Predicting the Nursing Workforce Supply and Demand in Northeast Ohio, Building a Better Mousetrap. NE Ohio Background & Need.

Transcription

1 The Center for Health Affairs workforce initiative, NEONI Predicting the Nursing Workforce Supply and Demand in Northeast Ohio, Building a Better Mousetrap Lisa Anderson, MSN, RN, The Center for Health Affairs/NEONI Patricia J. Cirillo, Ph.D., Cypress Research Group National The Conference Center for of Health Nursing Affairs Workforce workforce Centers initiative, June 2012NEONI. NE Ohio Background & Need Conducted a series of studies since 2001 snapshots describing the current nursing workforce (size and type) and the nursing educational system (size and type). Nagging problems were: Data was not dynamic, slice in time Trends could only be roughly predicted And There s More Employers told us in real time if they were having difficulty filling open nurse positions. We lacked the ability to predict what the employers (and the nurse workforce) would face in the near or distant future. Large events (e.g., the 2008 financial crisis) resulted in predictable changes in the demand for nurses. Is there better a way to know if a shortage OR a surplus is around the corner? 1

2 Building the NEONI Forecast Tool Followed a lead for the CAN DO tool in MA Developed economist & statistician consulting team Reallocated unspent grant funds to cover project costs Basic Info Needed for Model How do we define region? What geography do we want to model? Current size of workforce By specialty and setting Current size and demographics of population served Our Particular Data Journey Yours Could Be Very Different Survey of NE Ohio hospitals Current nursing workforce levels Survey of NE Ohio nursing programs Capacity Ohio State Board of Nursing Data for RN's and LPN's licensed in the State of Ohio Size and characteristics (age, etc.) of workforce The Center s Volume Statistics Data, U.S. Census Intensity factors Population statistics Hospital Annual Reports Strategic Plans 2

3 Deliverables Report of regionwide demand for nurses (by type) in the next decade, using certain assumptions. Dynamic model, which allows users to manipulate those assumptions and see the impact on demand for nurses. User Support to assist in working with model. Model updates as fresh data (e.g., Census 2010) are made available. What Drives Demand? The size of the population served Norms for the region ex. healthcare workertopatient unit of care (intensity factors) The age and gender of the population The opportunities for treatment available in region The proportion of urban population The cost of medical care for the patient The disposable income of the population Modeling Demand Demand for HEALTHCARE in major care categories Age and Gender distribution of population over time Urban versus NonUrban Other Hospital inpatient Emergency Visits Nurse Education Healthcare Settings Ambulatory Care Demand for NURSING FTE nurses needed to meet each healthcare category intensity factors Public Health Home Health Nursing Facilities 3

4 Intensity Factors The number of nurses needed per unit of care in each healthcare setting They are based on surveys of various types of health care organizations The estimated number of units of care times the intensity factor equals FTE nurses demanded Modeling Supply Data on graduation and licensure We take into account things like aging nurses working fewer hours Projections also utilize annual data: Assumption of nurses recruited into the region Assumption of nurses leaving the profession and leaving to take other jobs Assumption of nurses leaving the region 11 Is a Shortage of Nurses Likely in Northeast Ohio? Time Frame is 2010 through 2020 Estimated Annual Demand for Nurses Estimated Annual Supply of Nurses Shortage = Demand Supply 4

5 Is a Shortage of Nurses Likely in Northeast Ohio? 55,000 50,000 45,000 40,000 NEO: Regional Supply Of and Demand For of RN's Demand Baseline New Grads Recruits Start to see shortage Shortage is Acute 35,000 30,000 40,513 41,220 41,634 42,064 42,453 42,811 43,093 43,294 43,501 43,682 43,906 25,000 Scenario 1 What if What if we change intensity factors for nurses in hospitals? A 10% increase in the intensity factory (# of nurses needed for each unit of care) for just hospitals, we would need 4% more nurses in the region overall. 46,000 44,000 42,000 40,000 38,000 36,000 34,000 32,000 30,000 Baseline Demand for RNs If we increase the intensity factor in hospitals by 10% If we decrease the intensity factor in hospitals by 10% 4% more or 1,700 RNs Scenario 2 What if What if we increase/decrease the number of ER visits? Little impact on overall demand for RNs 44,000 42,000 40,000 38,000 36,000 34,000 32,000 Baseline Demand for RNs If we increase the # of ER visits by 10% If we decrease the # of ER visits by 10% 30,000 5

6 Scenario 3 What if What if.we increase/decrease the number of hospital days? A 10% decrease in the # of regional hospital days result in a decrease in the need for RNs by 18%. 45,000 43,000 41,000 39,000 37,000 35,000 33,000 31,000 29,000 27,000 25,000 Baseline Demand for RNs If we increase the number of hospital days by 10% If we decrease the # of hospital days by 10% 18% less or 7,000 RNs Scenario 4 What if What if.nurses did not decrease hours worked as they age, or the great majority worked fulltime? We can t expect significant relief once RNs return to their typical pattern of working PT once they turn 55. However, if a great majority of RNs worked fulltime throughout their careers, a shortage would be greatly alleviated If 85% of all RNs work full-time If we increase the number of RNs who go to part-time at age 55 by 10% Scenario 5 What if What if.we train more new nurses? Recruit nurses into the region? Both would help, but to alleviate a 10% shortage would require a massive increase in the # of nurses trained and recruited into the region Baseline Supply for RNs If we increase the number of RNs graduates by 10% from current levels If we recruit 500 new RNs into the region in the first year

7 Scenario 6 What if What if we trained enough RNs to meet the demand? In order to meet the demand for RNs in our region over the next 8 years, our schools would need to educate from 38% to 108% more RNs each year. Year % Increase RN Grads 2010 No change 2011 No change % more grads % more grads % more grads % more grads % more grads % more grads % more grads % more grads % more grads Scenario 7 What if What if we decreased intensity factors in hospitals to a level where the demand for RNs would be met in the entire region? In order to meet the demand for RNs in our region over the next 8 years, the intensity factor for the hospitals would need to drop from 7.0 to 4.3. Year Change in Intensity Factor Hospital Setting How Will Other Trends Affect Future Demand for Nursing? National Healthcare Reform will increase demand how much? Will LongTerm Care play a greater role in subacute care and therapy? Will the major medical institutions expand? Import more patients? 7

8 The Big Picture Evaluate Policy Alternatives How large an increase in nurses is really necessary, what types of nurses, and when? Which changes in policy will have the desired impact on the future supply of nurses at the least cost? What are the tradeoffs between the quantity of care needed and the quality of care provided? What if.? Additional Questions Please contact: Lisa Anderson, MSN, RN The Center for Health Affairs/NEONI Patricia J. Cirillo, Ph.D. Cypress Research Group Learn More about NEONI: Visit NEONI s website at Like NEONI on by searching NEONI Workforce Initiative for the latest information. 8