMJ explains that higher monthly turnover among nurses and senior doctors links with higher mortality for emergency patients admitted to NHS hospitals. When you reduce attrition in the first ninety days, you protect continuity on wards, support safer staffing, and give patients more consistent care teams.
Against this background, early attrition becomes not only an HR metric but also a quality and safety metric.
Why Traditional Healthcare Recruiting Software Falls Short On Retention
You likely already use healthcare recruiting software to post jobs, collect applications, and track candidates. That step matters, yet it does not guarantee retention.
Most legacy systems:
- Focus on requisition status and compliance, not predicted tenure
- Treat every applicant as equal once they pass minimum checks
- Offer limited visibility into who tends to stay and who tends to leave early
In practice, hiring managers often select nurses based on speed to start, interview impressions, and traditional credentials. Those signals matter, yet they offer little insight into whether the nurse will stay past day ninety.
You need healthcare recruiting software that treats retention as a design requirement, not a reporting afterthought. This is where predictive hiring enters the picture.
Predictive Hiring In Healthcare: What It Means In Practice
Predictive hiring uses data from previous hires to estimate the likelihood that a new hire will meet specific outcomes, such as staying past ninety days. In healthcare, those predictions must stay grounded in clinical reality and ethics.
According to a recent article from CWS Healthcare, systems such as Mount Sinai Health System used predictive analytics to forecast nurse attrition and achieved a 17 percent reduction in voluntary turnover after targeted interventions. A paper in the International Journal of Research and Review explains that AI-driven predictive analytics helps HR teams identify turnover patterns and flag employees at higher risk of leaving before they resign, which supports proactive retention strategies.
For your organisation, predictive hiring means you:
- Use historic data on tenure and performance for nurses and clinical staff
- Identify patterns that link early attrition with pre-hire signals
- Score new applicants on their predicted likelihood to stay
- Integrate those scores into healthcare recruiting software workflows
Cadient SmartSuite™ brings this idea to life through SmartTenure™, SmartScore™, and connected modules such as SmartSource™, SmartMatch™, SmartScreen™, SmartInterview™, SmartReferenceCheck™, SmartTexting™, SmartHire™, SmartOffer™, SmartOnboard™, and SmartFeedback™.
Case Study: Regional Health System Under Pressure
A large not-for-profit health system, which we will call HorizonCare Health, operates multiple hospitals and clinics across two states. The organisation employs more than 8,000 staff, including several thousand nurses, nursing assistants, and clinical support roles.
HorizonCare Health: Baseline Challenges
Before adopting predictive hiring with SmartSuite™, HorizonCare Health faced:
- 90-day attrition near 23 percent for medical-surgical nurses
- Higher than expected turnover for patient care technicians in high acuity units
- Heavy reliance on contract labour for nights and weekends
- Long time-to-fill for critical roles, which created extended vacancies
Recruiters used a basic healthcare recruiting software platform to track requisitions and process applications. Managers relied on experience and intuition. Interview questions varied widely, and little data flowed back once employees left.
Finance leaders flagged nurse turnover as a strategic risk. Quality leaders raised concerns about constant team changes on priority units. HR leaders received a clear directive: reduce early attrition without slowing hiring.
Strategic Choice: Move To Predictive Hiring With SmartSuite™
HorizonCare Health selected Cadient SmartSuite™ as a new healthcare recruiting software foundation. The leadership team focused on three modules as the core of a predictive hiring approach for clinical staffing:
- SmartTenure™ to estimate likelihood of retention for each candidate
- SmartScore™ to bring match, screening, reference, and tenure signals into one score
- SmartHire™ to manage the hiring workflow and connect decisions to outcomes
SmartSuite™ also offered SmartSource™, SmartMatch™, SmartScreen™, SmartInterview™, SmartReferenceCheck™, SmartTexting™, SmartOffer™, SmartOnboard™, and SmartFeedback™, which supported a complete hiring and feedback cycle for nurse recruitment and broader healthcare hiring.
Phase 1: Build A Retention-Focused Data Foundation
The first phase focused on learning before changing selection decisions. HorizonCare Health used SmartSuite™ to gather and connect data from previous years of hiring.
Collect And Link Historic Hiring And Retention Data
The project team brought together:
- Applicant records from previous healthcare recruiting software
- SmartHire™ data as new roles opened under SmartSuite™
- HRIS records for start dates and termination dates
- Feedback from exit interviews and SmartFeedback™ surveys
Data science specialists from Cadient and HorizonCare Health worked as one team to link pre-hire signals with outcomes. The group focused on:
- Job category, unit, and shift pattern
- Experience level, credentials, and previous settings
- Assessment results and interview scores
- Time-to-fill and offer timing
SmartTenure™ models then learned from this combined data to predict likelihood of staying past ninety days and past one year for new hires.
