Supporting the Health Care Workforce

High-quality care can’t happen without talented teams of health care professionals. To meet Pennsylvanians’ health care needs now and into the future, we must make a persistent and sustained effort to grow and support the health care workforce.

The Health Care Workforce is in Crisis

Health care workforce shortages across Pennsylvania and the nation were approaching a crisis even before the COVID-19 pandemic. An aging population means more health care professionals are retiring just as demand for care is increasing. There is not enough infrastructure in place to educate and train the next generation of health care workers who will be needed to care for Pennsylvanians.

Hospitals and health systems are working hard to grow their workforce today and for the future. While they are making progress reducing staff turnover and vacancies, comprehensive investments and public policies are needed to help them strengthen Pennsylvania’s health care workforce.

Hospitals are Leading with Solutions

HAP’s November 2023 survey of Pennsylvania hospitals highlights the ways hospitals and health systems are aggressively working to develop, recruit, and retain health care professionals. HAP’s survey found:

  • Hospitals are taking extraordinary efforts to recruit and retain clinicians. Nearly all are increasing base pay (97%), offer flexible work schedules (95%), and provide professional development and/or tuition reimbursement (89%). Roughly half offered sign-on, schedule-based, and/or referral bonuses (56%) and retention bonuses (49%), and 39 percent provided child care, compared to fewer than 6 percent of all employers nationwide.
  • Hospitals are working with educators and their communities to grow the health care workforce. Nearly all are partnering with community colleges and four-year colleges/universities (99%) and high schools (92%). More than half are also partnering with trade/technical schools and/or community organizations (55%) and many are reaching all the way to the middle school level (25%).
  • Hospitals are transforming how care is delivered to better meet the needs of patients, reduce strain on staff, and empower professionals to practice at the top of their licenses. This includes adopting innovative models such as team-based care, virtual nursing, telemedicine, hospital-at-home programs.

As a result of these efforts, hospitals reduced turnover for direct care professionals by 28 percent on average, statewide from 2022–2023.

HAP Report: Hospital Workforce Survey, January 2024
HAP Report: Hospital Workforce Survey, January 2024
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Pennsylvania’s Workforce Shortages are Among the Most Severe

There is a national health care workforce shortage but the challenges in Pennsylvania are among the most severe.

A 2021 report ranked Pennsylvania’s shortage of nurses the worst in the nation and the commonwealth’s shortages of nursing support staff and mental health professionals third most severe. Among the commonwealth’s 67 counties, 63 are entirely or partially primary care health professional shortage areas (HPSAs) and 53 are entirely or partially mental health HPSAs.

Infographic showing Pennsylvania's ranking among states for workforce shortages; worst for registered nurses, 3rd worst for mental health professionals, 3rd worst for nursing support staff

Despite improvement over 2022, hospitals continue to experience statewide average vacancy rates of 19 percent for nursing support staff, 14 percent for registered nurses, and more than 10 percent for most direct care positions. Hospitals in rural communities face even greater challenges with average vacancy rates of 28 percent for nursing support staff and 26 percent for registered nurses.

Public Policies Can Help Grow the Workforce

HAP supports public policies that help to grow the commonwealth’s health care workforce. HAP is currently advocating for:

  • Growing the number of nurse educators and training sites by allowing flexibility in educator credentialing requirements, offsetting the earnings disparity between nurses who practice and nurse educators, and investing in nurse preceptors and clinical space.
  • Keeping providers in Pennsylvania by expanding student loan repayment for front-line nurses and primary care providers.
  • Bringing to scale proven programs that grow the health care workforce via partnerships between health care, education, community organizations, and the commonwealth.
  • Recruiting international professionals by increasing administrative staffing for, awareness of, and the number of J1 visas. 

During 2023, HAP—led by its Health Care Talent Task Force—developed comprehensive policy recommendations to serve as a roadmap for growing and supporting Pennsylvania’s health care talent. This roadmap builds on the task force’s initial recommendations issued during January 2020. 
 

HAP A Roadmap for Growing Pennsylvania's Health Care Talent
A Roadmap for Growing Pennsylvania's Health Care Talent
View report | Download report

Hospitals Support Safe Workplaces

Rising violence and abuse are adding to the strain on health care workers. Violence and abuse against health care professionals is never acceptable.

Hospitals are investing in workplace safety to protect employees amid rising violence against health care workers. HAP’s survey found that, during 2023, nearly all hospitals provided staff education on safety protocols (97%), implemented enhanced security measures (95%), provided de-escalation training (95%), and promoted respectful behavior (93%).

HAP supported state reforms enacted during 2020 that made it a felony to assault a health care worker and protected health care workers’ identities by allowing their last names to be omitted from ID badges. At the federal level, HAP supports the SAVE Act, introduced by U.S. Representative Madeleine Dean (D-4), which would make assaulting a health care worker a federal crime and provide grants to help hospitals improve safety.

 

HAP Contacts

For more information, contact Mary Marshall, senior director of workforce & professional development. Media inquiries should be directed to Chris Daley, vice president, strategic communications.

 


HAP News


Hospitals’ Efforts to Grow Workforce Are Reducing Turnover

Survey highlights progress and continued need to address workforce emergency

Harrisburg, PA (January 30, 2024) – Pennsylvania hospitals’ extraordinary efforts to develop, recruit, and retain health professionals helped reduce care team turnover by 28 percent over the past year, according to a report released today by The Hospital and Healthsystem Association of Pennsylvania (HAP).

Nearly all hospitals surveyed reported raising pay, offering flexible work schedules, and partnering with educators to develop the next generation of caregivers. HAP’s November 2023 survey also examined the ways hospitals are evolving care and enhancing staff safety.

Despite significant progress over 2022, hospitals continue to face challenges hiring direct care professionals, with statewide average vacancy rates exceeding 10 percent for most positions. Hospitals reported nearly 1 in 5 nursing support positions (19 percent) was vacant in late 2023 and close to 1 in 7 positions for direct care registered nurses (14 percent). Hospitals in rural communities reported even greater challenges with average vacancy rates of 28 percent for nursing support staff and 26 percent for registered nurses.

Pennsylvania is expected to have the worst shortfall of registered nurses nationally by 2026 and the third-worst shortfalls of nursing support professionals and mental health providers, according to projections from Mercer.

“Pennsylvania hospitals and health systems are leading solutions to attract and keep the caregivers they need to serve their communities today and develop the workforce that will meet a growing need as the commonwealth ages,” said HAP President and CEO Nicole Stallings. “We need comprehensive investments and public policies to build on this momentum and strengthen Pennsylvania’s health care workforce.”

Key findings from HAP’s survey include:

  • 97 percent of hospitals increased base pay, 95 percent offered flexible work schedules, and 89 percent provided professional development and/or tuition reimbursement. Additionally, 56 percent offered sign-on, schedule-based, and/or referral bonuses and 49 percent offered retention bonuses.
  • 39 percent of hospitals provide childcare, compared to fewer than 6 percent of all employers nationwide.
  • 99 percent of hospitals are partnering with community colleges and four-year colleges/universities to develop health care professionals, and 92 percent are working with high schools. More than 50 percent have partnerships with trade/technical schools and/or community organizations.
  • Hospitals are adopting innovative models such as team-based care, virtual nursing, telemedicine, and hospital-at-home programs to better meet the needs of patients, reduce strain on staff, and empower professionals to practice at the top of their licenses. The number of licensed practical nurses providing nursing care as part of team-based care models increased 68 percent from 2020 to 2023.

Detailed survey results and HAP’s workforce policy recommendations are available online.

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