NURSE LEADERS SURVEY
A Financial Component The second most cited reason for using contingent nurses, cited by 60% of nurse leaders, is to achieve operational and quality outcomes goals. Achieving positive patient outcomes is a paramount goal in itself for virtually all healthcare facilities. Today, however, achieving this goal also may have the added benefit of improving healthcare facility financial outcomes. As provider reimbursement moves from volume to quality-based models, nurses are having a growing impact on hospital finances. Patients often equate the quality of care they receive to the time and attention they receive from nurses. High nurse to patient ratios may lead to higher patient satisfaction scores and therefore to higher reimbursement under quality-based reimbursement models. High nurse to patient ratios also have been tied to better patient outcomes and fewer hospital readmissions, which also are rewarded in value-based reimbursement models. Though nurses are often viewed as a cost by hospitals, they can make significant contributions to the bottom line, particularly in emerging quality-based reimbursement systems. The survey indicates contingent nurses are often used to achieve quality outcomes goals, which in turn can have a positive effect on hospital revenues. Test Marketing and Labor Agreements Over one-third of nurse leaders (35%) indicated they use contingent nurses to open new programs or departments. The use of contingent nurses allows hospitals to test market new services or departments before they hire permanent nurse staff. An additional one-third of nurse leaders (32%) indicated they use contingent nurses to close gaps in labor agreements. In recent years, nurse to patient ratios have been a point of contention in nurse/hospital labor agreements. By using contingent nurses, hospitals can increase the number of nurses per patient, thereby closing staffing gaps and helping to revolve nurse labor disputes. Types of Contingent Nurses Used When asked what type of contingent nurses they use, more than three-quarters of hospital nurse leaders (76%) indicated their facilities use float pool nurses. A growing number of hospitals are establishing internal nurse float pools that act like travel nurse agencies, using various scheduling technologies to implement this option. Internal nurse float pools allow permanent staff to work on a flexible basis, similar to the manner in which travel nurses work. By providing this option, hospitals can retain permanent staff nurses who may otherwise have chosen to work as travelers. Seventy-three percent of nurse leaders said they use travel nurses, who typically work assignments lasting 13 weeks, while 63% use per diem nurses who are used to fill gaps as needed. An additional 17% of nurse leaders use emergency labor stoppage nurses, while 14% use international nurses, who typically work on two-year assignments, though they also may be directly hired on a full-time, permanent basis.
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