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What are health systems doing to attract and retain nurses?

Plus, the very high costs of quality reporting

July 2023
What are health systems doing to attract and retain nurses?

IN A NEW SURVEY of health system executives, more than 90% admitted that their nursing shortage was “critical” and that their health systems still rely on travel nurses. Among the 100 health system higher-ups surveyed, a sizeable portion reported that more than 25% of their nursing staff had worked in their organizations for less than a year.

The survey was conducted by Incredible Health, a nurse staffing company. As for how they are trying to secure permanent hires, 35% of executives cited sign-on bonuses and 26% were offering higher salaries. But while four out of five knew that many nurses—particularly younger ones—want more flexible schedules, only 11% of their health systems offer such flexibility.

Compared to their older counterparts, younger nurses also want more specialized roles and career advancement opportunities. But survey findings indicate that many health systems haven’t made creating such opportunities a priority. In related news, Michigan this summer launched a campaign to boost interest in health care careers with a Web site detailing training programs and scholarships in the state.

The high costs of quality reporting

A STUDY PUBLISHED in June by JAMA outlines the jaw-dropping amount of time and money associated with gathering data to meet CMS quality metrics.

Johns Hopkins Hospital did a retrospective study to look at the costs of collecting data for 162 quality metrics in 2018. The results: It took more than 108,000 person hours at an estimated personnel cost of more than $5 million for the hospital to prepare and report those data over the course of the year. Additional costs included $600,000 in vendor contracts.

Researchers found that, per metric, claims-based and chart-abstracted metrics used the most resources, while electronic metrics used far fewer. Among the metrics that data were gathered for, 59% were claims-based, 66% were related to outcomes and 62% were tied to patient safety. Extrapolating the findings to more than 4,000 acute care hospitals, the authors write that the annual price tag nationwide to report quality data is in the billions of dollars.

“Future innovation,” the researchers concluded, “should consider reducing metric volume and developing additional non-claims-based electronic metrics.”

Hospital forecast: Bariatric surgery will be down, home care will be (way) up

ACCORDING TO A new report, hospital capacity issues will continue into the next decade, driven by staffing shortages and rising patient acuity.

Prepared by the Vizient company Sg2, the report finds that hospital case mix index is up 5% since 2019 while the average length of stay has risen 10%. Analysts say those trends are due in part to workforce shortages that eliminated 30,000 hospital beds between 2019 and 2022. The forecast projects that hospitals will continue to see patient acuity increase because of patient age and chronic disease.

As for specific service lines, the number of bariatric surgeries is projected to fall 4% by 2033, losing ground to weight-loss drugs. Home care volume, on the other hand, is expected to rise 19% due to advances in remote monitoring and shifts in payment. While virtual visits should increase close to 30% over the next 10 years, more surgeries will migrate to outpatient centers while the growth in infusion therapies will also push more care out of hospitals into the outpatient setting.

Published in the July/August 2023 issue of Today’s Hospitalist

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