Becker's Hospital Review

26 CMO / CARE DELIVERY The cost of nurse turnover in 24 numbers | 2024 By Molly Gamble N urse shortages and mounting labor costs are among health system CEOs' top concerns, and a new survey puts numbers to the financial risks hospitals face from nurse vacancies and churn. e 2024 NSI National Health Care Retention & RN Staffing Report features input from 400 hospitals in 36 states on registered nurse turnover, retention, vacancy rates, recruitment metrics and staffing strategies. It found the average cost of turnover for one staff RN grew from January through December 2023 to $56,300, among other dollar figures and statistics that are helpful to understand the financial implications of one of healthcare's most challenging labor disruptions. Here are 24 numbers that illustrate the cost of nurse turnover, according to the most recent edition of the report, which is available in full here. 1. e turnover rate for staff RNs decreased by 4.6% in 2023, resulting in a national average of 18.4%. Given varying bed size, RN turnover can range from 5.6% to 38.8%. 2. e average cost of turnover for a staff RN increased by 7.5% in the past year to $56,300, with a range of $45,100 to $67,500. is is up from the average cost of turnover for an RN in 2022, which was $52,350. 3. Each percent change in RN turnover stands to cost or save the average hospital $262,500 per year. 4. e RN vacancy rate sits at 9.9% nationally. is marks an improvement, as hospitals hired an additional 153,000 RNs in 2023 and lowered the vacancy rate by 5.8%. 5. e average time to recruit an experienced RN ranges from 59 to 109 days, with the average for 2023 sitting at 86 days — nine days quicker than the year prior. 7. Every region represented in the 2024 report recorded a decrease to RN turnover, ranging from -1% to -5.1%. e South Central region saw the high end of this range while the North Central region saw the low end. 8. Over the past five years, RNs in step down, emergency services, and telemetry were most mobile with a cumulative turnover rate between 112% and 119%. "Essentially, these departments will turn over their entire RN staff in less than four and a half years," the report states. 9. RNs in pediatrics, surgical services, and women's health were less mobile, with 2023 turnover rates of 13.3%, 15.4% and 16.3%, respectively. n Hospitals' safety culture gap By Mackenzie Bean H ealthcare workers' perceptions of safety at their organizations is improving, though a gap still remains between senior leaders and front-line workers, according to an April 2 Press Ganey report. Press Ganey surveyed more than 1 million employees from 200 health systems in 2023. The poll included 19 questions related to safety culture across three domains: prevention and reporting, pride and reputation, and resources and teamwork. Three takeaways: 1. Staff safety culture scores have risen from an all- time low of 3.96 (out of 5) in 2021 to 4.01 in 2023. This increase was largely driven by improvements around staff members' perceptions of resources and teamwork, including views on adequate unit staffing. "While these improvements are encouraging, there's still a lot of work to do," Press Ganey said. "Pre- pandemic rates were never the desired end state, and it's important to note that nearly half (48.5%) of employees still have a low perception of safety culture." 2. Senior management reported the highest perceptions of safety culture at 4.53, while registered nurses and advanced practice providers reported the second- and third-lowest at 3.95 and 3.92, respectively. Security team members had the lowest perceptions of safety at 3.91. 3. A large gap was also seen between senior leaders and registered nurses regarding perceptions of workplace violence protections. Senior management gave their organizations a 4.30 out of 5 for having strong security measures in place to prevent violence, compared to just 3.36 for nurses. "This gap is particularly concerning given that nearly a third (29%) of RNs report experiencing violence 'occasionally' or 'frequently' from patients or patients' family members," Press Ganey said. n

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