/ en Tue, 29 Apr 2025 21:25:01 -0500 Wed, 30 Apr 25 06:00:00 -0500 /costsofcaring <div class="container"><div class="row"><div class="col-md-8"><h2>Introduction</h2><p>America’s hospitals and health systems are the cornerstone of the nation’s health care system, providing life-saving care to millions of patients each year. However, hospitals face a perfect storm of financial pressures: persistent cost growth, inadequate reimbursement, and shifting care patterns driven by both policy changes and an older, sicker population with more complex, chronic conditions. Hospitals are struggling to maintain access to essential services amid workforce shortages, supply chain disruptions, tariffs and policy decisions that often fail to reflect on-the-ground realities.</p><p>This report outlines the key trends impacting hospital financial stability in 2025.</p><h2>Hospital Expenses Have Surged and Remain Elevated</h2><h3>Labor Costs Dominate Hospital Expenses</h3><p><img src="/sites/default/files/inline-images/Figure-1-Labor-spend-still-dominated-hospital-expenses-in-2024_0.png" data-entity-uuid="2549d942-1df8-4906-b89f-4b2a3e7b16c1" data-entity-type="file" alt="Figure 1. Labor spend still dominated hospital expenses in 2024. Labor: 56%; $890 billion. Other: 22%; $352 billion. Supplies: 13%; $202 billion. Drugs: 9%; $144 billion. Note: Average expenses estimated by industry benchmark data from Strata Decision Technology, LLC. Labor is inclusive of purchased services and professional fees." width="485" height="457" class="align-right">Hospitals are among the few sectors that consistently employ a highly educated, highly paid workforce — anchoring local economies with middle- and high-skill jobs that cannot be outsourced or automated. Consequently — and despite growth in drug spending and other fast-rising non-labor costs — labor remains the single largest category of hospital spending. Total compensation and related expenses now account for 56% of total hospital costs (see Figure 1). Amid ongoing workforce shortages, hospitals offer competitive wages to retain and recruit staff. According to AHA analysis of Lightcast data, advertised salaries for registered nurses have grown 26.6% faster than the rate of inflation over the past four years. These increases are essential to maintain staffing levels but also contribute to the overall financial challenges hospitals face.</p><h3>Medicare and Medicaid Reimbursements Are Not Keeping Up With the Cost of Caring</h3><p><img src="/sites/default/files/inline-images/Figure-2-Inflation-Overshadows-IPPS-Net-Payment-Increases-FY-2022-to-2024.png" data-entity-uuid="dcf8f08c-3781-4459-9678-f45197fbc0e9" data-entity-type="file" alt="Figure 2. Inflation Overshadows IPPS Net Payment Increases, FY 2022 to 2024. Inflation: 14.1%. IPPS increases: 5.1%. Note: Net IPPS payment increase from FY2022-2024 market basket updates. Inflation measured using CPI-U from BLS using data between October of 2021 and October of 2024." width="484" height="403" class="align-right">Despite escalating expenses, Medicare reimbursement continues to lag behind inflation — covering just 83 cents for every dollar spent by hospitals in 2023, resulting in over $100 billion in underpayments, according to AHA analysis of AHA Annual Survey data. From 2022 to 2024, general inflation rose by 14.1%, while Medicare net inpatient payment rates increased by only 5.1% — amounting to an effective payment cut over the past three years (see Figure 2).</p><p>The AHA estimates that this erosion in payment value due to inflation resulted in $8.4 billion in lost hospital revenue during that period, further straining hospitals’ ability to care for Medicare beneficiaries, who make up a large share of most hospitals’ patients. In total, hospitals absorbed $130 billion in underpayments from Medicare and Medicaid in 2023 alone. These shortfalls are worsening — growing on average 14% annually between 2019 and 2023.</p><h3>Hospital Expenses are Growing Faster Than Inflation</h3><p>Specifically, in 2024 alone, total hospital expense grew 5.1%, significantly outpacing the overall inflation rate of 2.9%. Though expense growth has started to slow in 2025, it remains elevated — particularly in areas driven by labor and supply chain pressures. Persistent expense growth threatens hospitals’ solvency and their ability to sustain comprehensive services in the communities they serve. A telling indicator of this strain is the average age of plant — a measure of the age of hospital infrastructure — which has risen by more than 10% over the last two years, according to industry benchmark data from Strata Decision Technology, LLC. This trend suggests that hospitals are increasingly unable to reinvest in critical physical assets, such as medical equipment, operating rooms and facility upgrades. Delayed capital improvements not only jeopardize care quality but also hinder hospitals’ ability to keep pace with evolving health care standards and technology.</p><h3>Impact of Chronic Disease Burden Costs Driven by Increased Utilization</h3><p>Rising hospital costs are increasingly driven by higher utilization and acuity, especially among patients with chronic conditions. According to the Centers for Medicare & Medicaid Services (CMS), recent growth in spending on hospitals reflects increased service intensity and use.<a href="#fn1"><sup>1</sup></a> For example, emergency department (ED) visits related to heart failure increased 126.7% per capita between 2010 and 2019 (see Figure 3), with associated spending growing 177.2%. Similar patterns are observed for type 2 diabetes and acute renal failure — some of the costliest conditions in terms of patient health and resource use. These trends underscore the demand-side pressures fueling cost growth.</p><img src="/sites/default/files/inline-images/Figure-3-Hospital-ED-Cost-Growth-for-Privately-Insurance-Patients-Driven-by-Increased-Utilization_0.png" data-entity-uuid="c82f1a54-9687-4310-8eb7-944970fa7b48" data-entity-type="file" alt="Figure 3. Hospital ED Cost Growth for Privately Insured Patients Driven by Increased Utilization. Heart Failure: 177.2% Total spending; 126.7% Encounters per capita. Acute renal failure: 56.5% Total spending; 50.0% Encounters per capita. Diabetes mellitus: 75.3% Total spending; 42.6% Encounters per capita. Note: AHA analysis of the data from the Institute of Health Metrics and Evaluation (IHME). Unitied States Health Care spending by Health Condition and County (2010-2019)." width="1039" height="423"><h2>The Growing Impact of Medicare Advantage on Hospital Finances</h2><h3>Observation Stays Are Increasing in Duration</h3><p><img src="/sites/default/files/inline-images/Figure-4-MA-Drives-Longer-Observation-Stays.png" data-entity-uuid="25bdfc97-fde8-4e32-be35-e8947ed26284" data-entity-type="file" alt="Figure 4. MA Drives Longer Observation Stays. Percent Longer MA Observation Stay Compared to Traditional Medicare. 2019: 28.6%. 2024: 36.9%. Note: Data from industry benchmark data from Strata Decision Technology, LLC." width="485" height="580" class="align-right">Medicare Advantage (MA) plans have long relied on extended observation stays to avoid admitting patients as inpatients — a strategy that helps plans reduce costs but shifts financial burden onto hospitals. Recent data show that this practice is worsening. In 2019, MA patients had observation stays 28.6% longer than those in Traditional Medicare; by 2024, the gap widened to 36.9% (see Figure 4). These prolonged observation stays drive up hospital costs without a corresponding increase in reimbursement, further straining hospital finances. Compared to inpatient admissions, observation stays are reimbursed at lower rates — or in some cases, not at all — leaving hospitals to absorb much of the cost. In 2024, MA plans reimbursed just 49% of the actual cost for patients held in observation status, according to industry benchmark data from Strata Decision Technology, LLC.</p><h3>Longer Stays, Lower Payments</h3><p>The inpatient setting reveals a similar pattern: longer stays for MA patients but with lower reimbursement. From 2019 to 2024, the average length of stay for MA patients grew substantially compared to Traditional Medicare — more than doubling the gap over this period, according to industry benchmark data from Strata Decision Technology, LLC. Yet during the same timeframe, hospital reimbursement from MA plans fell by 8.8% on a cost basis. In other words, hospitals are being asked to do more with less.</p><h3>Discharge Delays Are Compounding the Problem</h3><p><img src="/sites/default/files/inline-images/Figure-5-MA-Delays-Discharges-to-Post-Acute-Care.png" data-entity-uuid="d76d655b-ff83-40d7-a6f0-f179c94a93a6" data-entity-type="file" alt="Figure 5. MA Delays Discharges to Post-Acute Care. Percent Longer MA Stay Compared to Traditional Medicare. 2019: 6.4%. 2020: 6.0%. 2021: 10.5%. 2022: 14.7%. 2023: 13.9%. 2024: 12.6%. Note: Data from industry benchmark data from Strata Decision Technology, LLC." width="592" height="434" class="align-right">Delays in discharging patients to post-acute care facilities are a growing contributor to longer inpatient stays. These delays are often driven by prior authorization requirements or insufficient post-acute provider networks within MA plans. Among MA patients, the average length of stay prior to discharge to post-acute care has doubled relative to Traditional Medicare between 2019 and 2024 (see Figure 5). These delays lead to higher costs, increased hospital crowding — including in the emergency department — and longer lengths of stay. In some cases, plans may use these delays to steer patients toward lower-cost care settings — or avoid post-acute care altogether — while the hospital continues to absorb the cost of care. A Senate Permanent Subcommittee report recently found that some MA plans disproportionately imposed prior authorization and claim denials on post-acute care, exacerbating delays and shifting costs to hospitals.<a href="#fn2"><sup>2</sup></a> Post-acute care providers also have faced lagging reimbursement rates from Medicare, which has exacerbated staffing challenges and made it difficult to accommodate discharge requests from acute-care hospitals.</p><h3>Lower Reimbursement and Increasing Administrative Burden</h3><p>Hospitals are increasingly reporting lower negotiated MA rates than Traditional Medicare for many common inpatient services (see Figure 6). These discrepancies continue to create significant financial challenges for hospitals, especially for those in rural areas that have seen relatively fast growth in the volume of MA beneficiaries in recent years.<a href="#fn3"><sup>3</sup></a></p><img src="/sites/default/files/inline-images/MA-Negotiated-Rates-as-a-Percentage-of-Traditional-Medicare-Rates-Selected-DRGs.png" data-entity-uuid="062e44a9-197b-4ab3-b674-4c5bff0ce4e5" data-entity-type="file" alt="MA Negotiated Rates as a Percentage of Traditional Medicare Rates, Selected DRGs. MS-DRG 190 Chronic Obstructive Pulmonary Disease: 96.5% of FFS rates. MS-DRG 280 Acute Myordial Infarction: 96.2% of FFS rates. MS-DRG 470 Major Joint Replacement or Reattachment of Lower Extremity: 97.6% of FFS rates. Note: AHA analysis of hospital price transparency data from Turquoise Health. Figures calculated by dividing hospital-level median MA rates by hospital-specific baseline FFS rates. Outliers excluded (5th and 95th percentiles)." width="1062" height="289" class="align-center"><p>At the same time, administrative complexity continues to increase. MA plans issued nearly 50 million prior authorizations in 2023 — up more than 40% since 2020, according to KFF.<a href="#fn4"><sup>4</sup></a> A Premier study found that hospitals spent $26 billion in 2023 managing insurance claims — a 23% increase over the previous year.<a href="#fn5"><sup>5</sup></a></p><p>Notably, 70% of denied claims were eventually paid, but only after multiple costly reviews. These burdens not only strain hospitals financially but also delay care and divert clinical staff from patient care. A Morning Consult survey commissioned by the AHA found that 85% of clinicians report that prior authorization and other requirements delay necessary care.</p><h2>Impact of Tariffs on Hospital Costs</h2><p>Hospitals and health systems rely on the right medicines, devices and other supplies used at the right time to support the delivery of safe and effective care. The supply chain for these essential medical goods is complex, weaving together both domestic and international sourcing, and is prone to significant disruption. For example, as of March 2025, there were 270 active drug shortages in the U.S., including shortages of life-saving intravenous (IV) fluids stemming from Hurricane Helene in 2024.