Today's Top Healthcare Workforce Challenges

Hospitals facing workforce challenges recognize that these aren't just passing concerns, but are enduring issues that affect the wellbeing of their operations, their employees, and, above all, patient care. These challenges comprise of several dynamic and interconnected issues ranging from staffing shortages and reliance on contingent labor to hospital closures.

In fact, the latest American College of Healthcare Executives survey indicated that workforce challenges have ranked as the top concern for healthcare CEOs in 2023 for the second year in a row. For 16 years, financial concerns held the top spot until recently - highlighting the devastating state of the workforce crisis.

This article aims to examine the multifaceted nature of healthcare workforce challenges, examining their complexities, impacts, and the strategies hospitals are adopting to navigate these difficulties.

Top Healthcare Workforce Challenges include:

1. Staffing Shortages

2. Aging Workforce and Loss of Skills

3. Burnout and Mental Health Issues

4. Recruitment and Retention

5. Regulatory and Compliance Issues

6. High Cost and Reliance on Contract Labor

7. Rural Hospital Closures

8. Workforce Management Inefficiency and Visibility

9. Diversity and Inclusion

10. Workplace Violence

1. Staffing Shortages

Staffing shortages are one of the most significant workforce challenges healthcare institutions face. It’s no secret that healthcare has been struggling with shortages for years, many of which have been brought to attention since the pandemic. These looming shortages have been issues longstanding for decades prior to COVID , but have since been amplified with the added stresses, burnout, and workloads resulting from the pandemic.

Shortages are projected to span across several clinical roles including nursing, physicians, and support staff for the next decade. The Bureau of Labor Statistics (BLS) predicts that there will be 194,500 annual job openings for registered nurses through 2032. This is made worse by estimations that place 177,400 total new expected nurses between 2022 through 2032 , a figure that barely covers the need for a single years’ demand of 194,500.

Physicians too, face a shortage of 23,600 openings for each year over the next decade . We can also expect increased demand for allied health positions from respiratory therapists, physical therapist to pharmacists .

Several factors contribute to these shortages:

• Aging population: This demographic shift impacts shortages in two key ways. First, an aging workforce preparing for retirement means loss of expertise – furthering the shortage problem (we’ll explore this in greater detail in the next section). Second, an aging population necessitates greater healthcare services. Projections indicate that by 2050, there will be a 14.7% increase, with 82 million Americans aged 65 or older, compared to 58 million in 2022 . This demographic is more prone to health conditions and a surge in demand for healthcare services will leave a gap with limited professionals available.?
• Education: There is an insufficient number of graduates entering healthcare professions. Medical and nursing schools often face limitations such as lack of faculty, clinical training sites, and financial resources, which limits the ability of students to enroll. Education limitations in turn limit a clinical pipeline entering the field.
• Turnover and Burnout: High turnover rates and burnout further exacerbate the staffing shortages. Greater demands, workloads, long hours and emotional stress are placed on healthcare professionals – many of which were heightened with the onset of COVID-19, but have remained a problem. Stress can lead to burnout, characterized by physical, emotional, and mental exhaustion, prompting many professionals to leave their positions or the healthcare field altogether. Burnout not only reduces the number of active professionals, but also affects the morale and productivity of remaining staff, creating a vicious cycle of increased workload and further burnout.

Hospitals are employing various strategies to address staffing shortages:

• Recruitment and Retention:?Offering competitive salaries, benefits, sign-on bonuses, career development, continuing education, and mentorship programs.
• Flexible Schedules:?Implementing flexible work schedules, part-time, and job-sharing options.
• Technology Utilization:?Utilizing telemedicine and remote monitoring to alleviate in-person staff burdens and optimize resource allocation.?
• Workforce Solutions: Implementing services and technology aimed at streamlining recruitment, management, scheduling, and provide detailed reporting on staffing and resource allocation.
• Well-being Programs:?Investing in stress management, employee assistance, and wellness initiatives to support staff health and reduce burnout.
• Workplace Culture:?Fostering an inclusive and supportive workplace culture to enhance employee satisfaction and retention.

Check out how Staffency helped this renowned Children’s Hospital overcome shortage challenges in this case study! ?

2. Aging Workforce and Loss of Skills

As mentioned previously, an aging workforce is a major challenge health systems are beginning to face as it means a greater loss of not only workers, but valuable expertise and skills, as clinicians begin to retire. These seasoned professionals bring decades of experience and specialized skills that are not easily replaced. Increasing clinician retirements will further strain healthcare systems and staffing challenges, disrupt the workforce and affect the quality and accessibility of care.

