Clinical nonlicensed personnel comprise a large portion of the U.S. health care workforce, yet almost no research has examined their staffing levels in U.S. hospitals. Professor Patricia (Polly) Pittman of the Milken Institute School of Public Health’s Department of Health Policy and Management (HPM), who serves as co-director of the GW Health Workforce Institute, was the first author of a new publication provides important information about and insights into employment trends for clinical nonlicensed personnel. Xinxin Han, an HPM doctoral student and GW Health Workforce Institute researcher, was a coauthor of the publication in Nursing Outlook.
In “Clinical nonlicensed personnel in U.S. hospitals: Job trends from 2010 to 2015,” Pittman, Han and colleagues from Mathematica Policy Research and Premier, Inc. report trends in staffing of 25 clinical nonlicensed personnel jobs and graduate nurses (GNs) in U.S. hospitals from 2010 to 2015, based on their skill levels. The results were obtained using Premier's OperationsAdvisor database, and the data are also broken down by hospital units, including medical–surgical units, outpatient units, and emergency departments.
The research team reports that, over the 6-year period from 2010 to 2015, the average number of high-skill and middle-skill clinical nonlicensed personnel full-time equivalents (FTEs) declined by 22% and 7%, respectively. Over the same period the average number of low-skill and graduate nurse FTEs increased by 38% and 117%, respectively. “This skill mix shift appears to be most pronounced in emergency departments,” they wrote.
In their article, Pittman and her colleagues conclude that the changes in staffing levels and the skill mix of the hospital workforce that they observe “warrant further study to understand both the reasons behind the observed changes and their effects on health outcomes.” They stress that, “although labor efficiency is an important goal, it is also critically important to assess whether reductions and/or the skill mix shifts among support staff impact nurse workload and, by extension, patient safety.”