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Hospital Turnover in 2018: The Trend Continues

New Study Shows Hospital Turnover Continued to Increase in 2018
Vitaliy Vodolazskyy/

New data, the 2019 National Health Care Retention & RN Staffing Report, published by NSI Nursing Solutions, Inc. reveals demand for nursing staff and other hospital professionals continues to outpace supply.  For institutions struggling to meet headcount, the numbers are worrisome. Voluntary turnover continues to increase. Competition for talent is also driving turnover, with employee poaching becoming the new norm.

While the average turnover rate across all industries in the US is 15%, hospital turnover for 2018 was at 19.1%, an increase of almost a percentage point over 2017, and the highest in the decade. Although turnover is high and the applicant pool is shrinking, of the over 200 institutions polled, almost 43% report intention to increase headcount.

For nursing professionals, 2018 saw a 17.2% turnover rate, up from 16.8 in 2017. Pediatrics, women’s health, surgical services and burn care saw the lowest rate of turnover, while ER, behavioral health, and telemetry saw the highest. Certified Nursing Assistant turnover was almost 32% in 2018. To add to the dilemma, the Bureau of Labor Statistics projects the nursing labor shortage will reach 1.13 million by 2024.

Tenure troubles

Turnover in the first year of employment continues to be the highest category across all employees and nurses in particular. For 2018, over 32% of all new hires didn’t make their first year anniversary; nearly 28% of nurses left within one year. For those who were nearing their second anniversary, overall turnover and nursing turnover both reached 20.5%. This data reveals half the new hires an institution makes will not reach the 24-month mark.

Why are healthcare employees leaving?

At almost 93%, voluntary resignation is the top reason for turnover. When asked specifically why they were separating, the top three reasons were personal needs (caring for a child or parent, disability or marriage), career advancement, and relocation. Fourth on the list: retirement. As more Baby Boomers age out of the workforce, expect this number to increase. They’re hitting retirement age at 10,000 per day and will continue to do so through 2030.

How can you help them stay?

For many institutions, a heavier focus on the onboarding process may reduce early turnover, as these staff members receive more resources to gain tenure. Regular check-ins with HR can help correct problems and provide the new hire an easier transition. More opportunities for career development may be another useful retention strategy.

The high cost of employee churn in healthcare

Replacing nursing staff is a costly line item for institutions. On average, the cost to replace a bedside nurse tops $50,000. Its estimated hospitals lose between $4 and almost $7 million dollars per year because of turnover.

Time to hire nursing staff continues to increase, with the average nearing 3 months. It’s estimated that for each percentage reduction in nurse turnover, the average hospital could save almost $330,000 per year.

What the future holds

As demand increases, hospitals are looking at high priced solutions to staffing. Increased use of overtime pay, agency and travel staff usage, and other approaches have become commonplace. Over 40% of hospitals project an increase in their total labor force for the coming year, and 45% expect to increase nursing staff.

Where help is needed

Recruiters, who are often short-staffed and over worked are feeling the rising pressure. To meet the demands on the department, on average, the number of Full-Time Equivalents in HR should be 1 for every 100 employees. Today’s healthcare facility ratio is 1:145. Hospitals surveyed in the study anticipate growth in staffing budgets of over 30%, but only 20% intend to increase recruitment staff. Increasing the budget for talent may be futile if facilities don’t have the recruiters to affect hires.

Where help can be found

For most facilities, outsourcing some of the rote tasks HR performs has the potential of freeing up recruitment staff to focus more on acquisition. Screening and scheduling software can reduce the amount of time recruiters spend on routine tasks of the hiring process. Other areas, like outsourcing benefits administration and background checks can also be helpful.

Leveraging recruitment sources that net results is a smart strategy for HR professionals already stretched too thin. And while time may be in short supply, AI may help recruiters analyze data to find the best bang for their recruitment buck. Today and through the foreseeable future, healthcare facilities will need to be creative with their retention and recruitment strategies to provide the best patient outcomes possible.

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About Riia O'Donnell

Riia O’Donnell has over 20 year’s hands-on experience in all aspects of the Human Resource function. Beginning as a recruiter, she grew to lead in all areas of HR, including employee training and development, legal compliance, benefits administration, compensation evaluation, and staff management. She has been a contributing writer for a wealth of HR, training, and small business websites for the past 7 years. Connect with Riia on Twitter at @RiiaOD.

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