Based on the 2022 National Sample Survey of Registered Nurses, 23% of RNs employed in outpatient, ambulatory, and clinical settings have either retired or intend to retire within the next 5 years while 35% of physicians will reach retirement in the next five years .

There are a few strategies health systems are setting in place to prepare for these retirements that can include:

• Implementing mentorship and knowledge-sharing programs to transfer expertise of experience workers to less experience colleagues.
• Offering flexible work arrangements, such as part-time schedules and telecommuting, to help retain older employees in some capacity.
• Investing in training and up-skilling younger employees to ensure newer generations are well-prepared to fill advanced roles and maintain patient care continuity.

3. Burnout and Mental Health Issues

Touching on this point earlier, it’s important to further dive into the realities of burnout and its undeniable impact on workers, organizations, and patient care. Burnout is characterized by physical, emotional, and mental exhaustion brought on by prolonged stress and overwork.

Burnout is at the crux of many healthcare workforce challenges as this factor alone often fuels shortages and turnover in the first place. The CDC reported that a 2023 study found that nearly half of all healthcare workers (46%) reported feeling burned out in 2022 with 44% of workers intending to look for a new job .?

Causes of burnout include:

• Increased workloads and long hours: Healthcare workers often endure high patient loads and long working hours due to increasing patient numbers and staffing shortages. Extended shifts with limited breaks lead to chronic fatigue and stress.
• Emotional strains: Constant exposure to high-stress situations, such as life-and-death scenarios and patient suffering, leads to emotional exhaustion and a sense of helplessness.
• Administrative burdens: Spending considerable time on documentation, billing, and compliance detracts from patient care, causing further frustration.

Burnout affects morale, productivity, retention, and patient care and can result in:

• Greater workplace turnover
• Increased absenteeism
• Lack of engagement
• Increased medical errors
• Job dissatisfaction
• Reduced patient satisfaction

Mitigation strategies include:

• Implement workload management protocols
• Foster a supportive work environment
• Provide adequate resources and staffing
• Offer stress management programs
• Promote work-life balance initiatives

4. Recruitment and Retention

Finding an effective recruitment and retention strategy is no simple feat, but fine-tuning these approaches could lead to a strong workforce. It's important to balance recruitment and retention strategies in which an organization focuses on valuing their core staff and their needs, while building a pipeline for future sustainability.

Recruitment challenges stem from several factors that include:

• Tight competition for talent with other health systems
• Budget constraints and the ability to offer competitive compensations
• Slow recruitment and onboarding processes
• Lack of skills for evolving roles
• Excessive workforce turnover
• Hard-to-fill positions necessitating highly extensive experience
• Location-based challenges, such as rural settings

These challenges have resulted in elevated vacancy rates, with RN vacancy rates at 9.9% nationally, with 47.8% of health systems reporting a vacancy rate exceeding ten percent . Furthermore, it now takes 86 days (nearly three months) to recruit an experienced RN . This can have damaging effects on workplace morale and create financial stress due to higher recruitment and turnover-related costs .

Filling physician openings endure even longer time-to-fill rates with the average in 2022 being 126 days to fill an open position. Certain specialties take even longer to contract such as Urology (344 days) and Neurosurgery (254 days), leaving organizations to be without specialties for long periods of time .

To improve recruitment and retention, healthcare organizations should:

• Offer competitive salaries and benefits: Ensure attractive compensation and comprehensive benefits packages to draw qualified candidates.
• Enhance the candidate experience: Streamline the recruitment process, provide clear communication, and offer a positive interview experience - all of which can make a significant difference in attracting the right employees.
• Provide professional development opportunities: Invest in continuous education, training, and career advancement to develop employee skills and help them see a clear path for growth within your organization.
• Establish a pipeline: Building relationships with those in your talent pool can help reduce time-to fill positions and ensure a steady flow of qualified professionals.
• Flexible work arrangements: Offering scheduling flexibility, such as part-time schedules or telecommuting options, can help employees achieve better work-life balance and reduce burnout.
• Create a positive workplace culture: Promote teamwork, respect, and support to create a welcoming and inclusive environment – this attracts candidates.
• Leverage technology: Utilize recruitment and workforce platforms to streamline recruitment processes from sourcing, screening, and compliance to onboarding, making the recruitment process more efficient and effective.
• Recognition and reward programs: Acknowledging and celebrating employee achievements further contribute to job satisfaction and loyalty.
• Open communication: Soliciting employee feedback enables organizations to address concerns quickly and demonstrate responsiveness to employee needs.
• Creative partnerships: Partner with workforce solutions providers that specialize in healthcare recruitment and workforce management to optimize staffing levels for both permanent and temporary clinical and non-clinical positions.?