<a href="#fn6"><sup>6</sup></a> Recent changes in U.S. trade policy are creating additional uncertainty, with the Administration implementing new tariffs that affect medical devices and supplies, and considering new tariffs on pharmaceuticals. Tariffs on these critical goods could exacerbate shortages, disrupt patient care and raise costs for hospitals.</p><p>Despite efforts to bolster the domestic supply chain, a significant proportion of essential medical goods come from international sources. For example, nearly 70% of medical devices marketed in the U.S. are manufactured exclusively overseas.<a href="#fn7"><sup>7</sup></a> In 2024 alone, the U.S. imported over $75 billion in medical devices and supplies, according to AHA analysis of Census Bureau data. These imports include many lowmargin, high-use essentials in hospital settings — such as syringes, needles, blood pressure cuffs, and IV saline bags. Hospitals rely on imports for advanced surgical tools and other critical technologies as well.</p><p>Moreover, hospitals rely on international sources for a significant proportion of the protective equipment for their caregivers. In 2023, Chinese manufacturers supplied the majority of N95 and other respirators used in health care. Additionally, China was the source for one-third of disposable face masks, two-thirds of non-disposable face masks, and 94% of the plastic gloves used in health care settings.<a href="#fn8"><sup>8</sup></a></p><p>Many pharmaceuticals — and especially the key starter ingredients that go into them — also are sourced from overseas. The U.S. gets nearly 30% of its active pharmaceutical ingredients (APIs) from China.<a href="#fn9"><sup>9</sup></a> According to a 2023 Department of Health and Human Services estimate, over 90% of generic sterile injectable drugs — such as certain chemotherapy treatments and antibiotics — depend on key starter materials from either India or China.<a href="#fn10"><sup>10</sup></a> Even temporary disruptions in access to medication and supplies can impact care and increase the risk of patient harm.</p><p>Tariffs on medical imports could significantly raise costs for hospitals. A recent survey found that 82% of health care experts expect tariff-related expenses to raise hospital costs by at least 15% over the next six months, and 94% of health care administrators expected to delay equipment upgrades to manage financial strain.<a href="#fn11"><sup>11</sup></a> Tariffs also may force hospitals to seek new vendors — often at higher cost or with lower reliability. In fact, 90% of supply chain professionals are expecting procurement disruptions.<a href="#fn12"><sup>12</sup></a></p><h2>Conclusion: Supporting Hospitals Means Supporting Patients</h2><p>Hospitals are not only centers of care but also vital economic engines in their communities. Rising costs, inadequate reimbursement, and policy-driven inefficiencies jeopardize the ability of hospitals to deliver high-quality, timely care. To ensure that hospitals can continue to serve patients and communities, policymakers should:</p><ul class="arrow"><li class="arrow">Recognize that rising expenses reflect real pressures, such as labor shortages and increasing demand — not inefficiency.</li><li class="arrow">Acknowledge Medicare and MA payment policies must be updated to reflect the actual cost of care.</li><li class="arrow">Address structural drivers of cost, such as care delays and excessive administrative burdens, instead of simply cutting payments.</li></ul><p>As we look to the future, preserving access to hospital care should be a national priority. Supporting hospitals means supporting patients, communities and the entire health care system.</p><hr><h2>Notes</h2><ol><li id="fn1"><a href="https://www.healthaffairs.org/doi/10.1377/hlthaff.2024.01375" target="_blank">healthaffairs.org/doi/10.1377/hlthaff.2024.01375</a></li><li id="fn2"><a href="https://www.hsgac.senate.gov/wp-content/uploads/2024.10.17-PSI-Majority-Staff-Report-on-Medicare-Advantage.pdf" target="_blank">hsgac.senate.gov/wp-content/uploads/2024.10.17-PSI-Majority-Staff-Report-on-Medicare-Advantage.pdf</a></li><li id="fn3"">aha.org/system/files/media/file/2025/02/growing-impact-of-medicare-advantage-on-rural-hospitals.pdf</li><li id="fn4"><a href="https://www.kff.org/medicare/issue-brief/nearly-50-million-prior-authorization-requests-were-sent-to-medicare-advantage-insurers-in-2023/" target="_blank">kff.org/medicare/issue-brief/nearly-50-million-prior-authorization-requests-were-sent-to-medicare-advantage-insurers-in-2023/</a></li><li id="fn5"><a href="https://premierinc.com/newsroom/blog/claims-adjudication-costs-providers-25-7-billion" target="_blank">premierinc.com/newsroom/blog/claims-adjudication-costs-providers-25-7-billion</a></li><li id="fn6"><a href="https://www.ashp.org/drug-shortages/shortage-resources/drug-shortages-statistics?loginreturnUrl=SSOCheckOnly" target="_blank">ashp.org/drug-shortages/shortage-resources/drug-shortages-statistics?loginreturnUrl=SSOCheckOnly</a></li><li id="fn7"><a href="https://www.medicaldevice-network.com/analyst-comment/trump-tariffs-us-medical-device-market/" target="_blank">medicaldevice-network.com/analyst-comment/trump-tariffs-us-medical-device-market/</a></li><li id="fn8">AdvaMed presentation, 2023.</li><li id="fn9"><a href="https://www.atlanticcouncil.org/blogs/econographics/the-us-is-relying-more-on-china-for-pharmaceuticals-and-vice-versa/" target="_blank">atlanticcouncil.org/blogs/econographics/the-us-is-relying-more-on-china-for-pharmaceuticals-and-vice-versa/</a></li><li id="fn10"><a href="https://aspe.hhs.gov/sites/default/files/documents/3a9df8acf50e7fda2e443f025d51d038/HHS-White-Paper-Preventing-Shortages-Supply-Chain-Vulnerabilities.pdf" target="_blank">aspe.hhs.gov/sites/default/files/documents/3a9df8acf50e7fda2e443f025d51d038/HHS-White-Paper-Preventing-Shortages-Supply-Chain-Vulnerabilities.pdf</a></li><li id="fn11"><a href="https://www.beckershospitalreview.com/supply-chain/hospital-finance-supply-leaders-predict-15-increase-in-tariff-related-costs/" target="_blank">beckershospitalreview.com/supply-chain/hospital-finance-supply-leaders-predict-15-increase-in-tariff-related-costs/</a></li><li id="fn12"><a href="https://www.beckershospitalreview.com/supply-chain/hospital-finance-supply-leaders-predict-15-increase-in-tariff-related-costs/" target="_blank">beckershospitalreview.com/supply-chain/hospital-finance-supply-leaders-predict-15-increase-in-tariff-related-costs/</a></li></ol></div><div class="col-md-4"><p><a href="/system/files/media/file/2025/04/The-Cost-of-Caring-April-2025.pdf" target="_blank" title="Click here to download the The Cost of Caring: Challenges Facing America’s Hospitals in 2025 report PDF."><img src="/sites/default/files/inline-images/Page-1-The-Cost-of-Caring-April-2025.png" data-entity-uuid="658521c4-19cc-4776-a588-acc23144a3be" data-entity-type="file" alt="The Cost of Caring: Challenges Facing America's Hospitals in 2025 page 1." width="695" height="900"></a></p><div class="external-link spacer"><a class="btn btn-wide btn-primary" href="/guidesreports/2025-04-28-2024-costs-caring" target="_blank">View the 2024 Costs of Caring Report</a></div><div class="external-link spacer"><a class="btn btn-wide btn-primary" href="/guidesreports/2024-09-10-skyrocketing-hospital-administrative-costs-burdensome-commercial-insurer-policies-are-impacting" target="_blank">View the Skyrocketing Hospital Administrative Costs, Burdensome Commercial Insurer Policies Are Impacting Patient Care Report</a></div><div class="external-link spacer"><a class="btn btn-wide btn-primary" href="/guidesreports/2024-05-01-2023-costs-caring" target="_blank">View the 2023 Costs of Caring Report</a></div><div class="external-link spacer"><a class="btn btn-wide btn-primary" href="/guidesreports/2023-04-20-2022-costs-caring" target="_blank">View the 2022 Costs of Caring Report</a></div><div class="external-link spacer"><a class="btn btn-wide btn-primary" href="/guidesreports/2021-10-25-2021-cost-caring" target="_blank">View the 2021 Costs of Caring Report</a></div></div></div></div> h2 { color: #9d2235; } h3 { color: #003087; } ul.arrow { list-style: none; margin-left: 20px; padding-left: 0; } li.arrow { padding-left: 1em; text-indent: 1em; } li.arrow:before { content: "🠲"; color: #003087; padding-right: 10px; margin-left: -42px; } Wed, 30 Apr 2025 06:00:00 -0500 Nurses /aha-center-health-innovation-market-scan/2025-04-29-4-key-takeaways-evolving-nurse-care-models <div class="container"><div class="row"><div class="col-md-8"><p><img src="/sites/default/files/inline-images/4-Key-Takeaways-on-Evolving-Nurse-Care-Models.png" data-entity-uuid="0bd83292-0524-47c1-b393-cca932532cb1" data-entity-type="file" alt="4 Key Takeaways on Evolving Nurse Care Models. Nursing Leadership Insight Study: Navigating Evolving Challenges and Opportunities in a Complex Health Care Landscape. Download the report." width="900" height="508"></p><p>As hospitals and health systems redesign care to improve efficiency, optimize workforce deployment and improve outcomes, interesting trends are developing among nursing leaders.</p><p>Virtual care (32%), including telehealth, virtual nursing and patient monitoring, remains a top focus, reflecting its growing role in care delivery, notes the AHA’s American Organization for Nursing Leadership’s (AONL) <a href="https://www.aonl.org/resources/nursing-leadership-survey" target="_blank" title="AONL: Nursing Leadership Insight Study">“Nursing Leadership Insight Study”</a> released last month. Interdisciplinary collaboration (30%), upskilling leaders (21%) and team-based models of care (21%) highlight the role of teamwork and leadership development in improving patient outcomes.</p><h2>Redesign Care to Improve Efficiency</h2><p>Significant differences exist in care redesign priorities, according to data and analyses in the AONL study. The findings include:</p><ul><li><strong>Nurse managers</strong> prioritized interdisciplinary collaboration and workforce well-being tools, with strong statistical evidence supporting this focus. They placed less emphasis on upskilling leaders and ensuring that work is performed at the top of the licensure scope of practice.</li><li><strong>Chief nursing officers (CNOs) and chief nursing executives (CNEs)</strong> prioritized upskilling leaders and advocacy for policy change, focusing on strengthening leadership capacity and driving systemic improvements. They placed less emphasis on interdisciplinary collaboration and workforce well-being, the key focus areas for managers.</li><li><strong>Directors,</strong> positioned between managers and CNOs/CNEs, indicated a slight emphasis on workforce well-being tools, aligning partially with managers’ focus.</li></ul><h3>Key Takeaway</h3><p>Align strategies to be effective. These contrasting priorities among nurse leaders underscore the diverse approaches to care redesign and the need for alignment across leadership tiers (managers, CNOs/CNEs and directors) to achieve cohesive and effective strategies.</p><h2>Optimize Workforce Deployment</h2><p>The March 2025 AONL study assessed the effectiveness of various strategies to address staffing challenges, with respondents rating each on a scale of 1 to 5, where 5 indicates “very effective.”</p><p>The most effective strategies identified by nurse leaders were listening and responding to feedback from staff (average 3.51) and partnering with nursing schools (average 3.44). Notably, listening and responding to feedback was the only solution with a median score of 4, highlighting its unique importance among the options evaluated. The findings emphasize collaboration, responsiveness to staff needs and fostering relationships with nursing schools.</p><p>Other strategies rated above average included allowing days off when necessary (average 3.43), increasing nurse recognition (average 3.39) and increasing shared governance (average 3.35). Measures such as increasing wages or bonuses, allowing adequate time for meals and breaks and offering flexible scheduling also scored well, each with averages between 3.28 to 3.30.</p><h3>Key Takeaway</h3><p>Develop targeted strategies. Overall, these results underscore the importance of targeted, staff-focused strategies in nurse well-being and retention.