Trends in Oklahoma Hospital Professions Supply, Vacancies, Turnover & Educational Capacity Expansion

April 2009

Results of a 2005 staffing survey of Oklahoma Hospital Association (OHA) member and non-member hospitals statewide were incorporated into the comprehensive “Oklahoma’s Health Care Industry Workforce: 2006 Report,” produced by the Governor’s Council on Workforce & Economic Development (GCWED). Based on the vacancies measured in 2005, projected shortages for Oklahoma health care workers by 2012 were as follows: 3,000 nurses, 500 lab technicians, 400 physical therapists, 300 surgical technologists and 200 occupational therapists. Needs were also quantified for radiology and respiratory professionals as well as pharmacists. Health care professional supply data were collected in 2005 by the Oklahoma State Regents for Higher Education (OSRHE), in collaboration with the Oklahoma Department of Career and Technology Education (ODCTE). These results, also published in the 2006 GCWED Health Care Industry Report, indicated only 57% (5,266) of all interested and qualified applicants (9,193) were admitted into nursing and allied health programs. The primary reason attributed for this was the lack of faculty available to teach in nursing and allied health programs. In 2008, the Oklahoma Health Care Workforce Center (OHCWC) and OHA again surveyed hospitals in Oklahoma to determine vacancies and turnover in high demand professions and to compare these numbers with 2005 industry data. In 2008, emergency responders and mental health professionals were added to the hospital survey. While industry data were being collected, the OSRHE, in collaboration with the ODCTE, surveyed educational institutions again to determine trends in educational capacity and the production of high demand health care professionals. The following is a brief summary of these 2008 surveys.

VACAnCy & SuPPly DATA 2005 & 2008

2

In terms of highest vacancy rate percentages among Oklahoma hospitals (with the number of “intend to fill” positions listed in parentheses below), the following roles, listed in descending order, had the most significant vacancy rates in 2005 and 2008:

HOSPiTAl VACAnCiES

Those professions making the top 10 list in Oklahoma hospitals in 2005 and 2008 include: LPNs, occupational therapists, physical therapists, and registered nurses. See Appendices 2 & 3 for further details on the 2005 & 2008 Survey Comparisons.

2005 2008

1 Occupational Therapist (38) EMT- Intermediate (10) 2 Physical Therapist (83) Chemical Dependency Counselor (3) 3 MR Technologist (13) EMT- Paramedic (37) 4 Registered Nurse (1,129) Physical Therapist (69)

5 Licensed Practical Nurse (221) Occupational Therapist (25) 6 Scrub Technician (44) EMT- Basic (20) 7 Ultrasound Technologist (15) Licensed Practical Nurse (308) 8 Pharmacist (39) Registered Nurse (1,354)

9 Vascular Interventionist (7) Laboratory Technologist (33) 10 CT Technologist (13) Respiratory Therapist (89)

In 2008, the number of qualified applicants accepted into nursing and allied health programs across the state increased to 63%, from 57% in 2004. However, nearly 3,000 interested and qualified applicants were turned away. Significant improvements were measured within nursing programs. Qualified applicants admitted into BSN programs in 2008 increased to 85%, from 68% in 2004, while associate degree in nursing programs statewide admitted 71% of qualified applicants, up from 43% in 2004. Eighty-nine (89) percent of health profession graduates stay and work in Oklahoma (Employment Outcomes Report, 2008).

EDuCATiOnAl CAPACiTyimPrOVEmEnTS

3

EDuCATiOnAl CAPACiTyimprovements (Cont’D)

4

According to the 2007 Annual Report issued by the Oklahoma Board of Nursing the number of nursing graduates from Oklahoma nursing education programs reached a record high in FY 2007.

Between 2003 and 2007:• Applications to nursing education programs (practical, associate and baccalaureate degree) increased 35.6%; • Admissions to nursing education programs increased 28%; • Student enrollment in nursing education programs increased 31.5%; • Graduates from nursing education programs increased 43.4%; • Individuals applying to take the RN licensure exam increased 43.5%; • New RN and LPN licenses issued increased 29.8%; and • Licenses to practice nursing in Oklahoma to those licensed in other states increased by 179.4%.

