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America’s hospitals confront serious workforce challenges

August 20, 2007
Hospitals had an estimated 116,000 registered nurse vacancies as of last December, according to “The 2007 State of America's Hospitals-Taking the Pulse,” an AHA survey of hospital leaders that was released last month.      Hospitals cite a litany of issues that contribute to a nationwide nursing shortage:  the demanding nature of nursing, a lack of nurse educators - and facilities - to teach qualified applicants, an aging nurse population, and inadequate funding at the state and federal levels to support nurse education. At the same time, growing numbers of older Americans and an increase in chronic illnesses contribute to more people needing nursing services.
To help address serious nursing shortages, many hospitals look overseas to hire highly qualified registered nurses (RN). The AHA has called for changes in the U.S. visa policy to help ensure that hospitals can recruit RNs and other health care professionals from overseas. As part of that effort, the AHA and other organizations recently urged Congress to undertake visa reform legislation this year to help address dire shortages of highly skilled workers, including health care professionals.
“The inability of our members to bring highly educated workers into the United States, and retain them permanently when needed, severely hurts their ability to compete in the global market," the groups said in Aug. 2 letters to House and Senate members. "It is imperative that reforms to the H-1B visa program and the [employment-based] green card system occur this year, allowing American businesses to remain competitive.”
In addition to the AHA, the letters were signed by the Business Roundtable, Financial Services Roundtable, National Association of Manufacturers, Society for Human Resource Management and U.S. Chamber of Commerce.
The AHA survey of hospital leaders found that workforce shortages are affecting patient care. These charts are included in the survey, which is at the “Research and Trends” section of www.aha.org. >

Hospitals face workforce shortages in key care-giving professions...

Vacancy Rates for Selected Hospital Personnel, December 2006

Therapists (ST, OT, PT)* 11.4%
Registered nurses 8.1%
Pharmacists 8.1%
Nursing Assistants 8.0%
LPNs 6.6%
Laboratory Technicians 5.9%
Imaging Technicians 5.9%
RN Vacancies 116,000*

Source: 2007 AHA Survey of Hospital Leaders

*Note: 116,000 vacancies is a national estimate created by extrapolating the vacancy rate to all 5,000 community hospitals in 2005.
ST: Speech Therapist, OT: Occupational Therapist, PT: Physical Therapist

...that are perceived to be getting worse...

Percent of Hospitals Reporting Recruitment More Difficut in 2006 vs. 2005

Therapists (Speech, Occupational, Physical 58%
Registered Nurses 44%
Pharmacists 44%
Laboratory Technicians 41%
Imaging Technicians 28%
Billing/Coders 28%
Nursing Assistants 22%
IT Technologists 20%
LPNs 19%
Housekeeping/Maintenance 17%

Source: 2007 AHA Survey of Hospital Leaders

...and are affecting patient care.

Percent of Hospitals Reporting Service Impacts of Workforce Shortage, 2006

Decreased Staff Satisfaction 49%
ED Overcrowding 36%
Decreased Patient Satisfaction 35%
Diverted ED Patients 21%
Reduced Number of Staffed Beds 17%
Delayed Discharge/Increased Length of Stay 17%
Increased Wait Times to Surgery 13%
Discontinued Programs/Reduced Service Hours 13%
Cancelled Surgeries 9%
Curtailed Acquisition of New Technology 8%
Curtailed Plans for Facility Expansion 6%

Source: 2007 AHA Survey of Hospital Leaders

17 percent of hospitals reported hiring foreign-educated* nurses in 2006

Percent of Hospitals Reporting That They Hired Foreign-Educated* Nurses to Help Fill RN Vacancies in 2006

Yes
17%
No
83%

42 percent of hospitals reported That They Hired Foreign-Educated* Nurses in 2006 vs 2005

Percent of Hospitals Reporting More, Less or the Same Number of Foreign-Educated* Nurses to Fill Vacancies in 2006 vs 2005

More 42%
Less 23%
Same 35%

Source: 2007 AHA Survey of Hospital Leaders
*Foreign-Educated nurses are individuals who are foreign born and received basic nursing education in a foreign country. In general many of these nurses came to the U.S. on employment visas which allow them to obtain a green card.