</p><h2>5 Forward-Looking Care Models</h2><p>While current models have demonstrated their promise, several care models have emerged as avenues organizations can take to improve nurses’ working environments and make caring for patients more seamless, notes a recent Wolters Kluwer study, <a href="https://www.wolterskluwer.com/en/news/eight-out-of-ten-nursing-leaders-are-piloting-new-nursing-care-models-cites-wolters-kluwer-survey" target="_blank" title="Wolters Kluwer: Eight out of ten nursing leaders are piloting new nursing care models, cites Wolters Kluwer survey">“FutureCare Nursing 2025.”</a></p><p>The top five nursing care delivery models that health care organizations are planning to implement are:</p><img src="/sites/default/files/inline-images/Top-Five-Nursing-Care-Delivery-Models-That-Health-Care-Organizations-Are-Planning-to-Implement.jpg" data-entity-uuid="1983773d-e0bd-46db-91f2-6b2b22ac9a96" data-entity-type="file" alt="Home health nursing: 71%. Internal float pools: 68%. Virtual Nursing: 66%. Telehealth nursing: 66%. Multidisciplinary care: 61%. Source: Wolters Kluwer, 2025." width="597" height="212" class="align-center"><h3>Key Takeaway</h3><p>Tech will be vital to improve workflows. With these nursing models forecast to grow, new care-related technologies will be vital to enhance and improve daily workflows, particularly with home health, virtual and telehealth nursing. When asked how they will measure the success of these implementations, about half of the survey respondents highlighted the following areas as most impactful:</p><img src="/sites/default/files/inline-images/Success-Metrics-of-New-Care-Related-Technologies.jpg" data-entity-uuid="48eb6d82-a206-489c-b511-3290b6b8b528" data-entity-type="file" alt="Reduced medical errors: 51%. Optimized nurse staffing and workforce management: 50%. Improved clinical outcomes: 48%. Source: Wolters Kluwer: 2025." width="597" height="212" class="align-center"><h2>7 Nursing Roles to Be Most in Demand</h2><p>To support the rollout of new nursing care models, hospital and health system leaders will be looking for specialized skills and experience when increasing the engagement and retention of their workforce, the Wolters Kluwer report states. When polled about new roles they would look to add when implementing new care models, respondents ranked the following as the top areas:</p><ul><li><strong>Nurse informatics: </strong><span><strong>52%</strong></span></li><li><strong>Telehealth nurses: </strong><span><strong>50%</strong></span></li><li><strong>Nurse care coordinators: </strong><span><strong>50%</strong></span></li><li><strong>Nurse educators in telehealth and virtual care: </strong><span><strong>47%</strong></span></li><li><strong>Internal float pool nurses: </strong><span><strong>41%</strong></span></li><li><strong>Home health nurse coordinator: </strong><span><strong>41%</strong></span></li><li><strong>Nurse case manager: </strong><span><strong>41%</strong></span></li></ul><h3>Key Takeaway</h3><p>Encourage nurses to explore new roles. Nursing students and nurses looking to expand or change their careers should consider the growing demand for nursing roles that, in some cases, are tech-enabled, the Wolters Kluwer study states.</p></div><div class="col-md-4"><p><a href="/center" title="Visit the AHA Center for Health Innovation landing page."><img src="/sites/default/files/inline-images/logo-aha-innovation-center-color-sm.jpg" data-entity-uuid="7ade6b12-de98-4d0b-965f-a7c99d9463c5" alt="AHA Center for Health Innovation logo" width="721" height="130" data-entity- type="file" class="align-center"></a></p><p><a href="/center/form/innovation-subscription"><img src="/sites/default/files/2019-04/Market_Scan_Call_Out_360x300.png" data-entity-uuid data-entity-type alt width="360" height="300"></a></p></div></div></div>.field_featured_image { position: absolute; overflow: hidden; clip: rect(0 0 0 0); height: 1px; width: 1px; margin: -1px; padding: 0; border: 0; } .featured-image{ position: absolute; overflow: hidden; clip: rect(0 0 0 0); height: 1px; width: 1px; margin: -1px; padding: 0; border: 0; } h2 { color: #9d2235; } h3 { color: #9d2235; } Tue, 29 Apr 2025 06:15:00 -0500 Nurses /aha-center-health-innovation-market-scan/2025-04-29-ai-advances-reduce-burden-nurses-get-fresh-look <div class="container"><div class="row"><div class="col-md-8"><p><img src="/sites/default/files/inline-images/AI-Advances-to-Reduce-Burden-on-Nurses-Get-a-Fresh-Look.png" data-entity-uuid="12207187-a2cf-4fdd-8f6e-bb8cb6bc6429" data-entity-type="file" alt="AI Advances to Reduce Burden on Nurses Get a Fresh Look. An artificial intelligence (AI) bot and a nurse clinician share data." width="1200" height="677"></p><p>Using artificial intelligence (AI) to reduce the administrative burden on clinicians continues to gain momentum, but lately there has been an increasing focus on helping nurses in this endeavor.</p><p>Recent reports note that the electronic health record (EHR) giant Epic Systems is piloting <a href="https://www.epic.com/software/ai-clinicians/" target="_blank" title="Epic: AI for Clinicians">AI-powered documentation tools</a> to support nursing workflows and reduce administrative load. The technology suggests and pre-populates clinical data in patient records, mimicking earlier physician-focused applications.</p><p>Epic is partnering with Microsoft and <a href="https://www.abridge.com/" target="_blank" title="Abridge homepage">ambient AI vendor Abridge</a> in this effort. Epic officials believe generative AI and ambient generative AI offer nurses a new set of tools to reinvent how they work.</p><p>Nurses are testing Epic's Rover mobile app to record conversations through a smartphone, notes a <a href="https://www.modernhealthcare.com/digital-health/epic-ai-clinical-documentation-tools-nursing" target="_blank" title="Modern Healthcare: Epic pilots AI clinical documentation tools for nursing">Modern Healthcare report</a>. The AI tool puts relevant portions of a conversation into the EHR, such as a patient’s pain scores. A nurse then reviews the data in the Rover app and files them to the chart.</p><p>The technology also is being tested with Microsoft at nine health systems, including Baptist Health in Jacksonville, Florida, Mercy Hospital St. Louis and Stanford Health Care in California, the report states. Pilot participants will provide feedback to Epic to refine the tools through clinical testing and iterative feedback.</p><h2>Piloting AI in Nursing Workflows</h2><p>Elsewhere, Cedars-Sinai Medical Center earlier this year began testing an AI mobile app called <a href="https://www.aivahealth.com/aiva-nurse-assistant" target="_blank" title="Aiva Health: Aiva Nurse Assistant and the Dawn of Voice Charting">Aiva Nurse Assistant</a>. The app allows nurses to use a mobile phone to document patient information in real time through voice dictation. It transcribes the data and then — once validated by a clinician — the app files that information directly into the patient’s EHR.</p><p>Initially being tested by nurses and clinical partners on a 48-bed surgical unit, the pilot expands on similar technologies already in use by Cedars-Sinai physicians.</p><p><a href="https://health.universityofcalifornia.edu/news/writing-new-history-health-care-uc-nurses-set-vision-future-ai-nursing" target="_blank" title="University of California Health: “Writing the new history for health care”: UC nurses set a vision for the future of AI in nursing">University of California Health</a>, meanwhile, is using AI to augment clinical nurses’ practice skills and responsibilities. The health system is integrating different databases and technology systems to help make nurses’ work more efficient.</p><p>In a 12-hour shift, a nurse spends 132 minutes on average documenting patient information in the EHR system, according to Donna Wellbaum, MSN, R.N., chief nursing informatics officer at UCLA Health.</p><p>That’s about 18% of a nurse’s time per 12-hour shift and doesn’t account for other research that a nurse may need to conduct outside of the EHR to consult other databases and systems on policies, patient education, standards of care or other procedures.</p><p>Front-line nurses and nurses in management roles at UCSF both cite another key benefit that AI brings to the profession: being able to collect information from several sources and systems on a single screen to help them get what they need to help their patients.</p><p>Regardless, nurses always will need to apply clinical judgment and critical thinking in how they care for their patients. “Every AI tool necessitates the clinician to review and validate what was suggested," notes Kay Burke, R.N., vice president and chief nursing informatics officer at UCSF.</p></div><div class="col-md-4"><p><a href="/center" title="Visit the AHA Center for Health Innovation landing page."><img src="/sites/default/files/inline-images/logo-aha-innovation-center-color-sm.jpg" data-entity-uuid="7ade6b12-de98-4d0b-965f-a7c99d9463c5" alt="AHA Center for Health Innovation logo" width="721" height="130" data-entity- type="file" class="align-center"></a></p><p><a href="/center/form/innovation-subscription"><img src="/sites/default/files/2019-04/Market_Scan_Call_Out_360x300.png" data-entity-uuid data-entity-type alt width="360" height="300"></a></p></div></div></div>.field_featured_image { position: absolute; overflow: hidden; clip: rect(0 0 0 0); height: 1px; width: 1px; margin: -1px; padding: 0; border: 0; } .featured-image{ position: absolute; overflow: hidden; clip: rect(0 0 0 0); height: 1px; width: 1px; margin: -1px; padding: 0; border: 0; } h2 { color: #9d2235; } Tue, 29 Apr 2025 06:00:00 -0500 Nurses /guidesreports/2025-04-28-2024-costs-caring <div class="container"><div class="row"><div class="col-md-8"><h2><span>Introduction</span></h2><p><img src="/sites/default/files/inline-images/Figure-1-Labor-constitutes-largest-percentage-of-hospital-expenses.png" data-entity-uuid="d6c1793f-d4c3-44ea-8ba5-d1f15b6518e2" data-entity-type="file" alt="Figure 1. Labor constitutes largest percentage of hospital expenses. Labor: 60% ($839 Billion); Supplies: 13% ($181 Billion); Drugs: 8% ($115 Billion); Other: 19% ($269 Billion). Note: Average expenses estimated by Strata Decision Technology median 2023 values across all hospital spending. Labor is inclusive of purchased services and professional fees." width="718" height="752" id="figure1" class="align-right">Hospitals and health systems have been at the forefront of a major transformation while at a crossroads of increasing demand for higher acuity care and deepening financial instability. Persistent workforce shortages, severe fractures in the supply chain for drugs and supplies, and high levels of inflation have collectively fueled hospitals’ costs as they care for patients 24/7 (see <a href="#figure1">Figure 1</a>). At the same time, hospitals’ costs have been met with inadequate increases in reimbursement by government payers and increasing administrative burden due to inappropriate commercial health insurer practices.</p><p><strong>Taken together, these issues have created an environment of financial uncertainty where many hospitals and health systems are operating with little to no margin. While recent data suggest that some hospital and health system finances have experienced modest stabilization from historic lows in 2022, the hospital field is still far from where it needs to be to meet the demand for care, invest in new and promising technologies and interventions, and stand ready for the next health care crisis.</strong></p><p><img src="/sites/default/files/inline-images/Figure-2-Inflation-growth-was-more-than-double-the-growth-in-IPPS-reimbursement-2021-2023.png" data-entity-uuid="90ce5355-e63a-4187-bfae-5a641d891486" data-entity-type="file" alt="Figure 2. Inflation growth was more than double the growth in IPPS reimbursement, 2021–2023. Inflation: 12.4%; IPPS Increases: 5.2%. Note: Inflation calculated using annual average CPI-U between 2021 and 2023 from BLS. IPPS increase from FY2020–2023 market basket increases net of other adjustments." width="385" height="705" id="figure2" class="align-left">Fresh off a historically challenging year financially in 2022 in which over half of hospitals closed out the year operating at a loss, many hospitals spent much of 2023 simply struggling to break even.<a href="#fn1"><sup>1</sup></a> Economy-wide inflation grew by 12.4% between 2021 and 2023 – more than two times faster than Medicare reimbursement for hospital inpatient care (see <a href="#figure2">Figure 2</a>).