Personnel shortages a growing concern for hospital CEOs

Financial challenges remained the biggest concern for hospital CEOs, according to a survey conducted by the American College of Healthcare Executives (ACHE). But, in a shift from prior years, personnel shortages were a bigger worry for healthcare leaders than issues of patient safety and quality.

Nearly 300 community hospital CEOs responded to the survey, which asked them to rank 10 issues affecting their hospitals in order of “how pressing they are.” Here’s how the issues were ranked in descending order:

1. Financial challenges
2. Governmental mandates
3. Personnel shortages
4. Patient safety and quality
5. Patient satisfaction
6. Physician-hospital relations
7. Access to care
8. Technology
9. Population health management
10. Reorganization (e.g., mergers, acquisitions, restructuring, partnerships)

The top two were the same as surveys conducted in 2015 and 2015, but for 2017, personnel shortages made it in the top three.

"Assuring patient safety and providing quality care is the No. 1 job of hospital leaders," ACHE president and CEO Deborah Bowen said in a statement. “The survey results indicate that leaders are addressing the challenge of doing so in a changing and uncertain financial and regulatory environment. That personnel shortages have become one of the top three concerns suggests that hospitals are keeping their attention on attracting and retaining a talented workforce to ensure the short- and long-term needs of patients can be met.”

Survey respondents also broke down what specific financial challenges, government mandates or personnel concerns worried them. Medicaid reimbursement, increasing costs for staff and supplies and the need to reduce operating costs topped the list among financial pressures. More long-term goals, such as transitioning from volume to value and moving away from fee-for-service payments, were mentioned less frequently. CMS regulations, regulatory/legislative uncertainty and compliance costs were the top issues under governmental mandates.

For personnel problems, CEOs most frequently listed a lack of registered nurses as an issue, followed by primary care physicians—both positions where demand for their services is growing faster than the available workforce.