Nurse executives had their hands full in 2015. The amount of qualified nurses has dwindled while the amount of insured patients have increased under the Affordable Care Act. That’s created a tumultuous environment, one that’s already contributed to many full-time nurses leaving the profession in search of less stressful means.
The new year doesn’t appear to be much different, but there’s more beyond the nursing shortage hovering over nurse executives. Jennifer Stewart, from the Nursing Executive Center of Advisory.com, identified six main issues that nursing leaders will encounter in 2016:
- Ensure every patient receives the known standard of care in every setting, every time. The Affordable Care act has placed more emphasis on positive patient outcomes. To ensure these higher expectations are met, nursing leaders will make “significant investments” to deliver high-caliber care to ensure patients receive the known standard of care.
- Prepare for a potential nursing shortage. The nursing shortage is still just as relevant today as it was last year and before. According to a recent Georgetown survey, there will be some 1.6 million nursing job openings by 2020. Because there’s no end in sight, nursing leaders will continue offering sign-on bonuses, retention bonuses and other fiscal incentives to secure qualified nurses.
- Make early bets about reshaping their clinical workforce. According to Jennifer Stewart, it’ll take over a decade for a hospital with an average turnover rate to replace the staff hired in 2016. Because of that, Stewart suggests nursing leaders will make early decisions about what their future clinical workforce should look like. Those decisions will mold how facilities recruit staff with credentials and roles needed.
- Seek greater consensus on the “right” way to staff a clinic. Stewart cites the increased number of pilot projects that are increasing top-of-license practice for RNs, often by increasing top-of-license practice (or creating new roles) for medical assistants and licensed practical nurses. As Stewart writes, the projects are closely monitored but still new, meaning there’s no national consensus for nursing leaders on the right mix of staff in clinics just yet.
- Continue to control costs—but not by cutting labor. Despite the enormity of labor, it represents only about 15 percent of the cost-savings opportunity according to Stewart. Therefore, nursing leaders will focus on three cost-saving measures instead:Outdated care protocols
Unfavorable contract terms
- Expand front-line nurses’ focus from discharge to care continuity. Stewart says nursing leaders are building a clinical workforce that has surpassed “discharging” patient responsibility to a colleague in another unit or car setting. “The goal is to shift clinicians’ perspective and provide continuous, coordinated care across multiple sites and settings.”
It’s not getting any easier for nurse executives. While the strategy outlined by Stewart offers insight into solutions that will help ease the burden on nurses, the reality is there simply aren’t enough to meet demand.
As point No. 5 demonstrated, nursing leaders will be tasked with cutting costs without cutting labor. That opens the door for well-known solutions like travel nursing, a resource that is actually more cost-effective in comparison to overtime hours for full-time nurses.
Jennifer Stewart is a managing director with The Advisory Board Company. In that capacity she oversees the daily operations and research within the firm’s workforce terrain—including best practice research for the Nursing Executive Center and the HR Advancement Center. She facilitates interactive workforce and strategic planning sessions with executives and travels extensively sharing the firm’s workforce practices and insights.