Workflow efficiency takes on new importance as hospitals struggle with staffing shortages.

Public Health

What’s the Toll of Nurse Turnover on Hospital Finances, Patient Care and Workflow?

"When we consider the average age of nurses and the anticipated wave of retirements about to break, we need to keep in mind that some specialties will be impacted at a quicker pace."

Hospital nurse turnover is expensive.

It cost the average hospital as much as $10.5 million in 2022, and that’s with a nearly 5 percent decrease in  turnover from the prior year, according to estimates from NSI Nursing Solutions in its 2023 NSI National Health Care Retention & RN Staffing Report.

Historically, RN turnover has been lower than the overall hospital staff average, but 2021 changed all that. The turnover rate for all staff RNs was 27.1 percent in 2021, up more than 8 percent over the 18.7 percent rate in 2020, according to NSI, a nurse recruitment and retention firm.

Critical care, emergency services and medical/surgical departments were among those seeing even more turnover than the national average.

"When we consider the average age of nurses and the anticipated wave of retirements about to break, we need to keep in mind that some specialties will be impacted at a quicker pace," the report says. "This is particularly true for surgical services, behavioral health and women's health."

The Advisory Board, a global consulting firm, analyzed NSI’s findings (illustrated with several compelling charts) and noted that while the data show areas of progress, especially overall workforce and RN turnover declines, there are still key challenges. Those include the increased time it takes to fill nurse vacancies.

Those high turnover rates and staffing shortages also can lead to challenges when it comes to patient care.

For instance, there is a 15 percent higher risk of patient infection in hospital units that are understaffed, according to a report in NurseJournal. RN turnover is financially costly for hospitals, averaging about $52,350 for a bedside RN in 2022. For every percent that the average hospital can reduce its RN turnover, they can save $380,600 annually, according to NSI’s findings.

And as hospitals everywhere try to do more with fewer people, demands for new workflow efficiencies take on greater importance. Healthcare staff shortages, while not new, have spawned a world today where it can take hours to get an X-ray or pain medication for an injury.

Throughout the global COVID-19 pandemic, hospitals implemented innovative approaches to soften staffing shortages, from aggressive recruiting programs to bonuses. Labor shortfalls impacted medical device companies, as well, by dragging down procedure volumes at a time when the U.S. and other countries were getting better at managing novel coronavirus surges.

In response, medical device companies got innovative: Endoscopy companies, for example, have been touting single-use scopes as a tool to address staffing shortages. Flexible bronchoscopes and cystoscopes, made by companies such as Boston Scientific Corp. and Ambu A/S, are always available and are sterile straight from the pack.

This means that, unlike traditional endoscopes, they don’t require extensive staffing or training — for preparation, transport, reprocessing, and often direct procedure support. They can be simply used once and discarded.

The nursing shortage is not going away anytime soon. The U.S. Bureau of Labor Statistics projects job openings for about 203,200 nurses each year through 2031. Also, the American Association of Medical Colleges (AAMC) predicts a shortage of up to 122,000 physicians by 2032.

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