The Problem
There is a shortage now, but it is going to get worse if changes are not made. Even before 2020, there was a shortage of bedside nurses, physicians, healthcare aids, and nurse educators, COVID simply highlighted the problem and sped up the issues.
Aging population workforce – 1/3 of the workforce will be retiring within the next 10-15 years. (Haddad 2023). In 2020, the average age of nurses is 52 years old (Rosetter, 2022)
The US Bureau of Labor Statistics projects that 275,000 additional nurses will be needed between 2020 and 2030. (Haddad, 2023)
High workload, low staffing, and long shifts are causing burnout, and more nurses are leaving the profession. (Morris, 2023)
According to the US Bureau of Labor Statistics, in 2021 87.2% of nurses are women and the complex schedules of nurses working in hospitals impact childcare. (Morris, 2023)
The total supply of nurses fell by 100,000 from 2020 to 2021 (the largest drop observed in the past 40+ years (Rosetter, 2022)
It is projected that there will be a shortage of 446,000 home health aids by 2025. (Preston, 2023)
As of May 2023, the United States needs more than 17,000 primary care physicians, 12,000 dental practitioners, and 8,200 mental health practitioners. (Howard, 2023)
According to the Association of American Medical Colleges, the United States is projected to face a shortage up to 124,000 physicians by 2034. (Howard 2023)
The American Association of Colleges of Nursing (AACN) reported in 2021 that 91,938 qualified nursing students were turned away due to insufficient faculty. AACN also reported in 2022 that there is a total of 2,166 vacant full-time positions across the 909 nursing schools throughout the country. (Preston, 2023)
Current Efforts
There are many initiatives in place to address the healthcare staffing crisis we are facing in this country. Below are just a few examples:
AACN has been advocating for federal funding for nurse education and incentives for healthcare educators. (Rosetter, 2022)
The National Conference of State Legislators submitted a brief with initiatives such as adapting the scope of practice laws and offering incentives for nursing educators (Enlund, 2022)
University of Minnesota and the Minnesota State Government have partnered to develop the Coalition for Nursing Equity and Excellence (CNEE) which works with nurse education programs, healthcare providers, and other stakeholders with the goal of increasing enrollment in nursing education programs, expanding equity in the nursing workforce, and increase the success of nursing students. (University of Minnesota 2022)
Historically Black Colleges and Universities (HBCU) are working to increase not just the number of physicians, but the diversity of physicians. Currently, 5.7% of the physicians in the US are black. (Howard, 2023)
431 Healthcare CEOs who were surveyed reported some effective strategies to address recruitment and retention such as financial incentives, filling positions with traveling nurses, offering flexible hours, establishing a residency program, and assisting with finding employment for staff spouses/partners. (Athey, 2020)
Re-Imagining Healthcare: Possible Innovative Solutions
Addressing the healthcare staffing challenges will take a multifaceted approach with both short-term and long-term initiatives. Rethinking where and how care is provided moving care out of hospitals and into the community. Supporting and bolstering community-based healthcare for low-acuity patients may alleviate the utilization of hospital-based services. In addition, an increase in the use of healthcare technology in community-based healthcare will increase the availability of services.
Healthcare Technology leverages automation to reduce time spent on nonclinical work and increases opportunities for remote work. (Medlock, 2022)
o Remote Patient Monitoring (RPM) – Providing individuals with affordable technology in their homes that can monitor their vitals (blood pressure, cardiac monitoring, scales, glucose monitors, and pulse oximeters) and automatically send the results to their physician in real-time. Decreases the need for staff to take vitals during appointments allowing staff time to be repurposed.
o Telehealth – Especially when combined with RPM, telehealth can provide care in the community decreasing the need for office staff.
o Remote Caregivers Systems for facility use– Providing enhanced monitoring of individuals residing in assisted living and long-term care facilities by using devices such as bed sensors, motion sensors, fall pedants etc. The devices provide staff notifications of movement throughout the facility, buying back staff time to focus on other services and decreasing the staffing ratios.
o Remote Caregivers Systems for home use – The same systems can be configured to support individuals to age-in-place in the community while answering the “what ifs” for caregivers.
o Decreasing staffing ratios by allowing healthcare technology to supplement staffing for nonclinical activities.
o Healthcare Technology can provide access to healthcare for individuals living in remote and rural communities.
Small business is the backbone of the United States, and this includes healthcare organizations.
o Funding/support for small independent community-based healthcare organizations to implement healthcare technology solutions.
o Developing leaders in healthcare who are armed with the tools and resources to create a more positive work environment.
Implementing an Open Access (OA) model of care (offering patients same-day or next-day appointments) reduces the no-show rates by 7%, potentially decreasing the need for urgent care or emergency care. The OA model is increasingly being used by behavioral health and substance use providers. (Lesaca, 2017)
References:
o Athey, L., Villagomez, E. (2020) Addressing Personnel Shortages in Hospitals. Foundation of the American College of Healthcare Executives.
o Enlund, S. (2022). Addressing Nursing Shortages: Options for States. National Conference of State Legislators.
o Haddad, L., Annamaraju, P., Toney-Butler, T. (2023) Nursing Shortage. National Library of Medicine National Institutes of Health.
o Howard, J. (2023) Concern grows around US healthcare workforce shortage: “We don’t have enough doctors”. CNN.
o Lesaca, T. (2017) The impact of queue-controlled modified open access scheduling on the no-show rate in a community mental health child psychiatry med check clinic: A pilot study. Patient Experience Journal 4:1 Article 14. https://pxjournal.org/journal/vol14/iss1/14
o Medlock, M., Radis, E., Abrams, K., Bhatt, J. (2022) Addressing healthcare’s talent emergency: Stabilizing the industry staffing shortage should start with redesigning the work model, investing in people, and rebuilding trust. Deloitte Insights. https://www2.deloitte.com/us/en/insights/industry/health-care/healthcare-workforce-shortage-solutions.html
o Morris, G. (2023) Post-Pandemic Nursing Shortage Affecting Aspiring Nurses. Nurse Journal. https://nursejournal.org/articles/post-pandemic-nursing-shortage/
o Preston, R. (2023) The Shortage of US Healthcare Workers in 2023. Oracle. https://www.oracle.com/human-capital-management/healthcare-workforce-shortage/
o Rossetter, R. (2022) Fact Sheet: Nursing shortage. American Association of Colleges of Nursing: The Voice of Academic Nursing.
o University of Minnesota announces collaboration to address nursing workforce crisis. (2022, October)
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