Nursing Workforce Requirements in California - Educational Capacity Targets

Transcription

1 California RN Workforce: LA and Orange Counties (Regions 8 & 9) Update on the Projected RN Shortage & Setting of Educational Capacity Targets

2 LA & Orange Counties Region 8 and 9 Planning Meeting Welcome, Introductions, and Outcomes Review of Data and Educational targets Discussion

3 Outcomes of Meeting Share outcomes of education capacity target setting process with Deans/Directors and CNOs Begin the dialogue for building regional educational capacity to reach educational capacity targets through strategically driven actions Although state level actions are needed, actions that are going to make long term and enduring differences will occur at the local level driven by local stakeholders

4 California Institute for Nursing & Health Care CINHC is a nonprofit independent organization established to provide a forum to convene diverse groups of stakeholders to address state wide nursing issues that impact the health of Californians.

5 CINHC Program Areas Create a comprehensive and strategically-driven nursing workforce plan for California Build educational capacity Increase diversity of workforce Provide leadership development

6 What CINHC is Doing to Address the RN Shortage Developing a strategic plan to address the shortage Master Plan Sponsoring projects that support building educational capacity BANRC Working with policy makers, key agencies, and associations to address shortage Convening diverse stakeholder groups, serving as a catalyst for action Building a coalition of diverse stakeholders

7 Master Plan Development FOCUSED AREAS: Data Diversity Education Nursing Practice Recruitment Work Environment

8 CINHC Initiatives that Support Regional Planning BANRC CCPS, CFRC, RSC KT Waxman, Nikki West, FCCC partners Education White Paper Jan Boller Faculty Development Project Diane Welch Diversity Plan Bonnie Adams, Barbara Napper Southern California Coordinator Pat Chambers

9 UniHealth Grant 2 year grant which funds CINHC s Southern California Coordinator Serves as a catalyst for regional planning Outcomes Regional planning Flo s Cookie jar

10 Radical actions are required to meet the state s need for nurses Consider this: California is growing with many counties experiencing soaring population growth There were 580 RNs per capita in 2004, CA was ranked 50 th in the nation 1 The current RN population is nearing retirement so replacement needs must be factored average age of the working nurse is 47.7 years 47% of qualified nursing school applicants are not enrolled due to lack of capacity 7

11 California s population forecast is twice the expected RN growth The state s population will expand by 29% over the next twenty years RN workforce growth will only be 13.5% Population Increase 2000 to % 25% 20% 15% 10% 5% 0% All RNs

12 Regional Report Card States RN Jobs/100,000 population Letter Grade/No of States A 2 B 6 C+ 12 C 20 C- 6 D 4 F 0 Number of State Distribution of Grades across the 50 states A B C+ C C- D F Letter Grade

13 California P/MSAs Grades Compared to the States Grades Combined Letter Grade Spread of 50 States and 24 California MSAs and PMSAs States California MSAs and PMSAs A B C+ C C- D F Letter Grade

14 Goal for the California Nursing Workforce NATIONAL AVERAGE 70%: 580 Current/Threshold 90%: 743 Progress Target 100%: 825 Target per 100,000 population 2

15 Target: National Average CA RN Projections Current 90% 100% Note: current is 580; 90% is 743; 100% is 845 RNs employed per 100,000 population

16 Assumptions for Setting Educational Targets Assumes: 1. Utilization rates remain the same 2. Migration rates remain constant 3. Annual graduation rate same as in RN workforce aged 5. Population growth is major variable National Average is benchmark

17 Statewide Shortfall 70% of National Average 580 RNs/100, , , % of National Average 743 RNs/100, , , ,534 Current Ratio of employed RNs = 607/100,000 (per Spetz, best estimate, ) 100% of National Average 825 RNs/100, , , ,512

18 Statewide Short Fall (cont) 2004 RN/100, graduates 6,598 Target national average of 825 RNs/100, population growth 29% 2020 shortfall of RNs - 108,512 Annual increase to meet 2020 demand 7,234 % increase of educational capacity to meet 2020 demand 110%

19 The RN disparity presents greater challenges for some due to population growth Region 8 (LA) averages 14.5% growth but Ventura forcast is 22.5% Region 9 is forcast at 41%. Orange 23.5%, Riverside 72%, San Bernadino 43% 80% 60% 40% 20% 0% Population Growth 2000 to 2020: CA and select regions 2 Population CA Region 8 Region 9 LA/Long Beach Ventura Orange Riverside San Bernadino

20 Region 8 & 9 RN Workforce Projected Annual RN needs through EDD 3 At current RN per capita rate: 2569 new RNs are needed each year for LA County 701 new RNs for Orange County 135 new RNs for Ventura County Area % Change Growth Needs Replacement Needs Total Los Angeles Orange Ventura San Berna Unavailable Riverside Unavailable Source: Occupational Projections of Employment-Registered Nurses California LaborMarketInfo, Data Library

21 LA/Orange Counties RN Workforce Report Card CINHC 4 Regional grade range from C- to F P/MSA RN jobs/ Grade National average was 787 California average 622 the most common grade was D Los Angeles/ Long Beach Orange Cnty 100, C- D Report Card infers that region is between 60 to 70% of the national average Ventura Riverside/SB F D

22 Region 8 & 9 RN Workforce National Average Target Currently utilizing RNs at 70% of National Average, Region 8 (LA/Ventura) shortfall of RN is 6,369 Region 9 (Orange County/Riverside/SB) had an excess at 70% of 2,463 but with a pattern of commuting nurses into LA To maintain current utilization rate Region 8 will need: 4,380 more RNs in Reg 9 3,456 more RNs in Reg 9 At the national average 2005 Reg 8.-33,483 Reg 9-14, Reg 8-32,345 Reg 9-17, Reg 8-32,625 Reg 9-23,445

23 Consider Educational Capacity To meet National Average Target Additional graduates needed each year to catch up to targets by % of Natl Avg. (Current State) # % 100% Natl Avg. (Target) # % Region 8: % % LA/Ventura Region 9: % % Orange, Riverside San Bernadino

24 Considerations for Setting Regional Targets Population growth Demographics of population Healthcare delivery system Insured/uninsured population Nursing educational capacity Undocumented residents Age of nursing workforce Mandated staffing ratios Other?

