50 things to know about hospital staffing

Early in 2016 there were huge hospital layoffs, but in December hospitals added more than 10,000 jobs. Here are 50 things to know about hospital staffing, culture and nurse leadership salary.

Staffing by the numbers
The following data was gathered from the Bureau of Labor Statistics' Feb. 3, 2017, jobs report.

1. Healthcare added 43,200 jobs in January 2017, with hospitals contributing 10,700 to the total.

2. The healthcare industry added 35,000 jobs per month on average last year.

The following data was gathered from the American Hospital Association "Hospital Statistics" report, 2016 Edition. Full-time and part-time staff averages are for the hospital unit only and do not include separate nursing home units.

3. Average full-time staff for hospitals by size:

• Hospitals with 6 to 24 beds: 98
• Hospitals with 25 to 49 beds: 169
• Hospitals with 50 to 99 beds: 278
• Hospitals with 100 to 199 beds: 637
• Hospitals with 200 to 299 beds: 1,132
• Hospitals with 300 to 399 beds: 1,693
• Hospitals with 400 to 499 beds: 2,479
• Hospitals with 500 or more beds: 4,911

4. Average part-time staff for hospitals by size:

• Hospitals with 6 to 24 beds: 49
• Hospitals with 25 to 49 beds: 77
• Hospitals with 50 to 99 beds: 128
• Hospitals with 100 to 199 beds: 263
• Hospitals with 200 to 299 beds: 425
• Hospitals with 300 to 399 beds: 591
• Hospitals with 400 to 499 beds: 809
• Hospitals with 500 or more beds: 1,303

The following statistics were gathered from Nursing Solutions' "2016 National Healthcare Retention & RN Staffing Report." The report includes data from 138 healthcare facilities gathered in January 2016 reporting on data from the 2015 calendar year. The survey covers 474,545 healthcare workers and 120,630 registered nurses.

5. Hospital staff turnover in 2015 on average: 17.1 percent

6. Bedside RN turnover rate in 2015 on average: 17.2 percent

7. Certified nursing assistant turnover rate in 2015 on average: 23.8 percent

8. Hospital turnover by tenure for all employees:

• Less than one year: 35.6 percent
• One to two years: 20.8 percent
• Two to five years: 19.5 percent
• Five to 10 years: 11.5 percent
• More than 10 years: 12.5 percent

9. Hospital RN turnover by region:

• South central: 19.8 percent
• West: 17.2 percent
• North central: 17 percent
• Southeast: 16.6 percent
• Northeast: 14.6 percent

10. RN vacancy rate in 2016:

• Less than 5 percent: 28.1 percent of respondents
• 5 percent to 7.49 percent: 23.4 percent
• 7.5 percent to 9.9 percent: 15.6 percent
• 10 percent to 12.49 percent: 14.1 percent
• Greater than 12.5 percent: 18.8 percent

11. Average cost of turnover for bedside RN: $37,700 to $58,400 per RN

Hospital culture
The Agency for Healthcare Research and Quality's "Hospital Survey on Patient Safety Culture: 2016 User Comparative Database Report" reflects responses from 447,584 hospital staff members at 680 hospitals across the United States. The survey included questions about staffing, shifts, culture and employee satisfaction.

12. We have enough staff to handle the workload: 51 percent

13. Staff units work longer hours than is best for patient care: 50 percent

14. We use more agency/temporary staff than is best for the patient: 65 percent

15. We work in crisis mode, trying to do too much too quickly: 49 percent

16. Where employees see areas of strength at the hospital:

• Teamwork within units: 82 percent positive
• Supervisor/manager expectations and actions promoting patient safety: 78 percent positive
• Organizational learning/continuous improvement: 73 percent positive

17. The areas with the lowest average positive responses from employees, indicating there may be room for improvement, include:

• Nonpunitive response to error: 45 percent positive
• Handoffs and transitions: 48 percent positive
• Staffing issues: 54 percent positive

18. We are actively taking action to improve patient safety: 84 percent

19. Mistakes have led to positive changes at the hospital: 64 percent

20. After making changes to improve safety, we evaluate their effectiveness: 70 percent

21. Hospital management provides a work climate that promotes patient safety: 81 percent

22. Hospital management shows patient safety is a top priority: 76 percent

23. Hospital management seems interested in patient safety only after an event happens: 61 percent

24. Staff members are given feedback about changes put into place based on errors: 60 percent

25. Staff will speak freely if they see something that negatively affects patient care: 77 percent

26. Staff members feel free to ask questions about the decisions or actions of authority figures: 49 percent

27. Staff are afraid to ask questions when something doesn't go right: 65 percent

28. There is good cooperation among hospital units that must work together: 62 percent

29. Hospital units don't coordinate well with each other: 49 percent

30. It is often unpleasant to work with staff from other hospital units: 63 percent

The following statistics are based on the "Predictive Analytics in Healthcare 2016: Optimizing Nurse Staffing in an Era of Workforce Shortages" report developed by Avantas, an AMN Healthcare company. The survey included responses from 85 nurse managers, finance managers and registered nurses gathered June 30 to July 18, 2016.

