Category Archives: Continuity of Care

Hospitals average 100% staff turnover every 5 years — Here’s what that costs

Posted on by • Posted in Continuity of Care, Labor Cost Structure, Labor Shortages, Labor Spend Management, Nurse Agency Staffing, Nurse Retention, Nurse Travelers, Nurses Compensation, Nurses Shortage, Operating Expense Reduction, Operating Expenses, Quality of Care, Talent Competition, Talent Management, Workforce Retention, Workforce Shortages, Workforce Turnover • Leave a comment
https://www.beckershospitalreview.com/finance/hospitals-average-100-percent-staff-turnover-every-5-years-heres-what-that-costs.html?origin=RCME&utm_source=RCME&utm_medium=email&utm_content=newsletter&oly_enc_id=2893H2397267F7G

Hospitals have been paying astronomical prices for staff turnover, according to the “2022 NSI National Health Care Retention & RN Staffing Report.”

It covers 589,901 healthcare workers and 166,087 registered nurses from 272 facilities and 32 states. Participants were asked to report data on turnover, retention, vacancy rates, recruitment metrics and staffing strategies from January to December 2021. 

The survey found a wide range of helpful figures for understanding the financial fallout of one of healthcare’s hardest labor disruptions:

  • The average hospital lost $7.1 million in 2021 to higher turnover rates.
  • The average hospital loses $5.2 to $9 million on RN turnover yearly.
  • The average turnover cost for a staff RN is $46,100, up more than 15 percent from the 2020 average.
  • The average hospital can save $262,300 per year for each percentage point it drops from its RN turnover rate.
  • To improve margins, hospitals need to control labor costs by decreasing dependence on travel and agency staff, but only 22.7 percent anticipate being able to do so.
  • For every 20 travel RNs eliminated, a hospital can save $4.2 million on average.

In the past 5 years, the average hospital turned over 100.5 percent of its workforce:

  • In 2021, hospitals set a goal of reducing turnover by 4.8 percent. Instead, it increased 6.4 percent and ranged from 5.1 percent to 40.8 percent. The current average hospital turnover rate nationally is 25.9 percent, according to the report.
  • While 72.6 percent of hospitals have a formal nurse retention strategy, less than half of those (44.5 percent) have a measurable goal.
  • Overall, 55.5 percent of hospitals do not have a measurable nurse retention goal.
  • Retirement is the number four reason staff RNs leave, and it is expected to remain a primary driver through 2030. More than half (52.8 percent) of hospitals today have a strategy to retain senior nurses. In 2018, only 21.6 percent had one.

Historically, RN turnover has trended below the hospital average across all staff. For the first time since conducting the survey, this is no longer true: 

  • In the past five years, the average hospital turned over 95.7 percent of its RN workforce.
  • Close to a third (31.0 percent) of all newly hired RNs left within a year, with first year turnover accounting for 27.7 percent of all RN separations. Given the projected surge in retirements, expect to see the more tenured groups edge up creating an inverted bell curve.
  • Operating room RNs continue to be the toughest to recruit, while labor and delivery RNs are trending easier to recruit than in the year prior.
  • Hospitals are experiencing a dramatically higher RN vacancy rate (17 percent) compared to last year’s rate of 9.9 percent.
  • The vast majority (81.3 percent) reported a vacancy rate higher than 10 percent.

What to expect as Kaiser’s 4,000 behavioral health workers launch 5-day strike statewide

Posted on by • Posted in Case Load, Collective Bargaining, Continuity of Care, Health System, Hospital, Hospital Industry, Labor Spend Management, Labor Strike, Labor Union, Mental Health • Leave a comment

https://www.sacbee.com/news/local/health-and-medicine/article238378533.html

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Kaiser Permanente’s behavioral health clinicians will be picketing Monday outside the health care giant’s Sacramento Medical Center on Morse Avenue, joining in a weeklong labor strike that will affect services at more than 100 facilities around California.

Roughly 4,000 psychologists, psychiatric nurses and other behavioral health workers — members of the National Union of Healthcare Workers — say they want the company to shorten wait times for return appointments and reduce therapist caseloads.

“I know of nowhere else but in the Kaiser system that there is literally no definition of a caseload or maximum number of patients for which one is responsible,” said Susan Whitney, a Kaiser therapist in Kern County. “There are about 35 therapists and social workers that serve Kaiser’s Kern County population of 109,000 members, only one mental health worker for every 3,000 members. In contrast, Kaiser primary care physicians have a panel, or caseload, of 1,500 patients, and also have staff such as nurses and medical assistants that support them.”

Kaiser executive Michelle J. Gaskill-Hames said that proposals made to the union would keep Kaiser therapists among the highest paid in California, with excellent benefits, as well as offering them more time in their schedules for patient appointments and to take care of administrative tasks. Rather than strike, she said, the company has asked the union’s leadership continue to work with a mediator and Kaiser Permanente.

“Like every other health care provider, we are seeing a significant demand for mental health care in the face of a national shortage of qualified professionals,” said Gaskill-Hames, Kaiser’s senior vice president for Northern California hospital and health plan operations. “Despite this shortage, we have hired nearly 500 new therapists in California this year alone.”

The clinicians had initially planned the strike for mid-November but postponed it out of respect for the family of the late Kaiser CEO Bernard Tyson, who died unexpectedly last month.

WHAT UNION MEMBERS HAD TO SAY

The strike is to compel Kaiser to make mental health care as much of a priority as physical health care, Whitney said. Treating mental health issues also improves physical health, she said, as numerous studies have shown.

Since Kaiser was fined several years ago for lengthy waits for first appointments, the company has worked under state supervision to improve its performance in this area, Whitney said, but as it has improved in that metric, return appointments have become more difficult to schedule.

Vicki Hoskins, a therapist in Orange County, said that if a patient completed an intake appointment today and wanted to return to see her, that patient would have to wait until March. There is a backlog of vacant positions in some offices, she said, so new hires are often filling those rather than adding to the workforce.

WHAT KAISER LEADERS HAD TO SAY

Kaiser has been jointly working with an external mediator to help reach a collective bargaining agreement with the union, Gaskill-Hames said.

She said the mediator recently delivered a proposed compromise to both sides, but the union has rejected it and announced plans to strike instead of working through the mediated process.

This is union’s sixth noticed strike within a single year, and the repeated call for short strikes is disruptive to patient access, operational care and service, said Gaskill-Hames, who described the union’s action as irresponsible.

A strike puts patients in the middle of bargaining, which is not fair to them, especially during the holidays when rates of depression can spike, she said.

HOW WILL THE STRIKE AFFECT PATIENTS?

Kaiser Permanente will try to minimize patient disruption, Gaskill-Hames said, but the company may be forced to reschedule appointments and devote resources from elsewhere in the organization to address the continuity of care.

WHEN AND WHERE WILL PICKETS BE PROTESTING?

In the Sacramento area, pickets will be out from 6 a.m. to 2 p.m. at Kaiser’s Sacramento Medical Center, 2025 Morse Ave., on Monday; at the Roseville Medical Center, 1600 Eureka Road, on Wednesday; and at the South Sacramento Medical Center, 6600 Bruceville Road, on Friday. On Thursday, they will rally at the State Capitol at 10th and L streets at 10:30 a.m. and at the Department of Managed Health Care, 990 Ninth St., at 11:30 a.m. Elsewhere in the Central Valley, pickets will be at Fresno Medical Center, 7300 N. Fresno St., Monday through Friday.