It is imperative to address the workforce recruitment and retention issues that have only accelerated during the pandemic. Unfortunately, the hurdles are impressive – hospital turnover increased overall in 2021 by 1.7% to 19.5%, with nursing turnover specifically increasing 2.8% to 18.7%.
Employee recruitment and retention is always a concern for healthcare, but current-day urgency has led to many stopgap measures that are expensive and not viable in the long term. Leaders must break the cycle and rethink how the workforce is recruited and retained before it is too late. Here are three issues that must be addressed to ensure a path to a competent, resilient staff.
Healthcare organizations have always faced the struggle of having to do more with less, all while maintaining the quality of care. In 2021, there was an average nursing vacancy rate of 10%, which has a tremendous impact on quality of care and outcomes. This is an unsustainable situation, one that most organizations have sought to remedy with “quick fixes,” such as filling the gaps with high-dollar traveling nurses and offering signing bonuses.
It is likely healthcare is looking at a new normal, one where they will need reliable strategies to combat ongoing high levels of turnover. Instead, the goal should be to move beyond reactive strategies and shift focus and energy to factors like new hire time-to-productivity.
Bridging the school-to-practice gap is a complex process, one that includes steps many organizations still perform manually, so the opportunity for optimization is great. But there are also opportunities to ensure that all employees, whether its new hires or those floating from other practice areas, receive rapid onboarding that addresses their individual need for training.
The goal should be to ensure that 100% of a nurse’s time learning is purposeful in order to improve the time to bedside, which will require a focus individualized learning paths, technology and peer networks, and standardization.
of nurses surveyed say they are experiencing a shortage of nurses.1
of nurses surveyed say they are concerned about burnout.2
More than 20% of nurses report they are leaving bedside care, or the profession entirely.3
Almost all nurses (91.5%) are worried about the current shortage of nurses.4
Individualized learning paths
Providing targeted and individualized training has always been a problem in healthcare. In most cases, nurses are provided the same training path, whether they are novice or expert. In an onboarding scenario, this prolongs the time to productivity and often leaves the clinician frustrated and dissatisfied in the process. Technology and automation can be utilized to create personalized learning paths that address the individual’s learning journey and lead to more confident and capable caregivers.
Technology and peer networks
A rapid onboarding process should immediately enable your staff with a variety of tools to succeed. It’s crucial for new nurses to be a part of a strong community that educates and empowers, one that provides access to knowledge and experience. It’s also crucial to utilize technology that will make it possible to scale appropriately without sacrificing quality or competency. This is particularly true if we want to direct staffing to areas of need. The need to foster a safe, encouraging community for new nurses has always been there, but this has become foundational to achieving larger goals in the post-pandemic world.
When turnover is high, standardization is vital to ensure safe care is provided and risk is avoided. According to Trisha Coady, Senior Vice President and General Manager of Workforce Development Solutions at HealthStream, “Without standards, there is no logical basis for decision making or taking action.” In this way, it becomes your staff’s “superpower,” according to Coady, for optimizing preparedness and safe care during a shortage. Implementation is easier when technology is utilized to digitize processes and get rid of burdensome paper trails.
The pandemic has created a level of change and uncertainty that is unprecedented in healthcare. High turnover – and the crisis management solutions that have been used to combat the issue – could lead to a risk tsunami that healthcare organizations will struggle to overcome for decades.
Fortunately, we know that success always follows informed decision making. Leaders who have data and insights necessary to make informed decisions will be able to navigate complex staffing problems while maintaining quality care and eliminating unnecessary risks.
The University of Louisville Hospital reduced the time spent managing assessment and development of nurses by 50% using HealthStream’s jane®.5
HealthStream customers using the Quality Obstetrics (OB) Program had 22% less “OB risk claims identifiers” versus all hospitals in the U.S. 6
Surveys indicated 65% of new graduate nurses with less than one year of experience would be interested in a digital mentor, like jane®.7
Swedish Covenant Health reduced their spend by $1.4 million in agency spend by implementing a non-monetary incentive program
The need to improve outcomes is a constant. While the pandemic has added a new level of urgency, it’s worth noting that healthcare leaders have for many years elevated the problem of improving outcomes for high-risk, low volume events like maternal mortality or cardiac arrest. Providing educational opportunities is of course essential, but the solution is tied back to improving critical thinking skills. Nurses who cross-train to fill gaps in other areas will feel more confident and experience better outcomes if they know how to apply fundamental knowledge and problem-solving skills to inform their decision making.
