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Hospitals Face Healthcare Employment Challenges, High Turnover

With turnover rates among healthcare employers rising, hospitals have experienced healthcare employment challenges, such as difficulties retaining staff.

By Jacqueline Belliveau

- Recent healthcare employment trends could spell trouble for hospital revenue cycles across the nation. As quality and volume pressures continue to create difficult operational circumstances, some hospitals are finding that increasing turnover rates are leaving them without a stable healthcare workforce to appropriately treat patients.

Hospitals affected by healthcare employment challenges, such as rising turnover rates

The average turnover rate among healthcare employers in 2015 was 19.2 percent, a 1.5 percent increase from2014, reported a 2015 survey conducted by Compdata Surveys.

“Employers are reporting rising voluntary turnover rates, indicating the workforce has increasing confidence in the job market,” said Amy Kaminski, Vice President for Compdata Surveys.

“Your key employees have options when it comes to where they want to work. Understanding turnover trends allows you to put programs into place for retaining your quality employees, as well develop a solid plan for recruiting new ones.”

In Missouri, the effects of increased healthcare turnover rates are particularly pronounced, according to the Missouri Hospital Association.

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The average turnover rate among healthcare professionals in Missouri was 18.1 percent in 2015, representing a 1.8 percent increase from 2014, stated the association’s annual workforce report.

“Missouri hospitals need the right number of people with the right skills in the right place at the right time to deliver high quality care,” stated the report.

“Workforce instability associated with high attrition can negatively impact quality of care, patient safety and patient satisfaction. Recruitment and retention need continuous investment, not just by hospitals, but also by all stakeholders in Missouri to reduce turnover and improve vacancy rates.”

Out of the 36 hospitals surveyed by the Missouri Hospital Association, 11 reported that their employee turnover rate was 15 percent or higher.

The positions with the highest turnover rates included housekeeper (29.6 percent), registered behavioral health nurse (29.2 percent), unlicensed assistive personnel (25.9 percent), licensed practice nurse (21.8 percent), certified occupational therapy assistant (20.8 percent), and registered staff nurse (17.9 percent).

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While healthcare employment challenges span a variety of medical specialties, the Missouri Hospital Association reported that the turnover rate for staff nurses has reached a historical high since the association started collecting hospital workforce data in 2004.

High turnover and vacancy rates for staff nurses in Missouri may be caused by the state’s restrictive regulations regarding nurse practitioner responsibilities, explained the report. Nurse practitioners in Missouri do not have “full practice” approval status, which allows them to assess, diagnose, interpret diagnostic tests, and prescribe medications. Neighboring states, such as Iowa or Nebraska, have already granted nurse practitioners full practice status.

However, a 2016 report from NSI Nursing Solutions found that turnover rates for registered nurses has increased across the nation. The turnover rate for registered nurses was 17.2 percent in 2015, with nurses working in behavioral health, emergency departments, and surgical specialties experiencing the highest rates.

Researchers at NSI Nursing Solutions also revealed that increasing turnover rates have negatively impacted hospital revenue cycles. The average cost of a turnover for a bedside registered nurse can cost a hospital $37,700 to $58,400, which can lead to average losses of $5.2 million to $8.1 million annually.

The Missouri Hospital Association attributed state and national healthcare employment challenges to the changing healthcare landscape, such as increased demand for medical services.

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According to the report, some factors that are impacting the healthcare workforce are as follows:

• Less healthy hospital patients

• More access to healthcare

• New positions established by the Affordable Care Act

• An aging patient population

• Retirement of baby boomers from the healthcare field

• Millennials joining the workforce

• Web-based access to job opportunities

• Medicaid expansion projects

With the demand for healthcare services growing, the industry has quickly added more job opportunities. Nationally, about one in four jobs created so far in 2016 were in the healthcare sector, stated the Missouri Hospital Association.

“However, this has significantly shifted power in the labor market from primarily employer-driven to employee-driven, which can lead to increased vacancy and turnover,” reported the association.

As the industry transitions to a more employee-driven environment, potential and current healthcare workers are presented with more options when it comes to where they want to work and on what terms.

Furthermore, the healthcare employment challenges in Missouri as well as across the nation may not be fixed any time in the near future unless hospitals update their recruiting strategies.

The gap forming between supply and demand for healthcare workers could create more intense healthcare employment challenges for hospitals, reported a 2015 Health eCareers survey. As baby boomer healthcare professionals retire and more individuals gain access to healthcare coverage, there may be more substantial physician shortages.

In response to losing more employees in the highly competitive market, the survey found that turnover was the largest hiring and recruiting concern in 2015. Employers became more focused on retaining their healthcare workforce.

But when turnover did occur, the survey stated that more healthcare employers turned to online strategies for hiring in 2015. More employers used online job boards and social media to post open positions and connect with potential hires.

“As demand for healthcare services mushroom, successful recruiting will depend on how employers mind the gap between employment opportunities and a shrinking pool of available talent,” Health eCareers reported. “The recruiting leaders in healthcare surveyed here believe that digital marketing, social and professional networks, and employer brand are essential and long-lasting trends in recruiting.”

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