</p><p>Since the start of 2022, the number of days cash on hand for hospitals and health systems has declined by 28.3%, according to data from Strata Decision Technology, which provides data and cloud-based financial planning, decision support and performance analytics solutions.<a href="#fn2"><sup>2</sup></a></p><p>Diverting dollars from their reserves to maintain access to care has required tradeoffs that have limited many hospitals and health systems from investing in updated infrastructure, new medical technology and equipment, and other clinical needs — particularly among those hospitals in severe financial distress.<a href="#fn3"><sup>3</sup></a><sup>,</sup><a href="#fn4"><sup>4</sup></a> For example, the average age of capital investments for medical equipment and infrastructure, after years of remaining relatively flat, increased by 7.1% for all hospitals in 2023, according to data from Strata Decision Technology. While the constraints and burdens of increasing plant age present serious challenges to hospitals and health systems in their own right, the inability to make needed capital investments has contributed to bond rating agencies issuing rating downgrades, making it harder for some hospitals and health systems to borrow money.<a href="#fn5"><sup>5</sup></a> Ongoing reimbursement challenges, made worse by crises like the recent Change Healthcare cyberattack, and increased operating costs create an unsustainable financial environment.<a href="#fn6"><sup>6</sup></a> While these challenges alone could cripple any organization, hospitals and health systems continue to face additional threats from ongoing Medicaid redeterminations increasing uncompensated care<a href="#fn7"><sup>7</sup></a>, regulatory changes that add operational burden, cyberattacks that threaten the health care infrastructure and potential legislation that would further cut Medicare payments to hospitals.</p><p>This report provides a snapshot of the current cost realities facing hospitals and health systems and how they impact their ability to care for patients and communities.</p><h2><span>1. Costs of Providing Essential Services</span></h2><p><img src="/sites/default/files/inline-images/Figure-3-Cumulative-Medicaid-and-Medicare-underpayments.png" data-entity-uuid="1846fd31-a865-4fcb-8de7-b4ca6bf1b3f2" data-entity-type="file" alt="Figure 3. Cumulative Medicaid and Medicare underpayments. 2013 to 2017: -$375 Billion; 2018 to 2022: -$522 Billion. Note: AHA Annual Survey 2013 to 2022 all dollars inflation adjusted to 2022 values using CPI-U from the BLS." width="620" height="672" id="figure3" class="align-right">Hospitals often play the critical — and sometimes only — role in providing access to essential health care services, such as emergency care and behavioral health, which are necessary for the health and well-being of the communities they serve. Further, oftentimes these are services that are not offered by other types of health care providers. In 2022, the most recent year for which data are available, hospitals admitted nearly 137 million patients in emergency departments and delivered over 3.5 million babies.<a href="#fn8"><sup>8</sup></a> Many of these essential services are extremely resource intensive and costly to offer. Further compounding this issue are demographic trends such as an aging population and clinical factors such as higher patient acuity. This has driven a steady rise in the share of inpatient utilization among more clinically complex patients covered by Medicare and Medicaid.<a href="#fn9"><sup>9</sup></a> Not only are inpatient services costlier to provide, but public payer payments for these services fall well below costs. In fact, underpayments from Medicare and Medicaid totaled nearly $130 billion in 2022, and Medicare paid just 82 cents for every dollar hospitals spent caring for patients — resulting in a shortfall of almost $100 billion.<a href="#fn10"><sup>10</sup></a> Troublingly, cumulative underpayments in the second half of the last decade totaled more than half a trillion dollars — a nearly 40% increase compared to the first half even after adjusting for inflation (see <a href="#figure3">Figure 3</a>).</p><p>However, the reimbursement challenges do not end with Medicare and Medicaid Reimbursement for some services consistently fall below costs across all payer types. For example, payments for inpatient behavioral health services were 34.3% below costs across all payers on average in 2023, according to data from Strata Decision Technology (see <a href="#figure4">Figure 4</a>). This is especially concerning given the increased utilization of behavioral health services over the last few years.</p><img src="/sites/default/files/inline-images/Figure-4-Hospital-payments-do-not-cover-the-costs-of-providing-vital-patient-services-20240612.png" data-entity-uuid="96ed5e28-677a-4ba0-8659-407033fe0a56" data-entity-type="file" alt="Figure 4. Hospital payments do not cover the costs of providing vital inpatient services. Average margin on services: Behavioral Health -34.3%; Nephrology -34.1%; Burns and Wounds -24.1%; Pulmonology -19.4%; Infectious Disease -15.3%. Note: AHA analysis of 2023 average service line payment and cost across all payers from Strata Decision Technology. Does not include supplemental payments from Medicaid." width="1565" height="623" id="figure4"><p>In the outpatient setting, average payments for costly burn and wound services were 42.9% below costs across all payers (see <a href="#figure5">Figure 5</a>). These shortfalls have been especially acute for government payers like Medicare. For example, average Medicare margins for behavioral health services were -38.9% in 2023.</p><img src="/sites/default/files/inline-images/Figure-5-Hospital-payments-also-fail-to-cover-the-costs-of-providing-essential-outpatient-services.png" data-entity-uuid="a43ea45f-a309-46a9-9acc-fb54b385b5b2" data-entity-type="file" alt="Figure 5. Hospital payments also fail to cover the costs of providing essential outpatient services. Average margin on services: Burns and wounds -42.9%; Nephrology -32.3%; Behavioral Health -31.7%; Pulmonology -17.5%; Infectious Disease -12.1%. Note: AHA analysis of 2023 average service line payment and cost across all payers from Strata Decision Technology. Does not include supplemental payments from Medicaid." width="1558" height="616" id="figure5"><p>Taken together, these data highlight the challenges that hospitals and health systems face in providing essential services that communities need. This is particularly true for hospitals in rural areas, where the financial challenges can be even more severe.</p><h2><span>2. Hospital Administrative Expenses</span></h2><p><span><em><strong><img src="/sites/default/files/inline-images/Figure-6-Premiums-grew-twice-as-fast-as-hospital-prices-in-2023.png" data-entity-uuid="d158d191-431b-4548-aebc-57269df046dc" data-entity-type="file" alt="Figure 6. Premiums grew twice as fast as hospital prices in 2023. Health Insurance Premiums: 6.7%; Hospital Prices: 2.6%. Note: Health insurance premiums represent premiums for a family of four, from KFF Employer Health Benefits Survey, 2023. Hospital Prices: BLS, annual average Producer Price index for hospitals." width="607" height="790" id="figure6" class="align-right">Some commercial health insurer practices increase hospital costs and delay care to patients</strong></em></span></p><p>Hospitals have seen significant growth in administrative costs due to inappropriate practices by certain commercial health insurers, including Medicare Advantage (MA) and Medicaid managed care plans. In addition to increasing premiums, which grew twice as fast as hospital prices in 2023, commercial health insurers have overburdened hospitals with time-consuming and labor-intensive practices like automatic claims denials and onerous prior authorization requirements (see <a href="#figure6">Figure 6</a>).<a href="#fn11"><sup>11</sup></a></p><p>A 2021 study by McKinsey estimated that hospitals spent $10 billion annually on dealing with insurer prior authorizations.<a href="#fn12"><sup>12</sup></a> Additionally, a 2023 study by Premier found that hospitals are spending just under $20 billion annually in appealing denials — more than half which was wasted on claims that should have been paid out at the time of submission.<a href="#fn13"><sup>13</sup></a> Denials issued by commercial MA plans rose sharply by 55.7% in 2023.<a href="#fn14"><sup>14</sup></a> Notably, many of these denials were ultimately overturned, consistent with a study by the Department of Health and Human Services’ (HHS) Office of Inspector General (OIG) that found 75% of care denials were subsequently overturned.<a href="#fn15"><sup>15</sup></a> These denials are particularly concerning because they often occur for medically necessary care, which can result in direct patient harm. In fact, a recent HHS OIG report found that nearly one in five MA denials met Medicare coverage rules, which meant that had they been paid via Medicare fee-for-service, they would have been paid without denial.<a href="#fn16"><sup>16</sup></a> Even when denials are ultimately overturned, hospitals are not paid for the costs incurred to navigate that burdensome and resource-intensive process. Making matters worse, MA plans paid hospitals less than 90% of Medicare rates despite costing taxpayers more than traditional Medicare in 2023.<a href="#fn17"><sup>17</sup></a><sup>,</sup><a href="#fn18"><sup>18</sup></a> Although partly a function of lower rates, the worsening administrative overload is simply costing hospitals more and more.</p><p>Though these issues are often felt most acutely with MA and Medicaid managed care plans, it also is true for other commercial payers, where claims denials increased by 20.2% in 2023. Moreover, the time taken by commercial payers to process and pay hospital claims from the date of submission increased by 19.7% in 2023, according to data from the Vitality Index. For hospitals and health systems, these practices result in billions of dollars in lost revenue each year, which require hospitals to divert dollars away from patient care to instead focus on seeking payment from commercial insurers.<a href="#fn19"><sup>19</sup></a> Without further intervention, these trends are expected to continue and worsen. National expenditures on the administrative costs of private health insurance spending alone are projected to account for 7% of total health care spending between 2022 and 2031 and are projected to grow faster than expenditures for hospital care.<a href="#fn20"><sup>20</sup></a></p><h3><span>Other expenses</span></h3><p>Hospitals also are spending more on things that are not direct patient care services but are still critical to delivering care and maintaining operations. For example, the costs associated with implementing, maintaining and upgrading information management systems and overall technology infrastructure, while critical to improving efficiency and quality of care, typically represent significant investments.</p><p>Additionally, given the confidential nature of patient data in these systems, hospitals have increasingly become targets for cyberattacks. As a result, the costs of defending against these attacks and protecting patient data has grown steadily.<a href="#fn21"><sup>21</sup></a> Health care data breaches are by far the costliest of any other sector.<a href="#fn22"><sup>22</sup></a> As cyberattacks and data breaches in health care have grown and regulators are requiring more robust protections, hospitals and health systems are finding themselves increasingly trying to invest in cybersecurity.<a href="#fn23"><sup>23</sup></a> Protecting against cyberattacks and other vulnerabilities is important to patient care, but is increasingly costly. In 2022, hospitals spent nearly $30 billion on property and medical liability insurance, according to data from Lightcast.</p><h2><span>3. Hospital Drug Expenses</span></h2><p>An area of persistent cost pressure for hospitals and health systems has been the rapid and sustained growth in drug expenses. Hospitals spent $115 billion on drug expenses in 2023 alone. One of the factors fueling this growth is drug company decisions to impose large price increases on existing drugs. However, 2023 also saw a continuation of a long-standing trend of drug companies introducing new drugs at record prices. In 2023, the median annual list price for a new drug was $300,000, an increase of 35% from the prior year (see <a href="#figure7">Figure 7</a>).