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2022 Clinical Industry Report: Key Takeaways

November 23, 2022
November 23, 2022

Coady began by introducing the three major sources of data from the 2022 Clinical Industry Report:

  • Over 25 million course and assessment completions on the HealthStream platform in FY 2021
  • Results from HealthStream’s Clinical Pulse Survey conducted in April 2022; the study consisted of approximately 1,000 RNs. The majority reported working in hospital settings with adult medical, surgical intensive care and the emergency department representing the top three units. Just over 50% or respondents reported less than five years’ nursing experience.
  • Literature review of trends in competency development


Overall Market Findings

Burnout is a significant issue faced by the majority of respondents with 55% of respondents reporting they’ve experienced burnout at least once per week. Less than 10% of respondents said that they rarely or never experienced burnout.

When nurses were asked about factors that contributed to their burnout, workload and staffing ratios (62%) and compensation (57%) were identified as highly influential in burnout. Coady shared that of those respondents who said that workload and staffing were influential factors in their burnout, nearly half reported patient-to-nurse ratios of five to one. Coady also pointed out that historically, the role of compensation in burnout has generally fallen at the mid-point – not a primary driver or detractor.  

Nearly 12 years ago, when the Institute of Medicine (IOM) released their Future of Nursing Report, they recommended that nurses practice at the top of their licenses to the full extent of their training and education. However, when asked about workload, more than half of the respondents reported spending at least 25% of their time on tasks that could be delegated. Coady highlighted this as the second key finding. Healthcare organizations can potentially improve retention by adding support, allowing nurses to relinquish those duties that can be delegated. 

While compensation appears to be a key driver of burnout, Coady pointed out that many RNs (48%) actually indicated that they received an increase in their pay over the trailing 12-month period.

When asked what steps a Chief Nursing Officer (CNO) might take to increase job satisfaction, nurses cited increased pay, providing additional support staff and decreasing nurse-to-patient ratios.


HealthStream Solution-Specific Findings

Nurses were asked about Basic Life Support (BLS) training preferences and just under 65% of respondents expressed a preference for online resuscitation training. “The pandemic has forced a great deal of change on healthcare, but it has also created some opportunities in healthcare training,” said Coady. She went on to say that “online BLS training allows for more flexibility and the ability to maintain safe, social distancing when appropriate.”

In addition to health and safety benefits for learners, online training combined with skills validation that includes real-time feedback on critical components of CPR, such as accurate chest compression rate and depth, full chest recoil between compressions, minimizing interruptions in chest compressions and avoiding excess ventilation are best reinforced through real-time feedback. Using adaptive learning techniques, learners are able to adjust their technique in real time.

By diving into HealthStream’s data, Coady was also able to discover that those who use an adaptive learning approach are saving a substantial amount of money while improving performance. Coady pointed out that customers using the adaptive learning course by the American Red Cross saved $5 million dollars in 2021 because they were able to reduce seat time by eliminating content that nurses could test out of.

Coady also shared that utilization of jane® by HealthStream increased by a staggering 345% from 2020 to 2021. Jane is a HealthStream solution that assesses knowledge and then uses artificial intelligence (AI) to provide targeted training recommendations tailored specifically to the needs of each individual student. “The intent here is to optimize time spent learning and minimize risks by focusing on individual gaps,” said Coady. In the survey more than 70% of nurses agreed that AI should be part of nursing education.


Nurse Confidence Survey

Lastly, Coady shared new findings from HealthStream’s nurse confidence survey. The 2021 data showed a 26% increase in confidence over the course of their nurse residency program. “The finding was welcome news as nurses reported increases in confidence and knowledge as well as decreases in stress and anxiety as they progressed through their structured residency programs,” said Coady. She also recognized the state of Hawaii who reported an annual savings of 40% and a lifelong program retention rate of 93% after adopting HealthStream’s Nurse Residency Program. Coady cited the program as a real building block in the effort to build the healthcare workforce of the future.



In closing, Coady referred to a 2021 book by Bradley[1] as an excellent source for creating the strategic planning framework to begin to address these findings. There were eight recommendations.

  1. Make structural changes to drive integration with the goal of establishing consistency across the organization.
  2. Use compensation and benefits as leverage to encourage special certifications and preceptors.
  3. Improve staffing effectiveness by thinking creatively about the appropriate mix of staff for each shift.
  4. Improve nurse retention by incentivizing nurses to seek internal promotions and new clinical challenges.
  5. Advance the education of your nursing workforce by incentivizing education.
  6. Improve leadership effectiveness by focusing on developing leaders internally through education and coaching.
  7. Advance clinical excellence, specifically by offering certification prep content.
  8. Improve recruitment and retention of new graduate nurses by offering fair compensation and a structured nurse residency program.

[1] Bradley, C. (2021). Utilizing compensation strategy to build a loyal and engaged workforce. Nurse Leader, 19(6), 565–570. 

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