The 2023 MHA Workforce Report finds a nearly one-quarter turnover rate among all surveyed positions statewide, with more than 40% accounting for environmental services and dietary workers. The turnover rate among staff nurses was nearly 20% — one in five statewide. The nurse vacancy rate was more than 17%.

“This year’s workforce report is a reminder that we have work to do,” Jon Doolittle, MHA’s President & CEO, said. “Every Missourian has a stake in the outcome. The good news is that health professions are rewarding, stable and diverse. Hospitals want to be the employer of choice in the communities they serve. It’s essential that more young people looking toward the future, and individuals looking to make both a change and a difference, know that caring for their family and neighbors is a great option.”

The 2023 MHA Workforce Report includes statewide data on 28 hospital-based staff categories and four clinic and physician practice positions. The data also are available for 10 Workforce Development Regions and for the state’s critical access hospitals.

Several factors influence the workforce challenge. COVID-19 was very difficult for the health care workforce. Not only did the care environment change significantly with surges and lulls, but caregivers also were supplemented by costly agency staff, which distorted organizational processes and cultures — despite the benefit of the extra hands. A portion of these agency workers were Missouri’s own health care workers who shifted from their traditional employers to staffing companies. Some of these workers likely are returning to hospitals — which may be supporting the decrease in vacancy and turnover —while others continue in travel positions or have shifted to other parts of the workforce.

Presently, the pipeline for new workers is insufficient to deliver the workforce of the future. Without significant and ongoing investment, this will add to the supply and demand challenge for health care workers. In Missouri, an additional 64 full-time faculty positions would be necessary to accommodate all nursing school applicants who are qualified for admission. Each year, qualified nursing school applicants are turned away because of insufficient faculty. Moreover, without additional investment or innovative approaches to nurse training, the education system will struggle to replace the 98 Missouri nurse educators who are expected to retire within the next five years.

Hospitals are looking internally as well as externally to build the skills and systems to ensure workers are available to deliver the care Missourians need, when they need it. Hospitals are working to upskill employees and create career ladders that not only build the workforce, but support lives and families. They are engaging with stakeholders — including but not limited to state government, academia and workforce development partners — to strengthen the system for attracting the next generation to health professions.