25 LA RN Workforce 2005/ Hospital Survey HASC/CINHC 5 Participants Average vacancy rate Turnover rate New graduate retention: at 6 months at 12 months at 2 years Foreign recruitment engaged in foreign recruitment considering Region 8 Region 9 State Avg % 14% 12% 8% 13% 9.4% 63% 61% 71% 61% 82% 72% 47% 47% 57% 26% 18% 35% 11% Source: HASC/CINHC 2005 Report: Building Education/Service Partnerships, Hospital Study 2005

26 Current LA/Orange RN Workforce BRN % of RNs are already in the workforce 30% of RNs are >55 years old 56% White, 8% Hispanic, 27% Asian, and 5% Black 93% Female 30% have BSN, 48% ADN, 21% Diploma and <1% EML as initial education 7% have MSN, 36% BS, 65% ADN or Diploma as highest education 55% were educated in CA, 22% other states, and 23% were educated outside the US Source: CA BRN 2004 Workforce Data

27 LA/Orange County Current Workforce (cont) In the Southern California Region: 75% of RNs work at least 33 hours per week 63% work in acute care hospitals 16% work in out of hosp settings 4% work in skilled and extended care settings In the next 5 years: 22% plan to reduce their hours 12% plan to retire 4% plan to leave nursing

28 LA/Ventura Educational Capacity BRN 2005 ELM, 3 There were 31 prelicensure programs Number of graduates in 2005: 1,826 ADN 1,467 BSN ELM - 0 Accl BSN, 4 BSN, 5 Accl AD, 1 LVN/AD, 1 AD, 21 Source: CA BRN 2004/05 School Data

29 Orange, Riverside, San Bernadino Educational Capacity BRN 2005 There were 13 prelicensure programs Number of graduates in 2005: 999 ADN BSN BSN, 1 Accl BSN, 1 ELM, 0 AD, 11 Source: CA BRN 2004/05 School Data

30 LA, Ventura Applicant Success Prelicensure Applicants Qualified Applicants Enrolled Applicants Success Rate # # % Generic ADN % BSN % ELM % Total % Source: CA BRN 2004/05 School Data

31 Orange, Riverside, San Bernadino Applicant Success Prelicensure Applicants Qualified Applicants Enrolled Applicants Success Rate # # % Generic ADN % BSN % ELM - - -% Total % Source: CA BRN 2004/05 School Data

32 Region 8: LA, Ventura Student Retention Rate Students ADN BSN ELM* Total scheduled to complete 04/ % % na % Student dropped out % 39 10% na % Students completed on schedule % % na % Completed Behind sched.-began prev yrs na 223 na Total Completions** 1467 % 369 % na 1826 % Attrition Rate 35% 17% 32% *ELM did not report **Scheduled completions plus those behind schedule from previous years Source: CA BRN Schools Data

33 Region 9: Orange, Riverside, SB Student Retention Rate ADN BSN Total Students scheduled to complete 04/ % % % Student dropped out % 20 12% % Students completed on schedule % % % Completed Behind sched -began prev yrs na Total Completions* 862 % 137 % 999 % Attrition Rate 28% 38% 29% * Scheduled completions plus those behind schedule from previous years Source: CA BRN Schools Data

34 Regional Planning Challenges What drives area s demand for RNs? Including nonacute care hospital demands? What should be region s target for RNs employed/capita? Is C grade appropriate for Area? Or should it be lower or higher? What impact will increase retention in nursing programs and NCLEX success have on increasing RNs into workforce? What impact will increase retention in workplace have on RNs available? What should the region s educational capacity be to reach workforce targets? How will education be transformed to reach capacity targets?

35 Next Steps Convene representative subcommittee to craft a document that would meet the agreed upon targets meet on regularly scheduled basis Begin dialogue on how to strategically meet regional targets for educational capacity develop a regional strategic plan Determine actions best addressed at regional and/or state level Determine actions addressed at local level Build a profile of each school and identify schools specific strategies

36 Contact Information Pat Chambers RN,BSN,MBA Regional Coordinator/Southern California California Institute for Nursing & Healthcare 515 South Figueroa, Suite 1300 Los Angeles,Ca

37 Sources 1. March 2004: Preliminary Findings from the National Sample Survey Of Registered Nurses. HRSA. 2. State of California Dept. of Finance Census & Spetz, J. Regional Forecasts of the Registered Nurse Workforce in California, SF: UCSF Center for California Health Workforce Studies, Center for the health Professions, August. 3. Occupational Projections of Employment-Registered Nurses California LaborMarketInfo, Data Library 4. CINHC Regional Report Card, May 5. HASC/CINHC 2005 Report: Building Education/Service Partnerships, Hospital Study Spetz, J. Ibid 7. BRN Workforce Data 2004 Survey of Registered Nurses BRN Nursing Education Program Survey Report