Align Stakeholders On Ethics And Guardrails
Before using predictions in live nurse recruitment, HorizonCare Health engaged clinical leaders, legal, and DEI leaders. Together, they agreed that:
- Predictions support human decisions, not replace them
- Models exclude protected characteristics
- Teams monitor outcomes by demographic group to avoid unfair impact
- Hiring managers retain final decision responsibility
SmartSuite™ provided transparent views of which factors supported each SmartTenure™ prediction, so leaders could challenge and refine inputs where needed.
Phase 2: Use Predictive Hiring In Nurse Recruitment Decisions
Once leaders felt confident in the data foundation, HorizonCare Health started a live pilot for medical-surgical nurse recruitment across three hospitals.
Introduce SmartTenure™ And SmartScore™ Into Shortlisting
Recruiters and hiring managers received training on new healthcare recruiting software workflows. For each applicant, SmartSuite™ displayed:
- A SmartScore™ that reflected role match, screening responses, references, and other signals
- A SmartTenure™ indicator that estimated likelihood of staying past ninety days and one year
Recruiters then:
- Used SmartSource™ and SmartMatch™ to pull in nurse candidates from multiple channels
- Applied SmartScreen™ to run a structured pre-screen tailored to each unit
- Invited priority candidates to select interview slots through SmartInterview™
- Collected consistent feedback with SmartReferenceCheck™ where required
- Reviewed SmartScore™ and SmartTenure™ before preparing a shortlist
Shortlists included a mix of high-scoring candidates with strong predicted tenure and some with moderate scores but specific experience. Recruiters shared clear narratives with nurse managers so each decision linked back to evidence, not guesswork.
Adjust Offer Strategy And Onboarding For At-Risk Segments
Predictive hiring insights did not only influence selection. They also shaped retention plans.
For example, SmartTenure™ highlighted clusters of candidates with strong match scores but slightly higher predicted attrition risk on night shifts. HorizonCare Health responded with:
- Enhanced pre-hire education on shift expectations
- Buddy assignments in SmartOnboard™ for the first sixty days
- Early SmartFeedback™ check-ins at day thirty and day sixty
Offers still went to a mix of low, medium, and high risk profiles, yet higher risk segments received targeted support from day one.
Phase 3: Expand Predictive Hiring Across Clinical Staffing
After six months, the pilot showed promising shifts in 90-day attrition and manager feedback. HorizonCare Health then extended predictive hiring to other clinical staffing segments.
Extend To Allied Health And Patient Care Technicians
The next wave covered respiratory therapists, imaging technologists, and patient care technicians. For each group, HR leaders:
- Updated success profiles and competency models
- Tuned SmartTenure™ models with role-specific features
- Integrated SmartInterview™ guides with structured, job-related questions
Healthcare recruiting software views in SmartSuite™ kept the experience consistent. Managers across departments saw the same style of dashboard, even when models differed behind the scenes.
Tie Predictive Hiring To Workforce Planning
Predictive hiring data then flowed into strategic workforce planning. Talent acquisition leaders worked with finance, nursing leadership, and operations to:
- Forecast likely vacancies by unit and role
- Prioritise nurse recruitment campaigns for units with higher predicted risk
- Evaluate the impact of incentives, preceptor programmes, and scheduling changes on retention
SmartSuite™ reporting made it easier to show how investments in retention, orientation, and professional development shifted SmartTenure™ predictions over time.
Quantitative Results: How Predictive Hiring Shifted 90-Day Attrition
HorizonCare Health tracked results over twelve months across pilot and expansion roles. Selected outcomes for medical-surgical nurses:
- 90-day attrition dropped from 23 percent to 13 percent across pilot hospitals
- First-year attrition dropped by 9 percentage points
- Offer acceptance increased, driven by better expectation setting and communication
- Use of agency nurses reduced on pilot units, which freed budget for preceptor time
For patient care technicians:
- 90-day attrition dropped by 8 percentage points
- Supervisors reported fewer last-minute callouts and greater schedule stability
Predictive hiring did not remove every early exit. Life events, relocations, and family responsibilities still played a role. Yet SmartTenure™ and SmartScore™ helped the organisation reduce avoidable attrition related to misalignment between candidate preferences, shift patterns, and unit culture.
Qualitative Results: How Predictive Hiring Changed Experience
Numbers told part of the story. Feedback from leaders, managers, and candidates revealed how predictive hiring underpinned a new experience.