Improving workplace retention is a major struggle health system share, but finding the right strategy that keeps your employees can be a game changer. Increased retention means a stable workforce, happier employees, increased patient outcomes, lowered workplace turnover, reduced reliance on contract labor, and driving down overall recruitment and turnover costs.

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5. Regulatory and Compliance Issues

Managing compliance is another major obstacle health organizations often face. With regulations constantly changing, staying up-to-date on healthcare compliance items can be complex and costly for any compliance violations. The American Hospital Association’s Regulatory Overload Report (2017) revealed that hospitals and health systems must comply with 629 regulatory requirements across nine domains , a figure likely higher in today’s evolving landscape. Alongside the difficulties of tracking shifting requirements, institutions often have to dedicate personnel and financial resources to meet regulatory demands. The AHA report further indicated that hospitals and health systems collectively spend nearly $39 billion annually on administrative activities to ensure compliance standards are met.

Ways hospitals are tackling compliance tracking include:

• Training: Regular staff training and updates help keep teams informed about regulatory changes and requirements.
• Technology: Leveraging AI automation, such as vendor management systems , helps track compliance documents, identify missing items, monitor expirations, and send automatic notifications to all relevant parties. Look for technology that integrates with healthcare regulatory entities like NURSYS and the American Heart Association to manage licensures and certifications.
• Leadership and Accountability Systems: Establishing strong leadership and accountability systems cultivates a culture of compliance within the organization, ensuring consistent adherence to requirements.
• Partnerships: Hospitals outsourcing recruitment in an RPO (Recruitment Process Outsourcing) or MSP (Managed Service Provider) setting can have compliance processes outsourced as well. It’s important to partner with providers specializing in clinical compliance.

6. High Cost and Reliance on Contract Labor

Health systems face significant strain due to the increased reliance on contingent labor in the wake and aftermath of the pandemic. Growing talent shortages led many hospitals to turn to contract labor, often which comes at a hefty price. From 2019 to 2022, expenses for contract labor surged by 258% due to heightened demand for skills . One analysis further indicated that the average hospital spends $7.6 million on contract labor, accounting for approximately 3.5% of its total expenditures .

Though temporary clinicians can be an essential asset in a healthy workforce, reducing overreliance on them is crucial. Building a permanent workforce through creative recruitment and retention initiatives helps create a more sustainable, long-term strategy.

When attracting and retaining talent, offer incentives for full-time positions, such as competitive salaries, benefits, and career advancement opportunities. Also ensuring a strong and inclusive workplace culture and implementing employee recognition programs can help foster belonging and loyalty for retention.

Additionally, it's important to have visibility on staffing levels and stay ahead of staffing surges. Health systems are increasingly using advanced technology and AI to track optimal staffing levels, monitor scheduling, and help make informed staffing decisions ahead of time.

Hospitals can also benefit from Market Rate Analytics, which provides real-time insights into clinical and non-clinical contract rates, ensuring cost efficiency when using contingent labor.

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7. Rural Hospital Closures

Hospitals, particularly in rural areas, are increasingly facing closures, presenting significant challenges for healthcare professionals and patient care. The American Hospital Association cites 136 hospital and health system closures between 2010 and 2021 . In 2024 alone, hospitals and emergency departments have experienced 13 closures .

Trends driving increased closures include low patient volumes in rural areas, high staffing shortages, financial challenges from funding cuts and low reimbursements , and increased operational costs.

These closures not only result in job losses for healthcare professionals, but also place additional strain on remaining staff, who must manage increased workloads and patient care demands.

Moreover, hospital closures reduce access to essential healthcare services for communities, worsening disparities in healthcare access and outcomes.?

To mitigate the impact of hospital closures, organizations can:

• Advocate for policy changes to increase funding and support for struggling facilities.
• Implement innovative healthcare delivery models, such as telemedicine, to bridge gaps in care and reach underserved populations.
• Strengthen partnerships with community organizations to facilitate the provision of essential healthcare services and support for affected communities.

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8. Workforce Management Inefficiency and Visibility

Inefficient workforce management poses a major challenge for health organizations as it often undermines both operational efficiency and patient care quality.

Problems such as understaffing, overstaffing, slow recruitment and onboarding, and poor resource allocation lead to increased costs and decreased productivity. These inefficiencies not only affect hospital operations, but also affect patient care, resulting in longer wait times, decreased patient satisfaction, and negative clinical outcomes.

To improve workforce management and recruitment efficiency, health organizations need enhanced visibility, including real-time tracking of staff availability and allocation, and predictive analytics to anticipate staffing needs and trends.

