Toolkit: Immediate Strategies to Improve Nurse Staffing

The Nurse Staffing Think Tank – a diverse group of front-line nurses, nursing leaders and other key stakeholders including  patient safety representative, CEO, CFO and Human Resources – has published a set of priorities and recommendations that provide immediate strategies that can be feasibly implemented in the short term (12-18 months) to help address the nurse staffing crisis.

The Think Tank was launched by Partners for Nurse Staffing, a collaboration between the American Association of Critical-Care Nurses (AACN), American Nurses Association (ANA), American Organization for Nursing Leadership (AONL), Healthcare Financial Management Association (HFMA) and the Institute for Healthcare Improvement (IHI).

Appropriate nurse staffing has been a challenge for decades. Nurses, policy-makers, and health care leaders have used various approaches to meet the increasing demand to ensure safe, quality patient care and nurse satisfaction, but consistent, effective solutions have remained elusive. The COVID-19 pandemic magnified these challenges and generated new barriers to appropriate staffing.

The Think Tank convened six times between January and March 2022 to tackle a wide range of issues related to the nurse staffing crisis. Major topics included the impact of the COVID-19 pandemic on nursing, and the importance of trust and transparency to build healthy work environments. Members also discussed the connection between nurses’ well-being and staff retention, along with the best ways to utilize scheduling flexibility, compensation, and delivery models, among other topics.

“The COVID-19 pandemic has placed a spotlight on the value of nurses, and the nursing workforce,” said ANA Director of Nursing Programs Katie Boston-Leary, PhD, MBA, MHA, RN, NEA-BC. “At the same time, it has accelerated a persistent staffing shortage that has plagued the profession for decades toward a crisis. Without swift and sufficient action, the nation’s nurses, patients, and communities will continue to suffer.”

“Addressing workforce challenges is the top priority in health care. We can’t provide health care and services to our communities without our workforce,” said AONL CEO Robyn Begley, DNP, RN, NEA-BC. “Bringing together those who deliver care and those who ensure sustainability of care delivery is critical to developing outcomes-based staffing models, improving value and fostering a healthy practice environment to engage nurses and support resilience and well-being.”

Demand for health services continues to rise. Addressing nurse staffing at health care organizations is critical to manage these needs. An established body of evidence shows that appropriate nurse staffing is correlated with improved patient outcomes and greater satisfaction for both patients and staff.

“Healthcare is a human business. Hospitals can add all the rooms, beds and equipment they want, but none of that matters without nurses there to take care of sick patients,” said AACN President Beth Wathen, MSN, RN, CCRN-K. “For years, usual and accepted staffing models have viewed nursing as an expense, not an investment. And yet, there is ample evidence that links appropriate nurse staffing with optimized nursing care and improved patient outcomes.” 

At the conclusion of its work, the Think Tank developed actionable and immediate strategies for acute and critical care practice settings that address the nurse staffing crisis. The team identified six priority areas that need urgent action:

  1. Healthy work environment
  2. Diversity, equity and inclusion
  3. Work schedule flexibility
  4. Stress injury continuum
  5. Innovative care delivery models
  6. Total compensation 

The recommendations, actions and measurable outcomes for implementing each priority are now available on the Nurse Staffing Think Tank web page for health care leaders to access.

Insights from the Think Tank will help guide the efforts of the newly formed Nurse Staffing Task Force, which launched this month. In this next phase of work, the task force will focus specifically on driving a powerful dialogue on a national scale to develop mid-range to long-term sustainable solutions to the nurse staffing crisis. The task force brings together health care leaders, nurses, patient advocates, and representatives from numerous organizations, associations, and entities that are highly impacted and will provide evidence and insight on the nurse staffing crisis.

“HFMA shares in the Partners for Nurse Staffing’s commitment to identifying sustainable solutions to the nurse staffing shortage,” said HFMA President and CEO Joseph J. Fifer, FHFMA, CPA. “This group is well equipped to drive actionable solutions, which are urgently needed.”

“Health care has experienced setbacks in safety performance in safety culture scores, hospital-acquired infections, patient falls, pressure injuries, and workforce illnesses and injuries throughout the pandemic,” said Patricia McGaffigan, vice president of safety programs at IHI. “It’s imperative that health care organizations reinvigorate their focus on patient and workforce safety and ensure that nurses are codesigning care and staffing models that enable the best nursing care possible in the healthiest of work environments.”

Appropriate nurse staffing levels are crucial to optimize the quality of patient care, improve care outcomes, sustain the nursing workforce, and improve the work environment. Learn more about the Nurse Staffing Think Tank and Task Force.

 

About the American Association of Critical-Care Nurses For more than 50 years, the American Association of Critical-Care Nurses (AACN) has been dedicated to acute and critical care nursing excellence. The organization’s vision is to create a healthcare system driven by the needs of patients and their families in which acute and critical care nurses make their optimal contribution. AACN is the world’s largest specialty nursing organization, with more than 130,000 members and over 200 chapters in the United States.

About the American Nurses Association The American Nurses Association (ANA) is the premier organization representing the interests of the nation’s 4.3 million registered nurses. ANA advances the nursing profession by fostering high standards of nursing practice, promoting a safe and ethical work environment, bolstering the health and wellness of nurses, and advocating on health care issues that affect nurses and the public. ANA is at the forefront of improving the quality of health care for all. 

About the American Organization for Nursing Leadership As the national professional organization of more than 11,000 nurse leaders, the American Organization for Nursing Leadership (AONL) is the voice of nursing leadership. Our membership encompasses nurse leaders working in hospitals, health systems, academia and other care settings across the care continuum. Since 1967, the organization has led the field of nursing leadership through professional development, advocacy and research that advances nursing leadership practice and patient care. AONL is a subsidiary of the American Hospital Association. For more information, visit AONL.org.

About the Healthcare Financial Management Association The Healthcare Financial Management Association (HFMA) equips its more than 87,000 members nationwide to navigate a complex healthcare landscape. Finance professionals in the full range of work settings, including hospitals, health systems, physician practices and health plans, trust HFMA to provide the guidance and tools to help them lead their organizations, and the industry, forward. HFMA is a not-for-profit, nonpartisan organization that advances healthcare by collaborating with other key stakeholders to address industry challenges and providing guidance, education, practical tools and solutions, and thought leadership. We lead the financial management of healthcare. For more information, visit hfma.org.

About the Institute for Healthcare Improvement The Institute for Healthcare Improvement (IHI) is an independent not-for-profit organization based in Boston, Massachusetts, USA. For 30 years, IHI has used improvement science to advance and sustain better outcomes in health and health systems across the world. IHI brings awareness of safety and quality to millions, catalyzes learning and the systematic improvement of care, develops solutions to previously intractable challenges, and mobilizes health systems, communities, regions, and nations to reduce harm and deaths. IHI collaborates with a growing community to spark bold, inventive ways to improve the health of individuals and populations. IHI generates optimism, harvests fresh ideas, and supports anyone, anywhere who wants to profoundly change health and health care for the better. Learn more at ihi.org.

withyou android app