<a href="#fn24"><sup>24</sup></a> A recent report by the HHS Assistant Secretary for Planning and Evaluation (ASPE) found that between 2022 and 2023, prices for nearly 2,000 drugs increased faster than the rate of general inflation, with an average price hike of 15.2%.<a href="#fn25"><sup>25</sup></a></p><img src="/sites/default/files/inline-images/Figure-7-Annual-List-Prices-of-Novel-Drugs-Launched-in-2023.png" data-entity-uuid="b88a70d2-300e-48d9-90f9-e3fbe3b80e83" data-entity-type="file" alt="Figure 7. Annual List Prices of Novel Drugs Launched in 2023*. Elevidys: $3,200,000; Roctavian: $2,900,000; Veopoz: $1,799,980; Altuviiio: $970,000; Pombiliti: $650,000; Talvey: $360,000; Orserdu: $280,526; Adzynma: $245,000; Zynyz: $170,880; Filspari: $129,965; Velsipity: $74,000; Leqembi: $26,000. Median price of new drug: $300,000. Median household: $74,580. Average price of a new car: $48,759. Source: Annual list prices of novel drugs launched in 2023 are from a Reuters survey of new drug costs. Median household income is from 2022 Census Bureau data. Average price of new care is from Kelly Blue Book new-vehicle transaction price in December 2023." width="1563" height="771" id="figure7"><p><img src="/sites/default/files/inline-images/Figure-8-Increase-in-drug-shortages-and-drug-prices-2022-2023.png" data-entity-uuid="e6973989-b4db-4b1f-a2ac-dd8b512598d6" data-entity-type="file" alt="Figure 8. Increase in drug shortages and drug prices, 2022–2023. 2022: Drug Shortages 8.0%; Drug Prices 11.5%. 2023: Drug Shortages: 13.0%; Drug Prices 15.2%. Note: Drug shortage data from Utah Drug Information System; Drug price data from ASPE." width="607" height="691" id="figure8" class="align-right">While high drug prices alone pose significant challenges for hospitals and health systems, it is compounded by the fact that many of these same drugs are in shortage. In fact, 2023 saw the most drug shortages in over a decade; there were an average of 301 drugs in shortage per quarter, an increase of 13.0% from the previous year (see <a href="#figure8">Figure 8</a>). These shortages added as much as 20% to hospital drug budgets, according to data from the American Society of Health System Pharmacists (ASHP). These shortages can occur for many reasons, including fractured global supply chains lack of available raw materials, and decisions by drug companies that lack incentives to produce low-margin generic medications.<a href="#fn26"><sup>26</sup></a> An ASHP survey found that more than 99% of hospital and health system pharmacists experienced drug shortages in 2023, with 85% of respondents describing the severity of drug shortages as critically or moderately impactful.<a href="#fn27"><sup>27</sup></a> While generic drugs comprised the majority of medications in shortage, estimated to make up as much as 83% of shortages, many of these drugs also were used to treat cancer and autoimmune diseases.<a href="#fn28"><sup>28</sup></a></p><p>Hospital pharmacy staff have limited options for navigating drug shortages. They can purchase the drug by going outside their traditional suppliers and group purchasing agreements, access alternate concentrations or package sizes of the drugs than what is needed or purchase a substitute drug with the same clinical indication. However, all three of these options mean hospitals pay higher prices to acquire the drugs. An ASPE report found up to a 16.6% increase in the prices of drugs in shortage; in many cases, the increase in the price of substitute drugs were at least three times higher than the price increase of the drug in shortage.<a href="#fn29"><sup>29</sup></a> The costs incurred as a result of drug shortages are compounded by staff overtime needed to find, procure and administer alternative drugs, to manage the added challenges of multiple medication dispensing automation systems and changing electronic health records (EHRs), and to undergo training to ensure medication safety using alternative therapies.<a href="#fn30"><sup>30</sup></a></p><h2><span>4. Hospital Supply Costs</span></h2><div class="row"><div class="col-md-5"><p>Having adequate and up-to-date medical supplies, devices and equipment are necessary for hospitals to deliver high quality care to patients. These can include artificial joints used to treat patients with conditions such as arthritis, robotic surgery machines used to perform laparoscopic surgical procedures, and complex imaging machinery used for clinical diagnostics. Most of these items are expensive to acquire and maintain and rely on increasingly volatile global supply chains. Comprising approximately 10.5% of the average hospital’s budget, medical supply expenses collectively accounted for $146.9 billion in 2023, an increase of $6.6 billion over 2022, according to data from Strata Decision Technology. As technology and science are constantly evolving, hospitals routinely need to purchase new supplies, devices and equipment that meet clinical care standards and ensure high quality care.</p><p>The upfront costs for critical equipment and device upgrades come at a significant cost (<a href="#table1">Table 1</a>). For example, the advanced technology of cardiac magnetic resonance imaging (cMRI) machines, which have allowed doctors to develop a deeper understanding of cardiac pathologies and has led to improved diagnostics, costs hospitals on average $3.2 million. For some hospitals that have high demand for cardiac services, they may need to purchase multiple cMRI machines. The additional costs for ongoing maintenance, upgrades and staff training also add to the total costs hospitals must incur to deliver their patients with the high quality care.</p></div><div class="col-md-7"> table, th, td { border: 1px solid; } th { background-color: #69b3e733; } } <table id="table1"><tbody><tr><td><h3>Table 1. Medical Device and Equipment Market Prices</h3></td></tr><tr><td><em>Cutting-edge innovation and technologies provide hospitals with the means to enhance patient outcome in their continuous commitment to delivering top-tier patient care. The featured equipment is intricately connected to advancements in diagnostics, heightened success rates in cardiovascular surgery, and more effective joint replacement procedures.</em></td></tr></tbody></table><table><thead><tr><th>Medical Devices and Equipment</th><th>Average List Price</th></tr></thead><tbody><tr><td colspan="2"><strong>Point of Care ultrasound devices</strong></td></tr><tr><td>Pocket-sized handheld or tablet-based</td><td>$8,143</td></tr><tr><td>Compact ultrasound systems*</td><td>$73,797</td></tr><tr><td colspan="2"><strong>Cardiovascular diagnostic and surgical equipment</strong></td></tr><tr><td>Cardiac magnetic resonance imaging (cMRI) machine</td><td>$3,230,728</td></tr><tr><td>Cardiopulmonary bypass system</td><td>$325,442</td></tr><tr><td colspan="2"><strong>Joint implant proprietary software and equipment</strong></td></tr><tr><td>Image based planning software</td><td>$222,132</td></tr><tr><td>Navigation software system (guide surgeons in real-time)</td><td>$135,365</td></tr><tr><td colspan="2"><p>*Larger than handheld devices, but still portable. May have more advanced features.</p><p><span><strong>Note:</strong></span> Market prices of medical devices and equipment are courtesy of ECRI, an independent not-for-profit corporation that provides a wide range of services dealing with health care technology.</p></td></tr></tbody></table></div></div><h2><span>5. Hospital Labor Costs</span></h2><p>Hospitals’ labor costs increased by more than $42.5 billion between 2021 and 2023 to a total of $839 billion, accounting for nearly 60% of the average hospital’s expenses. Hospitals continue to turn to expensive contract labor to fill gaps and maintain access to care, spending approximately $51.1 billion on contracted staff in 2023.</p><p><img src="/sites/default/files/inline-images/Figure-9-Growth-in-Total-Hospital-Employee-Compensation-Far-Outpaces-Inflation.png" data-entity-uuid="5fa4709d-12e9-47f3-af06-07ac3b0937b6" data-entity-type="file" alt="Figure 9. Growth in Total Hospital Employee Compensation Far Outpaces Inflation. 2014 to 2023: Inflation 28.7%; Hospital Employee Compensation 45.0%. Note: BLS Annual average Employee Cost Index, 2014 to 2023 for hospitals and CPI-U, 2014 to 2023." width="522" height="592" id="figure9" class="align-right">Though expenditures on contract labor have moderated since pandemic highs, the spending remains elevated and has added to the financial challenges hospitals and health systems face. This is especially true for smaller, rural hospitals where the local workforce pool is smaller and it can be more difficult to recruit staff. Hospitals’ labor costs also can be very sensitive to sudden fluctuations in the demand and supply of labor. Growth in wages and benefits of hospital employees has vastly surpassed economy-wide inflation over the last decade (see <a href="#figure9">Figure 9</a>).</p><p>Yet, critical labor shortages persist, especially in the face of growing burnout among clinicians. Employee burnout hastened by the pandemic and further exacerbated by commercial insurer administrative burden and increase in violence against hospital employees, led to an unprecedented exodus of health care professionals in recent years.<a href="#fn31"><sup>31</sup></a> Resignations per month among health care workers grew 50% between 2020 and 2023, according to data from McKinsey.<a href="#fn32"><sup>32</sup></a> Additionally, hospitals have been forced to contend with record high turnover rates — fueling additional expenses for hospitals looking to recruit new workers.<a href="#fn33"><sup>33</sup></a></p><p>Consequently, hospitals and health systems have invested more to attract and retain talent. Data from Lightcast indicates that advertised wage rates across all hospital jobs jumped by 10.1% during 2023. With a growing gap between supply and demand for health care workers over the next decade, labor costs will likely continue to be an issue for hospitals.</p><h2><span>A Look Ahead to the Rest of 2024</span></h2><p>Though 2024 is the first full year out of the most recent public health emergency period, hospitals and health systems continue to face many challenges. Credit ratings agencies have painted a bleak picture for the hospital sector in 2024.<a href="#fn34"><sup>34</sup></a> According to the S&P, negative outlooks for not-for-profit hospitals are proportionally at their highest in over a decade, affecting 24% of the sector.<a href="#fn35"><sup>35</sup></a> Similarly, Fitch reported a credit downgrade-to-upgrade ratio of 3:1 — alarmingly close to the ratio seen during the 2008 financial crisis — calling it a “make or break” year and highlighting the sector’s struggles, particularly among smaller hospitals with annual revenues under $500 million.<a href="#fn36"><sup>36</sup></a> While it is expected that hospitals and health systems will continue to face cost increases for labor, drugs, and medical supplies, there are additional headwinds to consider which include:</p><ul><li>Coverage losses due to Medicaid redeterminations: More than 19 million Medicaid enrollees have been disenrolled through 2023.<a href="#fn37"><sup>37</sup></a> Though partially offset by record Marketplace enrollment and possible enrollment in employer-sponsored coverage, this has still resulted in a steady increase in uncompensated care costs throughout 2023 and will likely continue into 2024 – particularly for states that have not expanded Medicaid.<a href="#fn38"><sup>38</sup></a></li><li>Potential legislative actions to cut hospital Medicare payments for patient care: Congress is considering several bills that would impose additional payment reductions to services provided in hospital outpatient departments. These proposals, referred to as “siteneutral” payment cuts, would exacerbate financial challenges for hospitals and threaten patients’ access to quality care.</li><li>Cybersecurity risks impact providers and patient care: The cyberattack on Change Healthcare in February 2024 has underscored the extensive repercussions such incidents can have on patient care and hospital operations. The disruptions stemming from that cyberattack have significantly hindered revenue cycle management, pharmacy services, select health care technologies, clinical authorizations, and more across multiple health systems, serving as an example of how an attack can reverberate across the entire health care sector when a business that provides numerous mission-critical services is compromised.