31. Scheduling and staffing problems negatively affect overall staff moral, reported 94 percent of nurse managers.

32. Persistent staffing issues made 90 percent of the nurse managers feel underapreciated.

33. Seventy percent of nurse managers were concerned about the effects of nurse scheduling and staffing problems on patient experience and satisfaction.

34. Understaffing was a significant problem for nearly 50 percent of nurse managers.

35. Last-minute schedule changes were the most frequent staffing problem for more than 40 percent of respondents.

36. Twenty-three percent of nurse managers reported not use any nurse scheduling tools at all.

37. Twenty-four percent of nurse managers reported using paper-based staffing tools.

38. Nineteen percent of nurse managers use digital spreadsheets for staffing.

Hospital layoffs in 2016
Here are five of the largest hospital layoffs last year, beginning with the largest layoff in 2016.

39. Greenville (S.C.) Health System announced plans to eliminate 400 positions in March after suffering a $16 million shortfall in the first quarter of 2016.

40. Baystate Health in Springfield, Mass., reported in August it would lay off around 300 people after projecting a $75 million budget shortfall.

41. Chicago-based Presence Health reported it would lay off 250 employees in March and leave another 450 jobs unfilled 2016 after reporting a $186 million operating loss in 2015.

42. Cook County Health and Hospital System in Chicago reported approximately 200 employees would lose their jobs in 2016 after eliminating 320 positions, around 100 of which were already vacant.

43. Ozarks Community Hospital in Springfield, Mo., reported plans to lay off 200 employees in July after closing its surgery and emergency departments.

44. MemorialCare Health System in Fountain Valley, Calif., reported plans to cut 194 jobs as part of the planned closure of Saddleback Memorial – San Clemente (Calif.).

Nurse leadership compensation
The following data is based on the 2016 edition of the American Organization of Nurse Executives' "Salary and Compensation Study for Nurse Leaders" report, which includes 2,541 responses to all or part of the survey. Most of the respondents — 35 percent — were nurse directors; 21 percent were CNOs or chief nurse executives.

Note: Not all of the response areas add up to 100 percent, as percentages were rounded to the nearest whole number and in some cases respondents were able to select more than one response.

45. CNO/CNE salary in a non-system:

• $80,000 to $109,999: 5 percent
• $110,000 to $139,000: 14 percent
• $140,000 to $179,000: 26 percent
• $180,000 to $209,000: 22 percent
• $210,000 to $249,999: 16 percent
• $250,000 or more: 17 percent

46. CNO/CNE salary in a system:

• $70,000 to $109,999: 6 percent
• $110,000 to $139,000: 5 percent
• $140,000 to $179,000: 6 percent
• $180,000 to $209,000: 13 percent
• $210,000 to $249,999: 14 percent
• $250,000 or more: 52 percent

47. Nurse director salary in a health system:

• $60,000 to $99,999: 10 percent
• $100,000 to $119,000: 22 percent
• $120,000 to $139,999: 27 percent
• $140,000 to $159,000: 20 percent
• $160,000 to $189,000: 14 percent
• $190,000 to $219,999: 6 percent

48. Nurse leader (including CNO/CNE, consultant, director, management, president and vice president, professor and dean and specialist and coordinator positions) for acute care hospitals:

• Under $60,000: 1 percent
• $60,000 to $99,999: 20 percent
• $100,000 to $119,000: 18 percent
• $120,000 to $149,000: 21 percent
• $150,000 to $189,000: 18 percent
• $190,000 to $229,999: 13 percent

49. Nurse leader salary at an ambulatory (including CNO/CNE, consultant, director, management, president and vice president, professor and dean and specialist and coordinator positions) care facility:

• $60,000 to $89,999: 25 percent
• $90,000 to $109,999: 29 percent
• $110,000 to $119,999: 19 percent
• $120,000 to $139,999: 10 percent
• $140,000 to $159,999: 3 percent
• $160,000 to $199,999: 12 percent

50. Bonus as a percentage of base salary:

• 1 percent to 2.5 percent: 21 percent
• 2.6 percent to 5 percent: 19 percent
• 5.1 percent to 7.5 percent: 9 percent
• 7.6 percent to 10 percent: 13 percent
• 10.1 percent to 20 percent: 22 percent
• 20.1 percent to 30 percent: 10 percent

More articles on hospitals:
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10 healthcare layoffs in February
Texas hospital files for bankruptcy after $51.4M Aetna loss

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