A new report from the Wisconsin Hospital Association (WHA) sees multi-disciplinary teams as one way to ensure that patient care will continue to be accessible, affordable and effective, especially for those with chronic or complex diseases.
The report suggests that Wisconsin’s ability to meet an increased demand for care will require finding new ways to deliver care more efficiently, along with being able to recruit, educate and retain an adequate workforce.
The WHA report is based in part on its annual survey of 150 hospitals, health systems and specialty hospitals. The survey found health care employees are older than the general Wisconsin workforce. Almost 20 percent of the people who are employed in hospitals in professional occupations are age 55 or older. Nearly a quarter of the nurses employed in hospitals are over 55 years of age and more than 30 percent of the nurses in ambulatory care settings are over 55 years old. The anticipated shortage of registered nurses has eased in part because nurses have extended their working careers by delaying retirement.
“Health care workers are older, and the competition to attract young people to a health-related career is intense,” said Judy Warmuth, R.N., Ph.D. and WHA vice president, workforce development. “As those employees retire, it is going to create a new round of personnel shortages. Developing effective workforce strategies will require hospitals, policy makers and the academic community to work together to create an educational and regulatory structure that will support tomorrow’s workforce.”
The highest vacancy rate in the hospital workforce was for advanced practice nurses (APNs) at 9.7 percent. Hospitals are creating new positions for advanced practice professionals, which includes APNs, certified registered nurse anesthetists and physician assistants. Many hospitals reported that positions for APNs are their most difficult vacancies to fill. APNs may practice in the emergency room, urgent care, specialty nursing units or as hospitalists, and they are frequently included in team-based patient care models.
Shifts in where patient care is taking place are also influencing the job requirements for many positions. Technological advances have allowed more surgeries and procedures to be performed in outpatient settings; however, the WHA report suggests that education and training models for health care workers may not be keeping pace with the changes. In the past, acute care hospitals have provided the vast majority of training sites for health care professions, such as nurses, physical therapists, surgical technicians, etc., who must complete a rotation in a clinical setting, according to Warmuth.
“The decrease in the number of patients receiving inpatient care has not reduced the number of students, but it has increased the competition for clinical learning experiences in hospitals,” Warmuth said. “New, innovative and outpatient-focused learning must be designed, implemented and utilized to ensure future health care workers are prepared to practice in the environments where care is increasingly being provided.”
According to the WHA, 108,900 people were directly employed by a hospital in November, 2014. That makes hospitals one of Wisconsin’s largest employers. However, since 2011, the number of employees in outpatient settings has exceeded the number employed in acute care hospitals, with 119,900 workers in ambulatory health care facilities in 2014. According to the WHA Information Center, more than 70 percent of all surgeries and medical procedures are performed in outpatient and ambulatory care environments.
“The future of health care is based on creating value for patients, employers and payers,” said WHA president and chief executive officer Eric Borgerding. “Wisconsin hospitals and health systems are well-positioned to thrive in this new world, but the availability of a workforce that is highly trained and of adequate size is critical, whether the care is provided in a hospital, clinic, or through telemedicine.”
In developing what is considered to be one of the most complete reports in the state on Wisconsin’s health care workforce, WHA obtained data from the WHA Information Center and several state and federal sources.
“A workforce plan requires accurate workforce data and, to some degree, an ability to predict the future,” Borgerding said. “In an industry that is changing as rapidly as health care, one thing is certain -organizations that are committed to providing high-quality, high-value care, as we are in Wisconsin, are developing strategies now to ensure they will be able to meet the health care demands of people living in their communities today and in the future.”
See the 2014 WHA Workforce Report at http://www.wha.org/pubarchive/reports/2014WorkforceReport.pdf.
