How Florida Hospitals Cut Nurse Vacancy, Turnover By 38%

                                                               By Mariah Taylor

Florida has seen a 38% reduction in nurse vacancy and turnover rates in the last year, and five hospital strategies are emerging as particularly most effective.

The Florida Hospital Association has been tracking information on retention and vacancy since the 1990s. In August, the association published its annual workforce report. It found the turnover rate dropped by 12% in a year, and hospitals reported many nurses returning to their old jobs.

Here were the strategies that hospitals said worked:

-98% were offering pay incentives.

-90% were exploring flexible staffing.

-88% were implementing apprenticeships and mentor programs.

-80% are using nurse residency programs.

-80% offer earn-as-you-learn programs.

Mary Mayhew, president and CEO of the Florida Hospital Association, said recently that hospitals inform her their numbers are continuing to improve. Hospitals have also been seeing better results after "intensifying their focus on reinforcing to their staff that they are valued, they are appreciated, they are respected. Hospitals also communicate in a timely way to ensure everyone understands the mission and the vision, and they feel connected to it. That, for any organization, is fundamental."

Data and tending analysis, especially around vacancy and turnover, can identify which strategies are moving the needle.

"In any organization, you got to be careful that you're not trying to support 15 different initiatives and strategies," she said. "If we use employee satisfaction surveys, focus groups and town halls, we can gain more clarity around the strategies that make the biggest impact in vacancy and retention rates."

New programs that tip the scale

Hospitals are relying on proven strategies and new programs to continue to improve their staffing.

For example, Ms. Mayhew said many hospitals are launching apprenticeship programs and leveraging technology to make nurse workflow easier. They are also using smaller changes to create a big impact.

In one hospital, staff photos with their name and title are hung on a whiteboard for patients and staff to find easily. Another hospital is utilizing artificial intelligence like Alexa and Siri so patients can make requests from their rooms. Hospitals are also optimizing electronic health records and reducing administrative burden.

And many hospitals are utilizing virtual nursing to keep veteran nurses from retiring early. Remote monitoring opportunities are less stressful than bedside care and allow hospitals to maintain continuity of care for patients. It also allows longtime staff to support new nurses, Ms. Meyhew said.

"I think it's important for hospitals to recognize the amount of work and effort that have gone into various strategies," she said. "Sometimes they're too close to it and they need to take a step back to see the magnitude of effort. One hospital CEO told me, 'You know, we've been in a war room-type approach to addressing our shortages, vacancies and turnover rates. We've been brainstorming with a sense of urgency and reimagining, rethinking the way we build our team.' I would say, since the last survey, have the numbers continued to improve?"

Strengthening the pipeline

Hospitals are also doubling down on "creative programming" and partnerships with local colleges and university systems to create flexible career pathways, Ms. Mayhew said. These pathways make it easier for new nurses to begin working at hospitals.

The association holds quarterly meetings with nursing schools to hear concerns and what is working. That information is used to expand educational capacity for nursing across the state and get more nurses graduated, she said, but building capacity is a two-way street.

"We cannot expect nursing schools to be building additional capacity if we're not sharing timely data and information with them," she said. "As hospitals think about demographic changes in their community and the demand increases, they need to know how many more nurses to hire in two years from now. That information needs to be shared with schools so they can anticipate and plan as well."

Florida is forecast to have a nurse shortage of nearly 60,000 in 2035, Ms. Mayhew said.

"We began to improve the pipeline and the capacity and the Legislature immediately responded. A matching grant program was developed which, to date, includes 143 hospitals. The state provides a certain amount of funding to local nursing schools which hospitals match. That has been extremely successful, and the Legislature is increasing funding in their budget for next year."