Supporting new nurses during their transition from student to practice improves not only the nurses’ confidence and competence, but also the facility’s bottom line. Nurse satisfaction is directly tied to turnover rates, so anything that can be done to reinvent the transition-to-practice process to better support new nurses is impactful. If your transition support unavoidably lagged during the pandemic, now is the time to address the issue, because it can reduce risk long-term and increase your brand reputation as an employer of choice in a highly competitive market.
Flexibility and self-sufficiency are a key focus to ensure job satisfaction. A number of surveys have indicated that nurses want more flexibility in their scheduling, which comes as little surprise, but this goes beyond the benefits of work-life balance. Flexible scheduling and shift swaps also give employers enormous flexibility in filling open shifts to a much broader pool of employees.
Additionally, if you have sufficient capacity to cover each shift, high patient-nurse ratios are far less likely. These ratios can significantly increase risk – one study in the Annals of Intensive Care found there was a 95% probability that survival to hospital discharge was more likely to occur when the maximum workload-to-nurse ratio was less than 40.
As the healthcare workforce expands and diversifies, the future of clinical development will require solutions targeted to individual employee needs and expanded levels of support. From graduation to retirement, clinicians require continuous yet unique training opportunities, yet it can be difficult to provide a proper level of support with limited resources. Of course, this is difficult in most healthcare environments in the U.S., where resources are stretched and the average manager has 40 or more direct reports.
One of the key areas to focus on will be empowering staff with tools and resources that allow them to provide the best care possible, set their own learning path, and stay compliant. In fact, most clinicians desire autonomy – in a survey of over 25.6 million courses completed on the HealthStream platform, almost half were self-enrolled, and 65% of new graduate nurses indicated they would be interested in using a digital mentor system that facilitates learning recommendations.
of nurses surveyed feel the pandemic has made managers more attuned to the needs of nurses.9
of nurses surveyed feel supported by their direct manager.10
Two-thirds of leaders (66.3%) say they rely on recommendations from managers to identify employees with possible leadership skills.11
More than half of nurses indicate their employer has taken action to improve their well-being (54.7%). 12
Innovative learning approaches
The workforce is changing – it is becoming more diverse and more generations are active in the healthcare space than ever before. When it comes to innovative learning, employers who consider the needs of the multi-generational workforce will fare better than those who don’t. Building a culture of safety and self-efficacy in this complex environment will require giving employees more autonomy to build their individualized learning paths, more engagement touch points, and more technology to accommodate these needs.
Recognition and career development
Healthcare is unique from other industries. Most clinicians will have the same role or job title for life – if they graduate as a respiratory therapist, they will retire as a respiratory therapist. It’s a situation that requires more creative engagement strategies, recognizing excellence and promoting career advancement. A clinician who is recognized for their achievements and motivated to develop their career is poised for success. This is where automation and novel programs can be deployed to ensure as many of your high-achieving staff as possible are recognized for their accomplishments and given opportunities for career development that will keep them satisfied and retained.
Education and cross-training/upskilling
Although the healthcare workforce has a unique set of needs, that doesn’t mean organizational leaders can’t leverage the growing trend of cross-training and upskilling as successfully as in other industries. The pandemic has created a situation where many clinicians are being asked, perhaps for the first time in their careers, to move into new roles. This is a great example of necessity creating opportunity. If these stop-gap measures are expanded in a way that affords the workforce opportunities for growth and achievement they’ve never experienced previously, leaders could build back a workforce that is even more agile and competent than ever before.
The healthcare industry has been forever changed in the last two years. The pandemic has accelerated and intensified issues among the clinical workforce, particularly nursing, forcing many organizations to rethink how they develop and retain staff. The current workforce shortage will be unlike past shortages in many ways, with an ever-widening experience gap, requiring new approaches to learning, scheduling, and upskilling, among others. It has been a difficult time, but organizations are also facing an opportunity to enact change that will set their future workforce on the path towards success for years to come. It may not be easy, but with the right tools and support, we are confident many organizations will meet these challenges head on and become leading forces for change.
Let’s continue the discussion. We would love to hear more about how you plan to navigate the changing landscape and take advantage of opportunities to build back your workforce. HealthStream can help you prepare for the challenges that lie ahead. If you would like to speak to one of our healthcare experts, please fill out the form and we will be in touch.
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