<a href="#fn39"><sup>39</sup></a></li><li>Ongoing and escalating hospital violence: There has been a significant uptick in violence against health care workers in recent years.<a href="#fn40"><sup>40</sup></a> To address this issue, hospitals are making significant investments in violence prevention and preparedness efforts to support their employees.</li></ul><h2><span>Conclusion</span></h2><p>America’s hospitals and health systems are dedicated to providing high-quality 24/7 care to all patients in every community across the country. While the commitment to caring and advancing health never wavers, hospitals continue to face significant challenges making it difficult to ensure the care is always there.</p><p>The AHA continues to urge Congress and the Administration to support policies to make sure hospitals and health systems have the resources they need to continue providing 24/7 care to all patients and communities. These include:</p><ul><li>Rejecting Medicare and Medicaid cuts to hospital care, including harmful site-neutral proposals and forthcoming reductions to Medicaid Disproportionate Share hospitals.</li><li>Supporting and strengthening the health care workforce.</li><li>Protecting the 340B Drug Pricing Program from any harmful changes and reining in the increasing costs of drugs.</li><li>Taking actions to hold commercial insurers accountable for practices that delay, deny and disrupt care.</li><li>Bolstering support to enhance cybersecurity of hospitals and the entire health care system.</li></ul><hr><h2>End Notes</h2><ol><li id="fn1"><a href="www.kaufmanhall.com/news/2022-worst-financial-year-hospitals-and-health-systems-start-pandemic" target="_blank">www.kaufmanhall.com/news/2022-worst-financial-year-hospitals-and-health-systems-start-pandemic</a></li><li id="fn2"><a href="https://www.syntellis.com/sites/default/files/2023-11/aha_q2_2023_v2.pdf" target="_blank">www.syntellis.com/sites/default/files/2023-11/aha_q2_2023_v2.pdf</a></li><li id="fn3"><a href="https://fortune.com/well/2024/01/11/rural-hospitals-are-caught-in-an-aging-infrastructure-conundrum/" target="_blank">fortune.com/well/2024/01/11/rural-hospitals-are-caught-in-an-aging-infrastructure-conundrum/</a></li><li id="fn4"><a href="/guidesreports/2023-04-19-essential-role-financial-reserves-not-profit-healthcare" target="_blank">www.aha.org/guidesreports/2023-04-19-essential-role-financial-reserves-not-profit-healthcare</a></li><li id="fn5"><a href="https://www.modernhealthcare.com/finance/hospital-2023-credit-rating-downgrade-fitch-ratings-sp-global-moodys" target="_blank">www.modernhealthcare.com/finance/hospital-2023-credit-rating-downgrade-fitch-ratings-sp-global-moodys</a></li><li id="fn6"><a href="/cybersecurity/change-healthcare-cyberattack-updates" target="_blank">www.aha.org/cybersecurity/change-healthcare-cyberattack-updates</a></li><li id="fn7"><a href="/news/blog/2023-09-20-unwise-dsh-cuts-combined-rise-uncompensated-care-due-medicaid-redeterminations-coverage-losses-further" target="_blank">www.aha.org/news/blog/2023-09-20-unwise-dsh-cuts-combined-rise-uncompensated-care-due-medicaid-redeterminations-coverage-losses-further</a></li><li id="fn8">AHA analysis of 2022 Annual Survey data.</li><li id="fn9"><a href="https://www.trillianthealth.com/insights/the-compass/the-total-available-market-of-commercially-insured-patients-is-shrinking" target="_blank">www.trillianthealth.com/insights/the-compass/the-total-available-market-of-commercially-insured-patients-is-shrinking</a></li><li id="fn10"><a href="/news/headline/2024-01-10-aha-infographic-medicare-underpayments-hospitals-nearly-100-billion-2022#:~:text=AHA%20infographic%3A%20Medicare%20underpayments%20to%20hospitals%20nearly%20%24100%20billion%20in%202022,-Jan%2010%2C%202024&text=Medicare%20paid%20hospitals%20a%20record,negative%20Medicare%20margins%20that%20year." target="_blank">www.aha.org/news/headline/2024-01-10-aha-infographic-medicare-underpayments-hospitals-nearly-100-billion-2022#:~:text=AHA%20infographic% 3A%20Medicare%20underpayments%20to%20hospitals%20nearly%20%24100%20billion%20in%202022,-Jan%2010%2C%202024&text=Medicare%20 paid%20hospitals%20a%20record,negative%20Medicare%20margins%20that%20year.</a></li><li id="fn11"><a href="https://www.wsj.com/health/healthcare/health-insurance-cost-increase-5b35ead7" target="_blank">www.wsj.com/health/healthcare/health-insurance-cost-increase-5b35ead7</a></li><li id="fn12"><a href="https://www.mckinsey.com/~/media/mckinsey/industries/healthcare%20systems%20and%20services/our%20insights/administrative%20simplification%20how%20to%20save%20a%20quarter%20trillion%20dollars%20in%20us%20healthcare/administrative-simplification-how-to-save-a-quarter-trillion-dollars-in-us-healthcare.pdf?shouldIndex=false" target="_blank">www.mckinsey.com/~/media/mckinsey/industries/healthcare%20systems%20and%20services/our%20insights/administrative%20simplification%20 how%20to%20save%20a%20quarter%20trillion%20dollars%20in%20us%20healthcare/administrative-simplification-how-to-save-a-quarter-trillion-dollars- in-us-healthcare.pdf?shouldIndex=false</a></li><li id="fn13"><a href="https://premierinc.com/newsroom/blog/trend-alert-private-payers-retain-profits-by-refusing-or-delaying-legitimate-medical-claims" target="_blank">premierinc.com/newsroom/blog/trend-alert-private-payers-retain-profits-by-refusing-or-delaying-legitimate-medical-claims</a></li><li id="fn14"><a href="https://www.syntellis.com/sites/default/files/2023-11/aha_q2_2023_v2.pdf">www.syntellis.com/sites/default/files/2023-11/aha_q2_2023_v2.pdf</a></li><li id="fn15"><a href="https://oig.hhs.gov/oei/reports/OEI-09-19-00350.pdf" target="_blank">oig.hhs.gov/oei/reports/OEI-09-19-00350.pdf</a></li><li id="fn16"><a href="https://oig.hhs.gov/oei/reports/OEI-09-18-00260.pdf" target="_blank">oig.hhs.gov/oei/reports/OEI-09-18-00260.pdf</a></li><li id="fn17"><a href="https://www.ensemblehp.com/blog/the-real-cost-of-medicare-advantage-plan-success/" target="_blank">www.ensemblehp.com/blog/the-real-cost-of-medicare-advantage-plan-success/</a></li><li id="fn18"><a href="https://www.medpac.gov/wp-content/uploads/import_data/scrape_files/docs/default-source/reports/mar21_medpac_report_to_the_congress_sec.pdf#page=401" target="_blank">www.medpac.gov/wp-content/uploads/import_data/scrape_files/docs/default-source/reports/mar21_medpac_report_to_the_congress_sec.pdf#page=401</a></li><li id="fn19"><a href="https://www.ama-assn.org/practice-management/prior-authorization/health-systems-plagued-payer-takeback-schemes-110000#:~:- text=authorization’s financial impact-,Prior authorization’s financial impact,an increase of 67%.”" target="_blank">www.ama-assn.org/practice-management/prior-authorization/health-systems-plagued-payer-takeback-schemes-110000#:~:- text=authorization’s%20 financial%20impact-,Prior%20authorization’s%20financial%20impact,an%20increase%20of%2067%25.%E2%80%9D</a></li><li id="fn20">AHA analysis of NHE projections of 2022-2031 expenditures.</li><li id="fn21"><a href="https://www.healthcaredive.com/news/healthcare-ransomware-costs-comparitech-77-billion/698044/" target="_blank">www.healthcaredive.com/news/healthcare-ransomware-costs-comparitech-77-billion/698044/</a></li><li id="fn22"><a href="https://intraprisehealth.com/the-cost-of-cyberattacks-in-healthcare/" target="_blank">intraprisehealth.com/the-cost-of-cyberattacks-in-healthcare/</a></li><li id="fn23"><a href="https://www.healthcareitnews.com/news/cisos-face-budgetary-pressures-burnout-during-global-recession" target="_blank">www.healthcareitnews.com/news/cisos-face-budgetary-pressures-burnout-during-global-recession</a></li><li id="fn24"><a href="https://www.reuters.com/business/healthcare-pharmaceuticals/prices-new-us-drugs-rose-35-2023-more-than-previous-year-2024-02- 23/?utm_source=facebook&utm_medium=news_tab" target="_blank">www.reuters.com/business/healthcare-pharmaceuticals/prices-new-us-drugs-rose-35-2023-more-than-previous-year-2024-02- 23/?utm_source=facebook& utm_medium=news_tab</a></li><li id="fn25"><a href="https://aspe.hhs.gov/reports/changes-list-prices-prescription-drugs" target="_blank">aspe.hhs.gov/reports/changes-list-prices-prescription-drugs</a></li><li id="fn26"><a href="https://www.fda.gov/media/131130/download?attachment" target="_blank">www.fda.gov/media/131130/download?attachment</a></li><li id="fn27"><a href="https://news.ashp.org/-/media/assets/drug-shortages/docs/ASHP-2023-Drug-Shortages-Survey-Report.pdf" target="_blank">news.ashp.org/-/media/assets/drug-shortages/docs/ASHP-2023-Drug-Shortages-Survey-Report.pdf</a></li><li id="fn28"><a href="https://www.iqvia.com/insights/the-iqvia-institute/reports-and-publications/reports/drug-shortages-in-the-us-2023?utm_campaign=2023_ Drug_Shortages_Report_INSTITUTE_IS&utm_medium=email&utm_source=Eloqua" target="_blank">www.iqvia.com/insights/the-iqvia-institute/reports-and-publications/reports/drug-shortages-in-the-us-2023?utm_campaign=2023_ Drug_Shortages_Report_ INSTITUTE_IS&utm_medium=email&utm_source=Eloqua</a></li><li id="fn29"><a href="https://aspe.hhs.gov/reports/drug-shortages-impacts-consumer-costs" target="_blank">aspe.hhs.gov/reports/drug-shortages-impacts-consumer-costs</a></li><li id="fn30"><a href="https://link.springer.com/article/10.1007/s13181-023-00950-6#:~:text=Shortages%20compromise%20or%20delay%20medical,morbidity%20%5B1%2C%202%5D." target="_blank">link.springer.com/article/10.1007/s13181-023-00950-6#:~:text=Shortages%20compromise%20or%20delay%20medical,morbidity%20%5B1%2C%202%5D.</a></li><li id="fn31"><a href="/system/files/media/file/2023/06/fact-sheet-examining-the-real-factors-driving-physician-practice-acquisition.pdf" target="_blank">www.aha.org/system/files/media/file/2023/06/fact-sheet-examining-the-real-factors-driving-physician-practice-acquisition.pdf</a></li><li id="fn32"><a href="https://www.mckinsey.com/industries/healthcare/our-insights/how-health-systems-and-educators-can-work-to-close-the-talent-gap" target="_blank">www.mckinsey.com/industries/healthcare/our-insights/how-health-systems-and-educators-can-work-to-close-the-talent-gap</a></li><li id="fn33"><a href="https://www.healthcarefinancenews.com/news/rn-turnover-healthcare-rise" target="_blank">www.healthcarefinancenews.com/news/rn-turnover-healthcare-rise</a></li><li id="fn34"><a href="https://on24static.akamaized.net/event/44/67/84/2/rt/1/documents/resourceList1709062595167/ushealthcaresectorcreditbeat227241709062595167.pdf" target="_blank">on24static.akamaized.net/event/44/67/84/2/rt/1/documents/resourceList1709062595167/ushealthcaresectorcreditbeat227241709062595167.pdf</a></li><li id="fn35"><a href="https://www.spglobal.com/ratings/en/research/articles/231206-historical-peak-of-negative-outlooks-signals-challenges-remain-for-u-s-not- for-profit-acute-health-care-provi-12927513" target="_blank">www.spglobal.com/ratings/en/research/articles/231206-historical-peak-of-negative-outlooks-signals-challenges-remain-for-u-s-not- for-profit-acutehealth- care-provi-12927513</a></li><li id="fn36"><a href="https://www.fitchratings.com/research/us-public-finance/us-not-for-profit-hospitals-health-systems-outlook-2024-05-12-2023" target="_blank">www.fitchratings.com/research/us-public-finance/us-not-for-profit-hospitals-health-systems-outlook-2024-05-12-2023</a></li><li id="fn37"><a href="https://www.kff.org/report-section/medicaid-enrollment-and-unwinding-tracker-overview/" target="_blank">ww.kff.org/report-section/medicaid-enrollment-and-unwinding-tracker-overview/</a></li><li id="fn38"><a href="/news/blog/2023-09-20-unwise-dsh-cuts-combined-rise-uncompensated-care-due-medicaid-redeterminations-coverage-losses-further" target="_blank">www.aha.org/news/blog/2023-09-20-unwise-dsh-cuts-combined-rise-uncompensated-care-due-medicaid-redeterminations-coverage-losses-further</a></li><li id="fn39"><a href="/2024-02-24-update-unitedhealth-groups-change-healthcares-continued-cyberattack-impacting-health-care-providers" target="_blank">www.aha.org/2024-02-24-update-unitedhealth-groups-change-healthcares-continued-cyberattack-impacting-health-care-providers</a></li><li id="fn40"><a href="https://apnews.com/article/hospitals-workplace-violence-shootings-aa6918569ff8f76ff8a15b9813e31686" target="_blank">apnews.com/article/hospitals-workplace-violence-shootings-aa6918569ff8f76ff8a15b9813e31686</a></li></ol></div><div class="col-md-4"><p><a href="/system/files/media/file/2024/05/Americas-Hospitals-and-Health-Systems-Continue-to-Face-Escalating-Operational-Costs-and-Economic-Pressures.pdf" target="_blank" title="Click here to download Costs of Caring 2024: America’s Hospitals and Health Systems Continue to Face Escalating Operational Costs and Economic Pressures as They Care for Patients and Communities report PDF."