5-yEAr TrEnDSin nurSing

5

Since becoming established on Nov. 1, 2006, the OHCWC has had as its number one priority the need to expand educational capacity in nursing and allied health. Legislation was introduced in 2008 which proposed that $18 million dollars over a 3-year period be allocated to: 1) increase the number of faculty in Oklahoma’s nursing and allied health programs; 2) provide funds to educational institutions for “innovations in education” which would allow them to expand their pipeline through online, distance education, the use of simulation, etc; and 3) provide scholarships to nursing and allied health students. While legislation passed in 2008 and was signed by Governor Henry, no funding was attached to the bill. In 2009, subsequent legislation was introduced (SB 310) to keep the issue alive and to continue to make the case for the need for legislative funding to expand Oklahoma’s educational capacity, thereby increasing more health care professionals. A report produced by the OHCWC and the OHA in the fall 2008 quantified hospitals’ contributions to higher education over a 3-year period ($30 million from 2005-2007) and stressed the need for public funding earmarked to address this critical need. See Charts 7-8.

OngOing EffOrTS TO inCrEASE EDuCATiOnAl CAPACiTy &

SuPPly Of HEAlTH CArE PrOfESSiOnAlS

6

OngOing EffOrTS TO inCrEASE EDuCATiOnAl CAPACiTy &

SuPPly Of HEAlTH CArE professionals (Cont’D)

7

The OHCWC prepared a comprehensive proposal, which was shared with the Governor and state leaders in March. The proposal outlines priority areas for funding in order to further develop Oklahoma’s health care workforce. The proposal, online at www.ohcwc.com under Reports/Resources, requests the state to provide funding for the following priorities: faculty development scholarships, innovations in education, student scholarships, a multidisciplinary data repository to assist with tracking the ongoing supply of health care workers, a Web-based clinical placement portal to assist hospitals and schools schedule student clinicals in real time, and funding to make patient simulators more readily available to health care providers and educational facilities at a regional level.

AmEriCAn rECOVEry & rEinVESTmEnT ACT

(stimulus paCkage) proposal

8

Continue the dialogue with local college presidents and directors of technology centers about the critical need for more health care workers. Urge their active involvement in helping the OHCWC secure funding for higher education capacity expansion, via SB 310 and the ARRA/Stimulus Package. Use the data included in this report, along with the talking points below which were shared by the OHCWC with the Council of (College) Presidents of the OSRHE on March 4. The entire PPT presentation and this report can be downloaded for your use from the OHCWC Web site, www.ohcwc.com.

HOw yOu CAn HElP

ContactPlease contact Sheryl McLain or Kammie Monarch at the OHCWC if you would like their involvement or assistance in local or regional meetings around this important issue, sheryl@ohcwc.com, kammie@ohcwc.com, (405) 319-8690.

FACUlty• There is a shortage in nursing and allied health faculty (84);• The shortage is largest in RN faculty (60); • Another 52 RN faculty plan to retire in the next 5 years;• Nursing and allied health faculty with plans to retire within five years is 117;• Nursing faculty often leave for higher paying jobs in hospitals;StUdeNtS• There is a large number of qualified applicants being turned away from nursing & allied health programs;• Oklahoma needs to admit more applicants into its programs;• In general, graduation and licensure pass rates are great for students admitted into nursing & allied health programs;WHAt CAN yOU dO?• Urge your legislator to support the appropriation of more dollars to OSRHE for health care education capacity expansion (SB 310); • Ensure nursing and allied health faculty salaries are competitive with local health care industry rates in order to recruit and retain faculty; • Consider shared resources with other educational programs (e.g., faculty, facilities, simulators); Encourage course and admission alignment between programs; • Encourage and support the use of technology (e.g., simulation, online and distance education courses) to increase capacity & use scarce faculty resources more efficiently; • Encourage and support existing partnerships with local hospital partners & let them know the impact and ROI of their contributions.

9

2008 HOSPiTAl VACAnCiESAPPEnDix 1

25

25

58

68

69

76

85

86

89

308

1354

0 200 400 600 800 1000 1200 1400

Pharmacists

Occupational Therapists

Scrub Techs

All EMTs

Physical Therapists

Mental Health

Imaging

Lab & Medical Techs

Respiratory Therapists

LPN

RN

Hospital Staff Vacancies - 2008

10

2005 & 2008 HOSPiTAlS STATEwiDE:

VACAnCy rATES APPEnDix 2

11

2005 & 2008HOSPiTAlS STATEwiDE:

