Ohio RN Work Migration Patterns

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1 Ohio RN Work Migration Patterns Patricia Cirillo, PhD, VP Initiatives & Analytics National Forum of State Nursing Workforce Centers 2016 Annual Conference Serving Northeast Ohio Hospitals for 100 years neohospitals.org

2 Outline The Center for Health Affairs: Why focus on nursing workforce? Our strategies to ensure our region has the nurse workforce it needs Nurse pipeline: Defining it, tracking it, feeding it and unclogging it.

3 The Center for Health Affairs Initiatives

4 The Center for Health Affairs Mission To enhance the effectiveness of the healthcare community and the health of the communities it serves by providing expertise, resources and solutions to address the challenges faced by the region s healthcare providers.

5 The Center s Initiatives As the leading advocate for Northeast Ohio hospitals, The Center aims to enhance the effectiveness of the healthcare community and the health of the communities it serves by providing expertise, resources and solutions to address the challenges faced by the region's healthcare providers. NEONI, Workforce prep2practice TM ACEMAPP Nursing Forecaster PERQS Center Liaison Grant Funds Communication Equipment Training Wage Index Regional Volume Statistics Key Indicators Report Custom Reporting Issue Briefs Policy Snapshots Economic Impact Educating Legislators The Foundation Behavioral Health Community Health Needs Assessments Community Initiatives Healthcare Workforce Emergency Preparedness Finance & Reimbursement Policy & Advocacy Community Outreach The Center has a long history in workforce development, especially for nurses.

6 The Center s Membership Ashtabula County Medical Center Cleveland Clinic Health System o Cleveland Clinic o Cleveland Clinic Children s Hospital for Rehabilitation o Euclid Hospital o Fairview Hospital o Hillcrest Hospital o Lakewood Hospital o Lutheran Hospital o Marymount Hospital o Medina Hospital o South Pointe Hospital Grace Hospital Lake Hospital System o LakeWest Medical Center o TriPoint Medical Center Louis Stokes, Cleveland VA Medical Center o Louis Stokes, Cleveland VA Medical Center - Cleveland Mercy Health o Mercy Allen Hospital o Mercy Regional Medical Center MetroHealth System o MetroHealth Medical Center Sisters of Charity Health System o St. Vincent Charity Medical Center Southwest General Health Center Specialty Hospital of Lorain University Hospitals o Ahuja Medical Center o Ashland Medical Center o Bedford Medical Center o Case Medical Center o Conneaut Medical Center o Elyria Medical Center o Geauga Medical Center o Geneva Medical Center o MacDonald Women s Hospital o Parma Medical Center o Portage Medical Center o Rainbow Babies and Children s Hospital o Richmond Medical Center o Seidman Cancer Center o St. John Medical Center

7 NEONI Healthcare Workforce Brings nursing leaders, clinical agencies, educators and organizations together to address and seek solutions for healthcare workforce issues in Northeast Ohio. Define & Track Nurse Pipeline NEONI Membership 200+ members Fall Conference Nursing Leadership Event Legislative Updates Grants NEONI PERQS Center Practice Education Research Quality and Safety Share knowledge and best practices NEONI Nursing Forecaster Predictive Tool Nursing Supply & Demand Access future workforce needs

8 Career & Clinical Placement Build Nurse Pipeline prep2practice Online tool matches students with local healthcare career shadowing experiences 58 high schools, 11 hospitals expand to adults and offer experiences/internships in business sectors (IT and manufacturing) Moving to a student-fee based program Unclog Nurse Pipeline ACEMAPP Online pre-licensure nursing clinical training placement program since 2006 Fee-based for hospitals, schools and students 19 schools, 38 hospitals and 4,100 students Pilot program underway with CSU-NEOMED medical students

9 Nurse Forecaster

10 The Center s Workforce Focus Truly going all in on nurse workforce o Recognized in mid-2000 s that Hospital members were sporadically expressing great angst over recruitment of nurses As soon as we had data to understand issue, issue seemed to be better Needed a way to understand what drives this constant cycle and to predict what will happen next Nurse Forecaster was born in NE Ohio in 2010

11 25,000 Example: Regional Supply Of and Demand For RNs 20,000 15, ,000 16,292 16,040 16,087 16,092 16,021 15,929 15,836 15,746 5, Demand Baseline New Grads Recruits

12 Ohio RN Workforce

13 Ohio RN Snapshot One important component of understanding supply of nurses is to understand their migration patterns. o Previously, we had a static number of nurses in a region in Year One, and then a static number in Year Three. We had no way of knowing if they were most the same nurses in those two years or not until now. The nursing workforce can evolve in many ways: o Geographic location o Educational attainment o Work setting o Practice area

14 Ohio RN Snapshot Northwest Ohio Northeast Ohio Central Ohio Southwest Ohio Toledo Cleveland Columbus Dayton Cincinnati Southeast Ohio o State is divided into five regions for analysis. o We have learned through our nurse forecasting projects that regional variations in how nurses are used can vary tremendously. Therefore it is critical to look at and use data at the regional level.

15 Ohio Employer Regional Migration Working As A Nurse in 2015, Among Those Working As A Nurse in % 80% 70% 60% 50% 40% 30% 20% 10% 0% 76% 74% 78% 78% Northeast Ohio Northwest Ohio Central Ohio Southwest Ohio Southeast Ohio 63% Ohio s most rural region. o Regions differed in their retention rates of RNs. o SE Ohio shows the largest loss of RNs (to employers in other Ohio regions). o Statewide only 75% of the RNs were employed in the same region in 2015 as they were in 2013.

16 Predictors of Regional Migration o A regression model (logistic) highlighted the key characteristics most associated with regional migration. Age (<40 are 13% more likely to migrate) Child Psych practice area (7%) Gender (Males 6%) Moved to a nursing home setting (5%) Non-White (4%) With the exception of age, this designation signals an unusually high demand as they are being recruited from outside of their region.

17 Ohio Educational Advancement o 3,051 of the Registered Nurses in 2013 were APRNs by That represents 1.8% of the total RN workforce. o Most who begin a BSN finish it. Of those RNs enrolled in a BSN program in 2013: o 53% completed their BSN by 2015 o 30% were still working on it by 2015 o 16% did not complete and don t plan to o Intentions to start a BSN program are a bit optimistic. Of those with plans to begin a BSN program within 1-5 years in 2013: o 23% enrolled in a program by 2015 o 11% decided against obtaining a BSN in the future

18 Ohio Work Setting Migration o Within the two years from 2013 to 2015, 27% of the RNs changed their work setting. The settings which showed the largest loss rate were Patient-Centered Medical Home (78%) Hospital Outpatient (58%) Urgent Care (52%) Office Practices (Solo, Group & Specialty) (47%) Community Health (40%)

19 Ohio RN Practice Area Migration o Within the two years from 2013 to 2015, 55% of the RNs changed their practice area. The practice areas which showed the largest loss rate were: Public Health (61%) Pulmonology (60%) Family Practice (60%) Administration (57%) Research (55%) Urgent Care (55%)

20 Connect With Us Patricia J. Cirillo, PhD, The Center for Health Affairs CHAMPS Healthcare CHAMPS Twitter The Center for Health Affairs/ CHAMPS Healthcare LinkedIn champshealthcare neohospitals Oncology Outlook champshlthcare neohospitals YouTube Blog Pinterest

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