><img src="/sites/default/files/inline-images/Page-1-Americas-Hospitals-and-Health-Systems-Continue-to-Face-Escalating-Operational-Costs-and-Economic-Pressures.png" data-entity-uuid="4315111b-85e5-46dd-9949-8bb4ee5e6246" data-entity-type="file" alt="Costs of Caring 2024: America’s Hospitals and Health Systems Continue to Face Escalating Operational Costs and Economic Pressures as They Care for Patients and Communities page 1." width="695" height="900"></a></p><div class="external-link spacer"><a class="btn btn-wide btn-primary" href="/guidesreports/2024-09-10-skyrocketing-hospital-administrative-costs-burdensome-commercial-insurer-policies-are-impacting" target="_blank">View the Skyrocketing Hospital Administrative Costs, Burdensome Commercial Insurer Policies Are Impacting Patient Care Report</a></div><div class="external-link spacer"><a class="btn btn-wide btn-primary" href="/guidesreports/2024-05-01-2023-costs-caring" target="_blank">View the 2023 Costs of Caring Report</a></div><div class="external-link spacer"><a class="btn btn-wide btn-primary" href="/guidesreports/2023-04-20-2022-costs-caring" target="_blank">View the 2022 Costs of Caring Report</a></div><div class="external-link spacer"><a class="btn btn-wide btn-primary" href="/guidesreports/2021-10-25-2021-cost-caring" target="_blank">View the 2021 Costs of Caring Report</a></div></div></div></div> Mon, 28 Apr 2025 15:04:37 -0500 Nurses /news/headline/2025-04-17-qa-highlights-value-nurses-boards <p>A Q&A in the latest edition of AHA Trustee Insights highlights how boards value the perspective of nurses. Experts interviewed include Kimberly Cleveland, board chair emeritus of the Nurses on Boards Coalition, Ann Collins, M.D., board chair of UNC Health Rex in Raleigh, N.C., and Melissa Fitzpatrick, R.N., board member of UNC Health Rex. <a href="https://trustees.aha.org/what-nurses-bring-hospital-and-health-system-boards?utm_source=newsletter&utm_medium=email&utm_campaign=aha-today"><strong>READ MORE</strong></a></p> Thu, 17 Apr 2025 14:34:12 -0500 Nurses /patient-safety-awareness-week <div class="container"> @media (min-width:768px){ .sp_CTA1_holder{ top:-30px } } @media (max-width:768px){ .sp_CTA1_holder{ top:-1px; margin-bottom:25px } } .sp_CTA1_holder{ background-color: #f6f6f6; padding:15px 0; position: relative; overflow: auto } .sp_CTA1 h3{ color:#002855; font-size: 1.4em; margin: 0px ; } .sp_CTA1 span{ display:block; margin-top:10px } .sp_CTA1 span a{ color:#d50032; } .sp_CTA1 span a:hover{ color:#651d32; } .sp_CTA1 img{ /*width: 150px; max-width: 85%; */ max-width:64px; } @media (max-width:768px) and (min-width:361px){ .sp_CTA1 .col-xs-2{ width: 25%; left:15px } .sp_CTA1 .col-xs-10{ width: 70%; padding-right: 15px } } @media (max-width:360px){ .sp_CTA1 img{ margin: auto; display: block } .sp_CTA1 .col-xs-2{ width: 100%; } .sp_CTA1 .col-xs-10{ width: 100%; text-align: center; padding: 0 25px } } <div class="row sp_CTA1"><div class="col-sm-1"> </div><div class="col-sm-10 sp_CTA1_holder"><div class="col-xs-2"><img src="/sites/default/files/2020-02/Alert_navy_white_150px.png" alt="icon of an announcement horn" width="150" height="150"></div><div class="col-xs-10"><h3>Join us March 9-15</h3><p>AHA supports and celebrates the hospitals and health systems that prioritize patient safety every day in every corner of the country. Patient Safety Awareness Week offers an opportunity to raise awareness about patient safety, celebrate successes and share resources.</p></div></div><div class="col-sm-1"> </div></div><div class="row"><div class="col-md-10 col-md-offset-1"><h2 class="text-align-center">Patients and Staff Celebrate Safety Improvement</h2><p>In partnership with national data partners like Press Ganey and Vizient, the Patient Safety Initiative is driving the national conversation around patient safety with data-driven insights reports.</p></div> @media (min-width:768px) { .Sperate-rowEqual_768 { display: -webkit-box; display: -webkit-flex; display: -ms-flexbox; display: flex; flex-wrap: wrap; } .Sperate-rowEqual_768>[class*='col-'] { -ms-flex: 1; /* IE 10 */ /*flex: auto;*/ width: calc((100% / 2) - 20%); margin: 0 auto 20px; } } .Sperate-rowEqual_768 .col-md-4{ border:2px solid #003087; margin-bottom: 25px; } <div class="spacer col-md-12 Sperate-rowEqual_768"><div class="col-md-4"><div><a href="/guidesreports/2025-03-11-improvement-safety-culture-linked-better-patient-and-staff-outcomes" title="Read the Insights Report: Improvement in Safety Culture Linked to Better Patient and Staff Outcomes"><img src="/sites/default/files/2025-02/PG-PA-Report-700x532.jpg" alt="Cover for Insights Report: Improvement in Safety Culture Linked to Better Patient and Staff Outcomes" width="100%" height="100%"></a><div><strong>NEW</strong></div><h2 class="text-align-center">Improvement in Safety Culture Linked to Better Patient and Staff Outcomes</h2><p class="text-align-center"><a class="btn btn-primary btn-wide" href="/guidesreports/2025-03-11-improvement-safety-culture-linked-better-patient-and-staff-outcomes" title="Read the Insights Report: Improvement in Safety Culture Linked to Better Patient and Staff Outcomes">Read Report</a></p></div></div><div class="col-md-4"><div><a href="/guidesreports/2024-09-12-new-analysis-shows-hospitals-performance-key-patient-safety-measures-surpassing-pre-pandemic-levels" title="New Analysis Shows Hospitals Improving Performance on Key Patient Safety Measures Surpassing Pre-pandemic Levels"><img src="/sites/default/files/2024-09/Page-1-New-Analysis-Shows-Hospitals-Improving-Performance-on-Key-Patient-Safety-Measures-Surpassing-Pre-pandemic-Levels.jpg" alt="New Analysis Shows Hospitals Improving Performance on Key Patient Safety Measures Surpassing Pre-pandemic Levels" width="100%" height="100%"></a><h2 class="text-align-center">New Analysis Shows Hospitals Improving Performance on Key Patient Safety Measures Surpassing Pre-pandemic Levels</h2><p class="text-align-center"><a class="btn btn-primary btn-wide" href="/guidesreports/2024-09-12-new-analysis-shows-hospitals-performance-key-patient-safety-measures-surpassing-pre-pandemic-levels" title="New Analysis Shows Hospitals Improving Performance on Key Patient Safety Measures Surpassing Pre-pandemic Levels">Read Report</a></p></div></div></div></div><div class="row spacer"> .SliderOverlapA { display: flex; 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text-transform: uppercase; font-weight: 400; letter-spacing: 3px; } <div class="FlipFlop"><h2>AHA Hospitals Accelerating Patient Safety</h2> New Report </div> --></div><p>Across the country, AHA members are finding new and innovative ways to advance patient safety. Hospitals and health systems are focusing on fostering a culture of safety at the leadership level, addressing disparities in health care outcomes, enhancing workforce safety and integrating innovation into best practices.</p><div class="col-sm-12"><p><a class="btn btn-primary" href="/aha-patient-safety-initiative/us-hospitals-and-health-systems-enhance-patient-safety" title="U.S. Hospitals and Health Systems Enhance Patient Safety">U.S. Hospitals and Health Systems Enhance Patient Safety</a></p></div><div class="col-sm-4"><p><a class="btn btn-primary" href="/stories/2025-03-03-mainegeneral-augusta-maine" title="View the Full Report: MaineGeneral">MaineGeneral</a></p></div><div class="col-sm-4"><p><a class="btn btn-primary" href="/stories/2025-03-07-university-hospitals-cleveland-ohio-university-hospitals-excels-personalized-innovative-patient-care" title="View the Full Report: University Hospitals">University Hospitals</a></p></div></div></aside><aside class="aside aside-2 asideImg"><img src="/sites/default/files/2022-12/patient-safety-three-image-2.jpg" alt="People in a meeting" width="1500" height="1000"></aside></div></div> //Will auto create the height of the Background to the height of the text box when Window is resized window.addEventListener('resize', function(eventaa){ function getElementHeight() { const element = document.getElementById("insertcopy"); 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margin: 20px auto 50px; padding-bottom: 25px; } .CTApartner01 .CTApartner01Wrap{ /*background-color: red;*/ border: solid 4px #f6f6f6; padding: 10px; overflow: hidden; margin-bottom:25px; } .CTApartner01 .CTApartner01Wrap:hover{ opacity: .7; padding: 10px; transform: scale(1.09); transition: transform 1s; /* Animation */ } .CTApartner01 .CTApartner01Wrap img { width: 100%; } .CTApartner01Wrap h3 { font-size:18px; } .CTApartner01 .CTApartner01Wrap a{ text-decoration:none; } /* xxxxxxxxxxx */ @media (min-width:768px) { .CTApartner01 .rowEqual_768 { display: -webkit-box; display: -webkit-flex; display: -ms-flexbox; display: flex; flex-wrap: wrap; } .CTApartner01 .rowEqual_768>[class*='col-'] { -ms-flex: 1; /* IE 10 */ /*flex: auto;*/ width: calc((100% / 5) - 20px); margin: 10px; } } <div class="col-md-10 col-md-offset-1"><h2 class="text-align-center">Patient Safety in The News</h2><p>Chris DeRienzo, M.D., Chief Physician Executive and Senior Vice President of the AHA’s Health, Research and Education Trust, speaks to the current state of patient safety in US hospitals and health systems.</p></div><div class="col-md-12 rowEqual_768"><div class="col-md-3 CTApartner01Wrap"><h3>Newsweek</h3><h4><a href="https://www.newsweek.com/against-odds-hospitals-are-getting-safer-1967212" title="Newsweek | Against the Odds, Hospitals Are Getting Safer">Against the Odds, Hospitals Are Getting Safer</a></h4></div><div class="col-md-3 CTApartner01Wrap"><h3>Modern Healthcare</h3><h4><a href="https://www.modernhealthcare.com/safety-quality/hospital-infection-rate-patient-mortality-aha-vizient" title="Modern Healthcare | Hospitals Surpass Pre-pandemic Quality Outcomes: Aha, Vizient">Hospitals Surpass Pre-pandemic Quality Outcomes: Aha, Vizient</a></h4></div><div class="col-md-3 CTApartner01Wrap"><h3>Fierce Healthcare</h3><h4><a href="https://www.fiercehealthcare.com/providers/nationwide-hospital-mortality-risk-fell-acuity-volumes-rose-report-finds" title="Fierce Healthcare | Nationwide Hospital Mortality Risk Fell As Acuity, Volumes Rose, Report Finds">Nationwide Hospital Mortality Risk Fell As Acuity, Volumes Rose, Report Finds</a></h4></div><div class="col-md-3 CTApartner01Wrap"><h3>Axios</h3><h4><a href="https://www.axios.com/2024/09/12/hospitals-patient-safety-rebounds" title="Axios | Hospitals are Safer than They were Before The Pandemic: Study">Hospitals are Safer than They were Before The Pandemic: Study</a></h4></div><div class="col-md-3 CTApartner01Wrap"><h3>Chief Healthcare Executive</h3><h4><a href="https://www.chiefhealthcareexecutive.com/view/hospitals-improve-in-patient-safety-even-compared-to-pre-pandemic-levels-report" title="Chief Healthcare Executive | Hospitals Improve in Patient Safety, Even Compared to Pre-Pandemic Levels: Study">Hospitals Improve in Patient Safety, Even Compared to Pre-Pandemic Levels: Study</a></h4></div></div><div class="col-md-6"><h3>KCBS Radio - Better Hospitals</h3><p> Your browser does not support the audio element. </p></div><div class="col-md-6"><h3>WPTF Morning News - Patients Safer Today</h3><p> Your browser does not support the audio element. </p></div></div><div class="row"><div class="col-md-12 sp_Resource1_holder"><div class="col-sm-4 col-md-3"><a href="/leading-safety-aha-quest-quality-series" title="Leading for Safety: AHA Quest for Quality Series"><img src="/sites/default/files/2021-12/mindy-estes-board-player.png" alt="Mindy Estes" width="270" height="151"></a></div><div class="col-sm-8 col-md-9"><h2>Leading for Safety: AHA Quest for Quality Series</h2><p>The AHA Patient Safety Initiative presents Leading for Safety, a virtual series featuring insights from past Quest for Quality awardees. This series explores how health care leaders can drive safer, higher-quality care by fostering a culture of safety and innovation. Combining the prestigious Quest for Quality Prize with the AHA’s Patient Safety Initiative, Leading for Safety provides practical strategies for executive leadership in advancing patient safety.