The eight-dimension workforce assessment methodology for health and human services organizations. Published openly, because a diagnostic is only credible if it can be inspected.
The Workforce Workup™ is TWF's diagnostic methodology for health and human services organizations: a structured assessment that scores an organization across eight workforce dimensions, identifies which gaps are producing the most cost and risk, and maps each gap to a defined intervention. The name is deliberate. In clinical practice, a workup is the systematic examination that precedes any treatment decision. We hold workforce strategy to the same standard: no prescriptions before the diagnostic.
We publish the methodology openly because a diagnostic framework is only credible if it can be inspected. The dimensions, what each one measures, and what failure looks like are documented below. What TWF sells is not the secret of the framework. It is the fieldwork, the evidence review, the sector benchmark data, and the build that follows.
What it measures: Whether the organization can prove compliance on paper today: handbook currency, policy consistency, posting and notice obligations, state addenda, audit trail.
What failure looks like: An audit or charge arrives and the file tells a different story than the practice. Defensible decisions lost for lack of documentation.
What it measures: The health of the clinical record as a workforce output: timeliness, treatment plan linkage, medical necessity language, signature and credential integrity.
What failure looks like: Recoupments, failed surveys, and clinicians spending weekends on documentation catch-up that never ends.
What it measures: Time to fill, quality of screen, credential verification at intake, and whether onboarding produces a functioning employee or a 90-day departure.
What failure looks like: Vacancies that stay open for months, then fill with a mis-hire who leaves inside a quarter, doubling the cost.
What it measures: Position against the local market using published wage data, internal equity, and whether the pay structure can be defended out loud.
What failure looks like: Quiet resentment, counteroffer losses, and departures that exit interviews attribute to pay because nobody benchmarked it.
What it measures: Whether the organization has a bench: candidate flow, employer brand, relationships with schools and licensure pipelines, internal advancement paths.
What failure looks like: Every vacancy is an emergency because every search starts from zero.
What it measures: The systems layer: HRIS, files, workflows, tracking, reporting. Whether HR runs on architecture or on one person's memory.
What failure looks like: Institutional knowledge walks out the door with a single resignation, and nobody can produce a report an auditor asks for.
What it measures: Whether supervisors, most promoted from clinical roles, have been trained to manage: feedback, documentation, difficult conversations, consistent practice.
What failure looks like: Your best clinician becomes your weakest manager, and their team's turnover becomes your largest hidden cost.
What it measures: Turnover by role and tenure band, stay signals, engagement patterns, and whether departures surprise leadership or confirm what the data already said.
What failure looks like: The organization funds a phantom department of perpetual replacement while service quality erodes visit by visit.
1. Evidence intake. Documents over interviews: handbook, sample personnel files, turnover data by role and tenure, org chart, a chart documentation sample. What is provable, not what is believed.
2. Dimension scoring. Each of the eight dimensions scored against sector benchmarks, including TWF Market Intelligence wage and talent pool data for the organization's own metro.
3. Cost attachment. The two or three weakest dimensions get a number attached, using the same math as the turnover cost calculator. A gap without a dollar figure does not compete for a budget line.
4. Program mapping. Each priority gap maps to a defined intervention: D1 and D2 to Compliance Confidence™, D3 and D5 to Talent Magnet™, D4 and D8 to Retention Reset™, D6 to Foundation First™, D7 to Leadership Launchpad™.
5. Sequencing. One build at a time, in dependency order, with defined deliverables and re-scoring at each completion. The Workup is repeated annually; the score trend is the accountability.
Run the free version
The HR Diagnostic is the self-serve edition: 15 minutes, scores your top three risk dimensions. The full Workup is evidence-based fieldwork. Start with either.
Start the free diagnostic