Multi-stakeholder collaboration to advance employer surveys Judee Berg California Institute for Nursing & Health Care Forum of State Nursing Workforce Centers June 2014
The Challenges How can we track employer demand for nurses? Secondary data (inexpensive) State labor departments Data are not specific to nursing employment Long delays in data releases Targeted surveys (ideal) Available surveys might not have all the data you want Can be expensive Can be proprietary and inaccessible Public data is key for policy advocacy 2
What We Did Brought together 3 stakeholders Each was conducting a separate survey Data sharing was not consistent Funding sources were different Maintained separate surveys with intentional synergy Developed new projects as a team 3
The collaboration California Institute for Nursing & Health Care (CINHC) State Nursing Workforce Center (non-profit) Hospital Association of Southern California (HASC) Membership organization Philip R. Lee Institute for Health Policy Studies, University of California, San Francisco (UCSF) University, health workforce research center 4
The collaboration Funding from Betty Irene Moore Nursing Initiative HASC membership dues Other supporters California Hospital Association Hospital Council of Northern & Central California Hospital Association of San Diego & Imperial Counties 5
History HASC surveys Long-standing turnover & vacancy survey Completed by HR Directors Special surveys (such as Allied health workforce surveys 2010, 2013) Reports for members only CINHC surveys Chief Nursing Officer Surveys, from early 2000s Survey of new RN graduates Public reports; data access limited UCSF surveys RN surveys, RN schools surveys Reports & public-use files available 6
The nudge Gordon and Betty Moore Foundation Betty Irene Moore Nursing Initiative Wanted ongoing data to support workforce planning Needed data to evaluate their work Supported 2009 CINHC survey Conducted using HASC CNO mailing list Asked for collaboration between UCSF, CINHC, and HASC to standardize survey 7
Overarching strategy Maintain HASC survey Revise to align with Forum Minimum Demand Data Set recommendations Send to HR directors quarterly Continue CINHC survey Send to CNOs annually (by UCSF) Standardized CNO mailing list, updated annually Prior HASC surveys were to their member CNO list only HASC list included mix of settings 8
Some lessons learned Do not ask CNOs what they don t have, when you can ask HR Employment numbers, FTEs, vacancy counts Many Forum MDS questions are better for HR They have to go to HR for these data Do not ask HR what they don t know Residency programs Perceptions of difficulty recruiting Five-point ratings of perception of surplus/shortage are useful 9
More lessons learned Give CNOs multiple ways to respond Web-based survey Fillable PDF that can be emailed Automatically goes into database Fax return available Contact CNOs multiple times Introductory emails from hospital association Announcements in nursing leadership organizations Phone messages Short-form survey for quick telephone response 10
Bring the data together Complete datasets are shared by all partners Fully identified data Identified data not shared outside the collaborative CNO survey & HR survey: reported together More detailed HASC reports for members only 11
Annual webinar Includes data from Employer survey (CNO+HR) Biennial surveys of RNs (UCSF) New graduate surveys (CINHC) Annual schools surveys (UCSF) Attendees include Nursing deans & directors Hospital leaders Government officials (health, labor departments) National workforce leaders (HRSA) Other state nursing leaders 12
Perceptions of employers, 2013 0% 20% 40% 60% 80% 100% 2013 9.1% 32.1% 17.0% 28.5% 13.3% 0.0% 0.5% 2012 5.5% 45.0% 19.7% 17.0% 12.4% 2.0% 2011 4.6% 43.0% 6.6% 23.2% 20.5% 2010 5.0% 29.4% 11.3% 25.6% 23.8% 5.0% High demand: difficult to fill open positions Moderate demand: some difficulty filling open positions Demand is in balance with supply Demand is less than supply available Demand is much less than supply available Other 13
Change in difficulty recruiting compared to last year, Fall 2013 100% 90% 80% 70% 60% 50% 40% 30% 20% 10% 0% 18.6% 6.8% 28.7% 15.0% 66.7% 14.7% 53.8% 39.4% 69.3% 2.0% 77.4% 7.5% Less difficult About the same More difficult 14
Change in RN employment in the past year 100% 90% 80% 70% 60% 50% 40% 30% 20% 10% 0% 6.6% 33.5% 27.0% 16.8% 13.7% 41.6% 58.4% 62.6% 46.6% 58.1% 51.8% 19.9% 14.9% 24.8% 23.7% Decreased employment No change Increased employment 15
Changes experienced in past year Hiring freeze Increase in census Increase in use of travelers Less turnover Decrease in use of travelers Fewer nurses retiring Current staff working more Increased patient acuity Reduction in census Budget constraints 38 39 44 49 53 62 73 75 100 113 0 20 40 60 80 100 120 Number of responses 16
New RN graduate unemployment varies by education 50% 40% 47% 45% 41% 30% 20% 10% 0% AD BSN ELM 17
What does the 2012 RN survey tell us about employment? 100% 90% 80% 70% 60% 50% 40% 30% 20% 10% 0% 17.4% 10.7% 15.8% 12.5% 13.3% 13.1% 12.6% 14.9% 82.6% 89.3% 84.2% 87.5% 86.7% 86.9% 87.4% 85.1% 1990 1993 1997 2004 2006 2008 2010 2012 Employed in nursing Not employed in nursing 15.5% of working nurses have more than one RN job. Source: California Board of Registered Nursing Survey of RNs, 2012 18
Share of RNs employed in nursing by age 100% 90% 80% 70% 60% 50% 40% 30% 20% 10% 2004 2006 2008 2010 2012 0% < 30 years 35-39 years 45-49 years 55-59 years 65 + years Source: California Board of Registered Nursing Survey of RNs, 2012 19
What do Deans & Directors think is happening? Deans estimates of the percent of grads from the past year in each employment setting Type of degree 2008-2009 2009-2010 2010-2011 2011-2012 Hospital 71.4% 59.0% 54.4% 61.1% Long-term care 8.4% 9.7% 7.8% 8.3% Comm/public health 5.4% 3.9% 4.5% 3.6% Employed in CA 83.4% 81.1% 68.0% 69.6% Source: California Board of Registered Annual Schools Report, 2011-2012 20
Check out our website! http://rnworkforce.ucsf.edu 21
Questions? Thoughts? Ideas? Perspectives? 22