Daily Briefing

Workforce shortages top list of CEO concerns — again


Workforce shortages topped the list of hospital CEOs' biggest concerns for the third year in a row, according to a survey by the American College of Healthcare Executives (ACHE). Advisory Board's Monica Westhead explains why executives are especially concerned about technician and RN shortages and shares four tips on how leaders can take a holistic approach to the problem.

Hospital CEOs' biggest concerns in 2023

For the survey, 241 hospital CEOs ranked 11 issues affecting their hospitals in order of how pressing they are, and to identify specific areas of concern within those issues.

The top issues — and their respective average rankings — for hospital CEOs in 2023 were:

  1. Workforce challenges, 2.3
  2. Financial challenges, 2.6
  3. Behavioral health/addiction issues, 5.3
  4. Access to care, 5.6
  5. Governmental mandates, 5.7
  6. Patient safety and quality, 5.9
  7. Patient satisfaction, 6.4
  8. Technology, 7.3
  9. Physician-hospital relations, 7.6
  10. Population health management, 8.7
  11. Reorganization, 9.3

For the past three years, hospital CEOs named workforce issues as their top concern. While the issue "workforce challenges," which includes personnel shortages, was added to the survey in 2022, personnel shortages topped the list in 2021's survey  edition, with an average rank of 1.6. Previously, financial challenges held the top spot for nearly 20 years.

Within workforce challenges, a shortage of technicians was identified as the biggest concern (87%), followed by a shortage of RNs (86%). Within the second biggest concern, financial challenges, increasing costs for staff and supplies was identified as the top concern among 94% of respondents, up from 89% last year. And within behavioral health/addiction issues, lack of appropriate facilities and programs in the community was identified as the top concern by 83% of respondents, up from 78% last year. 

(Gooch, Becker's Hospital Review, 1/31; American College of Healthcare Executives survey, 1/2024)


Advisory Board's take

How to tackle workforce challenges, in 4 steps 

By Monica Westhead

It's no surprise that workforce challenges continue to be a top issue for executives. Challenges with the workforce hinder all strategic goals within an organization, including growth and cost control.

Why leaders are so concerned about technician, RN shortages  

The fact that shortages of technicians are the top workforce concern this year — narrowly edging out RN shortages (which is still an area of extremely high concern) — is intriguing. This shift represents a realization that unlicensed and assistive staff are the backbone of the healthcare workforce.  

Without enough of those team members, higher-licensed staff, such as RNs, physicians, and pharmacists, are unable to work at the tops of their licenses, harming efficiency and driving burnout. Many organizations have not invested heavily in resources aimed at retaining or developing technicians.

4 steps to approach workforce shortages  

Instead of simply focusing on labor costs, leaders should take a holistic approach to workforce shortages. While the costs can be high, the opportunity cost of not fixing the problem by changing the work environment and providing more support is higher. This means leaders should consider all of the responsibilities allocated to staff and evaluate whether they have the right team structure in place and the right technology available to support those staff.

Here are four steps leaders can take to address workforce shortages: 

1.       Invest in retention and development: This means providing ongoing training, support, and advancement opportunities to staff at all levels — and offering roles to keep them engaged and motivated. At the same time, providing flexible staffing arrangements can help retain staff while they pursue schooling or attend to their own work-life balance needs.

2.       Rethink staffing models: Leaders should consider whether they have the right mix of staff to meet patient needs. This may involve increasing the number of unlicensed and assistive staff members to support higher-licensed staff, including RNs and physicians. 

3.       Leverage technology: Organizations can use technology to help support their staff, improve efficiency, and reduce burnout. For example, virtual nursing programs can help address workforce shortages by allowing nurses to work remotely and collaborate with other care team members. 

4.       Advocate for policy changes: Healthcare leaders can advocate for policy changes that support the healthcare workforce, such as increasing funding for healthcare education programs.

By taking a comprehensive approach to addressing workforce shortages, healthcare leaders can ensure that their organizations are well equipped to provide high-quality care to patients while also supporting staff well-being and development.

If you want to learn more about how your organization can holistically approach workforce shortages, check out some of our recent workforce resources:

 


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