To combat the critical health care workforce shortage in Maryland, hospital leaders across the state formed a task force to study challenges in the workforce pipeline and provide comprehensive recommendations. Convened by the Maryland Hospital Association (MHA) in November 2021, the Task Force on Maryland’s Future Health Workforce released an extensive report this month on its findings.
Maryland is already experiencing a significant health care workforce shortage, with 1 in 4 nursing positions currently vacant. However, without corrective measures in place, the shortage could continue to worsen. Recent data from a 2022 Global Data report, commissioned by MHA, reveals there is a statewide shortage of about 5,000 full time registered nurses and 4,000 licensed practical nurses. Without intervention, the Global Data report showed shortages could double or possibly triple by 2035.
“Workforce challenges predated the COVID-19 pandemic, but the situation is now alarming,” said MHA President and CEO Bob Atlas in a statement. “Hospitals are essential to a vibrant society. Any threat to the workforce of our 60 hospitals and health systems threatens the health and wellness of all Marylanders and stability of our state’s core functions. We cannot take for granted that our excellent health care workforce will always be there.”
In response to the shortage, MHA convened the Task Force on Maryland’s Future Health Workforce, which includes dozens of hospital and health system leaders across the state. The resulting report includes recommendations tailored to hospitals as well as state lawmakers and policymakers.
Workforce Challenges
The report identified 3 key challenges contributing to the health care workforce shortage. First was a high staff turnover. The average vacancy rate for the top 10 hospital occupations (including RNs, nurse practitioners, and lab technicians) was 21.2% as of 2021. The turnover rate for LPNs was significantly higher, at 37.7%.An aging workforce, burnout from the COVID-19 pandemic, violence against health care workers, and Maryland’s unique hospital budget-capping system are all factors contributing to high turnover rates, the report said.
A shifting care delivery model is also causing workforce pipeline barriers. Shifts in patient demographics require more cultural competency and institutional bias training. The report said there is opportunity for the state to better utilize telehealth as a care delivery tool.
The 3rd challenge is an insufficient nursing pipeline, characterized by a lack of sufficient nursing faculty and preceptors, clinical sites, and other supports (such as tuition assistance and childcare).
Recommendations
The report provided specific recommendations that fall into 4 categories: expanding the workforce pipeline, removing barriers to health education, retaining the health workforce, and leveraging talent with new care models.
For example, to widen the pool of individuals joining the health care workforce, the report recommends that policymakers realign Maryland’s English language competency requirements with established standards to allow more internationally-trained providers to work. To remove barriers to health care education, the report recommends that hospitals provide additional clinical training sites available to nursing schools at no additional cost. The report also highlighted the importance of using data to effectively track the state’s health workforce to inform policy decisions.
“This data-driven report lays the groundwork to address the long-standing, and now urgent need to strengthen our pipeline of nurses in Maryland,” Ed Lovern, President & CEO of Ascension Saint Agnes and the chairman of the Task Force on Maryland’s Future Health Workforce, said in a statement. “While we won’t fix the nursing shortage overnight, the Task Force urges immediate and concerted actions to shore up the health care workforce we will need for generations to come.”