Recruiters Gained Clarity And Influence
Recruiters reported that SmartSuite™ turned healthcare recruiting software into a strategic tool, not only a tracking system. They appreciated that:
- SmartScore™ organised signals from sourcing, screening, and references
- SmartTenure™ added a retention lens without slowing their work
- SmartTexting™ helped keep nurse recruitment communication fast and clear
Recruiters entered intake meetings with nurse leaders ready to discuss risk, not only volume. That shift raised their influence in workforce planning discussions.
Nurse Managers Trusted The Process More
Nurse managers often felt sceptical about new tools. Over time, their view shifted. Many described three benefits:
- Shortlists felt more aligned with unit demands.
- The structured information from SmartScreen™ and SmartInterview™ helped them compare candidates on behaviours, not only experience.
- Early retention gains showed up in internal dashboards quickly, which built confidence.
Managers started to ask for SmartTenure™ and SmartScore™ data proactively and engaged with HR to refine success profiles for specialised units.
New Hires Felt More Prepared
SmartOnboard™ and SmartFeedback™ showed that new nurses in the pilot group felt more prepared for their roles. Several factors contributed:
- Clearer communication of shift expectations
- Targeted preceptor assignments for higher risk profiles
- Early check-ins that addressed issues before they escalated
Those steps relied on predictive hiring insights, yet they felt human and supportive at the bedside.
How To Bring Predictive Hiring Into Your Own Healthcare Recruiting Software
You might feel that predictive hiring belongs only in large academic centres or national systems. In practice, regional health systems, community hospitals, and specialty networks all gain from a structured approach.
Step 1: Quantify The Problem
Start with a clear view of your own 90-day attrition. For each hospital and role family, ask:
- How many hires leave before day ninety
- How those exits cluster by shift, manager, or unit
- How costs compare with department budgets
Include finance partners early. Use external benchmarks such as the NurseRegistry estimate that nurse replacement costs reach 40,000 to 64,000 dollars per nurse as context while you align on your own internal figures.
Step 2: Map Data Sources And Gaps
Review which data sits where:
- Applicant data in your current healthcare recruiting software
- Hire and termination data in HRIS
- Schedule and unit data in workforce management tools
- Engagement and feedback from surveys
SmartSuite™ integrates across these systems. SmartHire™ becomes the hub that links data from SmartSource™, SmartMatch™, SmartScreen™, SmartInterview™, SmartReferenceCheck™, SmartTexting™, SmartOnboard™, and SmartFeedback™.
Step 3: Pilot SmartTenure™ In A Focused Area
Pick one or two role families and one part of your network. Work with Cadient to:
- Train SmartTenure™ models on historic data
- Define score thresholds and alert rules
- Integrate SmartScore™ into recruiter and manager workflows
Keep the pilot scope simple. Focus on learning, not perfection. Give yourself room to adjust success profiles, question sets, and communication templates as you see early results.
Step 4: Design Retention Actions For High-Risk Segments
Predictive hiring adds most value when you link insights to action. For example:
- Tailor orientation for night shift hires with higher predicted attrition
- Offer targeted mentoring for new graduates in high acuity units
- Adjust nurse recruitment messaging to set clearer expectations for specific roles
SmartFeedback™ helps you see which actions shift experience and tenure, then SmartTenure™ models learn from each new cohort.
Step 5: Embed Predictive Hiring Into Governance
Finally, treat predictive hiring as part of governance, not only as a technical feature. You:
- Review model performance regularly with HR analytics and legal
- Monitor outcomes by demographic group to guard against unintended bias
- Share key retention and prediction metrics with executive teams
SmartSuite™ gives you the dashboards. Your governance discipline gives predictive hiring long-term credibility.
Predictive Hiring Becomes A Retention Advantage
Early attrition in healthcare creates clinical risk, financial strain, and reputational exposure. Traditional healthcare recruiting software supports process, yet often stops short of predicting which nurses and clinical staff will stay.
When you bring predictive hiring into the centre of healthcare hiring, you change that story. SmartSuite™ from Cadient gives you SmartTenure™, SmartScore™, SmartSource™, SmartMatch™, SmartScreen™, SmartInterview™, SmartReferenceCheck™, SmartTexting™, SmartHire™, SmartOffer™, SmartOnboard™, and SmartFeedback™, all working together. You move from reacting to exits to designing nurse recruitment and clinical staffing around retention from day one.
If you want to see how predictive hiring would work with your own data, take the next step. Visit Cadient and explore SmartSuite™. Request a working session where your team reviews 90-day attrition, maps data sources, and builds a practical roadmap for using healthcare recruiting software with predictive hiring to reduce early nurse turnover and protect patient care across your network.
You give clinical leaders more stable teams, finance leaders a clearer retention story, and patients the consistent caregivers they deserve.