TurnOVEr rATES APPEnDix 3

12

2008 rEgiOnAl & STATEwiDE: VACAnCy rATES

APPEnDix 4

13

2008 rEgiOnAl & STATEwiDE: TurnOVEr rATES

APPEnDix 5

14

HOSPiTAl PArTiCiPAnTSBy rEgiOn

Northeast Region Bristow Medical Center Cleveland Area Hospital Continuous Care Centers of Bartlesville Creek Nation Community Hospital, Okemah Cushing Regional Hospital Drumright Regional Hospital INTEGRIS Baptist Regional Health Center, Miami INTEGRIS Blackwell Regional Hospital INTEGRIS Grove General Hospital Jack C. Montgomery VA Medical Center, Muskogee Jane Phillips Medical Center, Bartlesville Memorial Hospital of Stilwell Muskogee Regional Medical Center Okmulgee Memorial Hospital, Inc. Perry Memorial Hospital Ponca City Medical Center Prague Municipal Hospital St. John Sapulpa Stillwater Medical Center Tahlequah City Hospital Wagoner Community Hospital Willow Crest Hospital, Inc., Miami Northwest Region Cimarron Memorial Hospital and Nursing Home, Boise City Fairview Regional Medical Center INTEGRIS Bass Baptist Health Center, Enid Kingfisher Regional Hospital Memorial Hospital of Texas County, Guymon Newman Memorial Hospital, Shattuck Okeene Municipal Hospital Seiling Municipal Hospital Share Medical Center, Alva St. Mary’s Regional Medical Center, Enid Watonga Municipal Hospital Woodward Regional Hospital Oklahoma City Region Bone & Joint Hospital, Oklahoma City Community Hospital, Oklahoma City Deaconess Hospital, Oklahoma City Griffin Memorial Hospital, Norman INTEGRIS Baptist Medical Center, Oklahoma City INTEGRIS Southwest Medical Center, Oklahoma City Lakeside Women’s Hospital, Oklahoma City McBride Clinic Orthopedic Hospital, LLC, Oklahoma City Mercy Health Center, Oklahoma City Midwest Regional Medical Center, Midwest City Norman Regional Health System Norman Specialty Hospital Northwest Surgical Hospital, Oklahoma City OK Center for Orthopaedic & Multi-Specialty Hospital, Oklahoma City OU Medical Center, Oklahoma City Select Specialty Hospital, Oklahoma City St. Anthony Hospital, Oklahoma City Surgical Hospital of Oklahoma, Oklahoma City The Children’s Center, Bethany Veterans Affairs Medical Center, Oklahoma City

Southeast Region Arbuckle Memorial Hospital, Sulphur Chickasaw Nation Health System, Ada Choctaw Memorial Hospital, Hugo Choctaw Nation Hlth Svcs Authority, Talihina Eastern Oklahoma Medical Center, Poteau Haskell County Healthcare System, Stigler Healdton Municipal Hospital Holdenville General Hospital INTEGRIS Marshall County Medical Center, Madill INTEGRIS Seminole Medical Center Johnston Memorial Hospital, Tishomingo Mary Hurley Hospital, Colgate McAlester Regional Health Center McCurtain Memorial Hospital, Idabel Medical Center of Southeastern OK, Durant Mercy Health Love County, Marietta Mercy Memorial Health Center, Ardmore Pauls Valley General Hospital Pushmataha Hospital, Antlers Solara Hospital of Muskogee Unity Health Center, Shawnee Valley View Regional Hospital, Ada Southwest Region Comanche County Memorial Hospital, Lawton Cordell Memorial Hospital Duncan Regional Hospital Elkview General Hospital, Hobart Grady Memorial Hospital, Chickasha Great Plains Regional Medical Center, Elk City INTEGRIS Clinton Regional Hospital Jackson County Memorial Hospital, Altus Jefferson County Hospital, Waurika Memorial Hospital & Physician Group, Frederick Sayre Memorial Hospital Tulsa Region Bailey Medical Center, Owasso Brookhaven Hospital, Tulsa Continuous Care Centers of OK, Tulsa Hillcrest Medical Center, Tulsa Oklahoma NeuroSpecialty Center, Tulsa Oklahoma State University Medical Center, Tulsa Parkside Comm. Psychiatric Services & Hospital, Tulsa Saint Francis Hospital, Tulsa Select Specialty Hospital, Tulsa SouthCrest Hospital, Tulsa St. John Medical Center, Tulsa

655 Research Parkway, Suite 325Oklahoma City, OK 73104

Phone: (405) 319-8690 Fax: (405) 319-8698

www.ohcwc.com