Healthcare workforce solutions play a crucial role in tackling these challenges.?These solutions range from Managed Service Provider (MSP) services to Recruitment Process Outsourcing (RPO) programs. Central to these programs are technologies such as vendor management systems (VMS) and applicant tracking systems (ATS) . These leading-edge technologies consolidate manual data tracking, streamline recruitment and workforce management processes, optimize scheduling, provide detailed reporting, and adjust staffing levels based on data-driven insights.

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9. Diversity and Inclusion?

Diversity and inclusion are essential for a successful healthcare workforce, fostering innovation, cultural competence, and improved patient outcomes. Several studies highlight the advantages of a diverse and inclusive clinical workforce for both employees and patients.

For patients, a varied workforce improves access to care, enhances communication, increases patient visits, and promotes better medication adherence, leading to improved patient outcomes , higher perceived care quality, and greater satisfaction. When patients relate to clinicians through shared backgrounds, it creates trust and encourages the disclosure of sensitive information, enabling culturally competent treatment plans that patients are more likely to follow .

For employees, workplace diversity fosters greater empathy towards colleagues and the patients they serve. It also increases employee morale and retention by creating a sense of belonging and inclusiveness. Additionally, diversity sparks greater creativity in problem-solving by incorporating a variety of perspectives. Studies have shown that diverse teams have improved team problem-solving skills compared to less diverse teams .

While diversity in healthcare has grown steadily , many groups remain underrepresented , with minority individuals comprising 32% of practitioners, according to the BLS .?

Achieving diversity faces challenges due to unconscious biases in hiring and promotion, while the lack of diversity in leadership roles perpetuates existing disparities. To promote inclusion, healthcare organizations can implement various strategies:

• Implementing diversity training programs to address unconscious biases
• Adopting inclusive hiring practices, such as blind resume reviews
• Establishing support networks and affinity groups for staff members from underrepresented backgrounds
• Offering coaching and leadership training opportunities for professionals from underrepresented groups
• Developing mentorship and pipeline programs to increase the representation of minorities in healthcare careers
• Offering financial aid to socioeconomically disadvantaged groups for higher education and entry into healthcare professions

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10. Workplace Violence

A major concern for health systems is the prevalence of workplace violence against healthcare workers. Workplace violence refers to any act or threat of physical violence, harassment, intimidation or other disruptive behaviors that occur at the work site, including verbal abuse and physical assaults. Healthcare itself has experienced the highest rates of injuries caused by workplace violence and workers are five times more likely to experience violence compared to employees in other industries according to the BLS . Actual incidences of violence may be three times higher due to underreporting .

Workplace violence has severe effects on employee wellbeing, causing psychological and physical harm. This can lead to increased stress, burnout and job dissatisfaction – all of which fuel turnover rates for health organizations.

Risk factors that contribute to workplace violence include emotional stress and unpredictable patient behavior (or that of their relatives), but it can also be attributed to organizational factors that include shortages and high-stress work environments .

To combat workplace violence, hospitals can implement the following measures:

• Training Programs:?Regular training for staff on recognizing, de-escalating, and responding to violent situations can empower employees and enhance their safety.
• Security Measures:?Investing in security personnel, surveillance systems, and emergency response protocols can help prevent potential incidents and provide assistance when violence occurs.
• Support Systems:?Establishing support systems, such as counseling services and peer support groups, can help with emotional recovery of affected staff.
• Reporting and Policies:?Encouraging a culture of reporting and developing clear policies and procedures for addressing workplace violence ensures that incidents are properly documented and managed.

Learn more about recommendations and standards from the Joint Commission on Workplace Violence Prevention.

Conclusion

Healthcare's workforce challenges are multifaceted and intertwined and include a range of issues such as staffing shortages, high turnover rates, burnout, and regulatory pressures. These challenges not only strain healthcare institutions, but also have detrimental impacts on the well-being of workforces and the quality of patient care.

Addressing these complexities requires comprehensive strategies, including creative recruitment and retention efforts, flexible work arrangements, and initiatives to enhance workplace safety and employee well-being. Investing in these areas can go a long way in resilience and operational efficiency – all of which ultimately improves patient outcomes.

Need guidance on navigating healthcare workforce challenges??

Explore longer-term solutions with Staffency. We create tailored workforce solutions that tackle recruitment challenges, streamline workforce management, and ensure compliance oversight. Our services drive-cost savings, build a healthy workforce, and empower data-driven growth to your workforce program. Learn about our services and leading-edge workforce technology !

Have questions? Message us our team directly on LinkedIn or email us at [email protected] .

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