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Survey Sheds Light on Health Care Workforce Needs

Pa. hospitals report increased vacancy and turnover rates for clinical staff

February 21, 2022

The COVID-19 pandemic accelerated the health care workforce shortage in Pennsylvania, making it even more challenging for hospitals to fill needed clinical staff positions, a HAP survey of Pennsylvania hospitals found.

Results of the survey, conducted late last year, are summarized in an executive summary report released today, Addressing Member Hospital Workforce Needs. The report is intended to inform public discussions about strengthening the health care workforce and help to support HAP’s advocacy in this area.

The findings demonstrate how the severity of hospitals’ workforce challenges increased from 2019 to 2021. Key findings include:

  • Vacancy and turnover rates are increasing:  The survey found vacancy and turnover rates have increased since 2019 among many areas of clinical staff. Responding hospitals reported average 2021 vacancy rates of:
    • 27 percent for staff registered nurses providing direct patient care, compared with 21 percent for 2019
    • 32 percent for clinical nurse specialists, compared with 15 percent for 2019
    • 45 percent for nursing support staff, compared with 32 percent for 2019
  • Hospitals face challenges hiring key staff:  Despite offering incentives and taking other measures to retain and recruit staff, hospitals face significant barriers hiring needed clinicians. Among responding hospitals:
    • 66 percent identified offering recruitment and retention bonuses and incentives as their top strategy for recruiting and retaining staff
    • 90 percent reported that finding qualified candidates is their top barrier to hiring needed staff
    • Emergency departments and medical-surgical units were identified as the top areas of clinical staff need
  • Staffing agency costs and use increased sharply:  Hospitals reported relying more heavily on temporary staffing agencies to fill needed positions and experiencing skyrocketing costs for contracting temporary staff. Responding hospitals reported that, on average, since 2019:
    • Hourly rates paid to staffing agencies for registered nurses providing direct patient care in medical/surgical and other units have increased by 108 percent from $59 per hour to $123 per hour while the average number of shifts per day worked by temporary staff increased from five to 11
    • Hourly rates paid to staffing agencies for registered nurses providing direct patient care in specialty units have increased by 82 percent from $66 per hour to $120 per hour while the average number of shifts per day worked by temporary staff increased from four to nine
    • Hourly rates paid to staffing agencies for nursing support staff have increased by 444 percent from $9 per hour to $49 per hour while the average number of shifts per day worked by temporary nursing support staff increased from three to five

Supporting and strengthening Pennsylvania’s health care workforce is among HAP’s top advocacy priorities. HAP’s Health Care Talent Task Force issued a report in 2020 with recommendations for addressing the shortage in clinical staff.

The executive summary of HAP’s survey is available online.



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