</p><p><a class="btn btn-wide btn-primary" href="/leading-safety-aha-quest-quality-series" title="Leading for Safety: AHA Quest for Quality Series">View Video Series</a></p></div></div></div><div class="raw-html-embed spacer"> <div class="row"> <div class="col-md-10 col-md-offset-1"> <h2> Safety Speaks Podcast Series </h2> <p> Empowering patients and health care professionals alike by fostering engagement in patient safety initiatives, bolstering public trust in hospitals and health systems, and promoting the uptake of evidence-based measures to ensure quality care. By addressing crucial issues such as preventable harms, health disparities, and misinformation surrounding patient safety, the podcast aims to drive meaningful change within the health care landscape. </p> </div> <div class="col-md-10 col-md-offset-1"> <div class="ctaArticleTiles rowEqual_768" id="more"> <div> </div> </div> <span id="dots"></span> Expand to See All </div> #more { height: 40vh; overflow: hidden; } button#myBtn { float: right; margin-top: 10px } function myFunction() { var dots = document.getElementById("dots"); var moreText = document.getElementById("more"); var btnText = document.getElementById("myBtn"); if(dots.style.display === "none") { dots.style.display = "inline"; btnText.innerHTML = "Expand"; moreText.style.height = "40vh"; moreText.style.overflow = "auto"; } else { dots.style.display = "none"; btnText.innerHTML = "Collapse"; moreText.style.height = "100%"; } } </div> </div><div class="row sp_Resource1"> .sp_Resource1 { padding: 25px 0 50px 0; display: inline-block } .sp_Resource1 h3 { margin: 10px 0 0 0; color: #555; font-size: .7em; text-transform: uppercase; font-weight: 400; letter-spacing: 3px; } .sp_Resource1 h4 { color: #002855; line-height: 1.2em; font-size: 30px; margin: 10px 0 15px 0 } .sp_Resource1 h2 { line-height: 1.2em; font-size: 30px; margin: 10px 0 15px 0; color: #002855; } .sp_Resource1_holder { background-color: #f6f6f6; padding: 15px; overflow: auto; /* max-width: 85%; */ /* margin: auto; */ } .sp_Resource1 .sp_Resource1_holder img { /*padding-bottom: 15px;*/ margin-top: 0px; } @media (max-width:768px) and (min-width:340px) { .sp_Resource1 .sp_Resource1_holder .col-xs-3 { width: 40%; } .sp_Resource1 .sp_Resource1_holder .col-xs-9 { width: 60%; } } @media (max-width:500px) and (min-width:361px) { .sp_Resource1 .sp_Resource1_holder img { margin: auto; display: block; margin-left: 100%; } .sp_Resource1 .sp_Resource1_holder.col-xs-3 { width: 100%; } .sp_Resource1 .sp_Resource1_holder .col-xs-9 { width: 100%; } } @media (max-width:360px) { .sp_Resource1 .sp_Resource1_holder img { margin: auto; display: block } .sp_Resource1 .sp_Resource1_holder .col-xs-3 { width: 100%; max-width: 150px; margin-left: calc(50% - 75px); margin-right: } .sp_Resource1 .sp_Resource1_holder .col-xs-9 { width: 100%; padding: 0 25px } } .sp_Resource1 .btn { margin-top: 20px; } <div class="col-md-8 col-md-offset-2 sp_Resource1_holder"><div class="col-xs-3 col-sm-4 col-md-4"><a href="/patient-safety-initiative-resources#VideoSeries" title="Patient Safety Leadership Perspectives Video Series"><img src="/sites/default/files/2024-09/PSI-Perspectives-Series-247x300.jpg" alt="Various people from the Patient Safety Leadership Perspectives video series" width="247" height="320"></a></div><div class="col-xs-9 col-sm-8 col-md-8"><h2>Patient Safety Leadership Perspectives</h2><p>Highlighting shifts in post-COVID-19 health care quality, the AHA Quality Collective emphasizes clinical strengths and priorities. The Patient Safety Initiative extends QC success, empowering hospitals in national safety discussions.</p><p><a class="btn btn-wide btn-primary" href="/patient-safety-initiative-resources#VideoSeries" title="Patient Safety Leadership Perspectives Video Series">View Video Series</a></p></div></div></div> @media (min-width:768px) { .rowEqual_768 { display: -webkit-box; display: -webkit-flex; display: -ms-flexbox; display: flex; flex-wrap: wrap; } .rowEqual_768>[class*='col-'] { -ms-flex: 1; /* IE 10 */ /*flex: auto;*/ /*width: calc(33.3% - 2px)*//*Safari Fix*/ ; } } .center_callout_3 { background-color: #f6f6f6; text-align: center; margin-bottom: 25px; } .center_callout_3 .center_callout_3_holder { margin-bottom: 25px; } /*.center_callout_3 h4,*/ .center_callout_3 h2 { color: #002855; line-height: 1.2em; font-size: 30px; margin: 10px 0 30px 0; } /*.center_callout_3 h3 { margin: 25px 0 0 0; color: #555; font-size: .7em; text-transform: uppercase; font-weight: 400; letter-spacing: 3px; }*/ .center_callout_3 div.center_callout_3_nolink { border: solid 3px #307fe2; display: block; margin: 15px 0 0 0; overflow: hidden; color: #002855; background-color: white; /*! 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In this conversation, Mindy Estes, M.D., former CEO of Saint Luke's Health System and former AHA board chair, and Roxanna Gapstur, Ph.D., R.N., CEO of WellSpan Health, discuss the strategies that enabled WellSpan to maintain high-quality care during and after the pandemic, solutions for nursing retention, and how WellSpan is addressing critical community health challenges.</p><hr><p></p><div class="raw-html-embed"><details class="transcript"> <summary> <h2 title="Click here to open/close the transcript."> <span>View Transcript</span><br> </h2> </summary> <p> 00:00:01:05 - 00:00:29:17<br> Tom Haederle<br> Welcome to advancing Health. Every hospital, every day and everywhere is striving to improve its quality of patient care. As the winner of the ���������� Association's prestigious 2024 quest for quality prize, WellSpan health serving 12 counties in Pennsylvania, is among the best at advancing health for those who depend on it. In today's podcast, we learn more about how the efficiencies WellSpan adopted during the pandemic are still in place and still paying dividends today. </p> <p> 00:00:29:20 - 00:00:43:05<br> Tom Haederle<br> Your host is Doctor Mindy Estes, former president and CEO of Saint Luke's Health System and former chair of the Board of trustees. </p> <p> 00:00:43:07 - 00:01:19:27<br> Mindy Estes, M.D.<br> I'm Dr. Mindy Estes, and today we have the privilege of speaking with Dr. Roxanna Gapstur, the president chief executive officer of WellSpan health, a position she has held since January 2019. Doctor gaster brings over 25 years of extensive health care leadership experience, having worked across various settings including practices, academic institutions and integrated health systems. Her background in strategic planning, business development and operational leadership, both at ambulatory and hospital settings, has been instrumental in her success at, well, speed. </p> <p> 00:01:20:00 - 00:01:36:03<br> Mindy Estes, M.D.<br> So let's just dive right in. To begin, can you provide our listeners with an overview of WellSpan health and its mission? Understanding the foundation of the health system gives context to the strategic discussions we'll be talking about today. </p> <p> 00:01:36:06 - 00:02:04:24<br> Roxanna Gapstur, Ph.D., R.N.<br> Yes, absolutely. WellSpan health is an integrated care delivery system in central Pennsylvania. We serve 12 counties and about a million and a half people have nine hospitals, 23,000 team members and about 2500 providers in our system. We are the largest provider of behavioral health in our region, and we also have a clinically integrated network which provides a basis for our value based care strategy. </p> <p> 00:02:04:26 - 00:02:07:27<br> Mindy Estes, M.D.<br> So your geographic footprint is quite large. </p> <p> 00:02:07:29 - 00:02:16:00<br> Roxanna Gapstur, Ph.D., R.N.<br> It's about 12 counties now in the center of the state. Yeah. We've been growing and serving more patients each and every year. </p> <p> 00:02:16:05 - 00:02:44:12<br> Mindy Estes, M.D.<br> Were you in WellSpan in 2019? And soon after a small event happened, the world was confronted with the Covid 19 pandemic. And despite these challenges, WellSpan was noted for maintaining high quality care and extensive community support. Could you share 3 or 4 critical factors that enabled your leadership team to be successful during this period, and what you've taken from it since? </p> <p> 00:02:44:14 - 00:03:11:23<br> Roxanna Gapstur, Ph.D., R.N.<br> Yeah, absolutely. One of our values here at WellSpan is working as one. And I think this was a moment for us to really live that value. And throughout the pandemic, we were able to rapidly adapt to changes. We practiced agility, and we practiced one of our other values to find a better way. We have a significant focus in a pretty big community health team that works across central Pennsylvania. </p> <p> 00:03:11:25 - 00:03:40:22<br> Roxanna Gapstur, Ph.D., R.N.<br> And little did we know that the pandemic was going to highlight some of the challenges. And that team really helped us respond quickly to some of those challenges. We focused significantly on the well-being of our team. Again, I think we all found at the beginning of the pandemic, perhaps this wouldn't last a long time. But as the pandemic went on, we needed to make sure that our team was taking care of and being one of the largest providers of behavioral health services. </p> <p> 00:03:40:22 - 00:04:03:24<br> Roxanna Gapstur, Ph.D., R.N.<br> We had pretty significant internal resources that we were able to bring to that issue. And then finally, we really empowered our teams to think differently. And at one point during the pandemic, even had developed our own N95 mask. So I think those were were some of the pieces that were most important because we unleashed the innovation within our own teams. </p> <p> 00:04:03:27 - 00:04:21:26<br> Roxanna Gapstur, Ph.D., R.N.<br> We were able to move pretty quickly on things like the outdoor testing, things like out-of-pocket costs. We were one of the first in the nation to say that we would provide things without charge. Really proud of the team for embracing agility and making sure that the well-being of our teams were front and center. </p> <p> 00:04:21:28 - 00:04:49:18<br> Mindy Estes, M.D.<br> You know, I want to pick up on something that you said, most of us in health care study things, and we study things for a long time, and then we pilot things, and sometimes we're pilot things. And I think the Covid crisis, if you think about making lemonade out of lemons, really told us that we could be agile, that we could make decisions quickly and in TAC one way or the other if we needed to. </p> <p> 00:04:49:21 - 00:04:55:13<br> Mindy Estes, M.D.<br> And the question I have for you, have you been able to maintain that agility? </p> <p> 00:04:55:15 - 00:05:23:13<br> Roxanna Gapstur, Ph.D., R.N.<br> We have actually, so was one of the things that we said to ourselves during our after action reviews that what were some of the silver linings of Covid, and how might we continue to capitalize on those? And one of those was being agile and making decisions quickly. I think because we are locally governed and one of the only health systems in our area that is locally governed, it helps us make decisions quickly because our headquarters are here and our family, friends and neighbors are here. </p> <p> 00:05:23:13 - 00:05:40:27<br> Roxanna Gapstur, Ph.D., R.N.<br> And so that is something we've been able to maintain. One of the things that I did with my team during Covid was we split into two teams. We had one team really focused on our long term strategy and another team that just focused on operations and taking care of patients each and every day. We've used that as well. </p> <p> 00:05:40:28 - 00:05:49:02<br> Roxanna Gapstur, Ph.D., R.N.<br> Since the pandemic ended, it was a great way for us to still make progress on some things, even though, you know, we had a lot on our plates. </p> <p> 00:05:49:05 - 00:06:06:24<br> Mindy Estes, M.D.<br> Well, you make an important point. The work of health care and the future of health care and what what we as organizations were going to do once the immediacy of the pandemic was over, it was tempting to put that on the back shelf and get back to it. But, you know, once you let it go, it's very difficult to restart. </p> <p> 00:06:06:25 - 00:06:28:21<br> Mindy Estes, M.D.<br> One of the things I was impressed by that I think goes into this long term thought, is that you had low nursing staff turnover during the pandemic. What strategies did you implement to have such a successful retention of nursing staff during, admittedly, an incredibly stressful and unknown time? </p> <p> 00:06:28:24 - 00:06:51:04<br> Roxanna Gapstur, Ph.D., R.N.<br> Yeah, that's a great question. I think one of the biggest areas was just the focus on the well-being of the team. We had a lot of peer to peer support going on, as well as our psychologists and psychiatrists across the system, working with our frontline care teams every single day. So we had real time coaching and support on all of our units. </p> <p> 00:06:51:07 - 00:07:12:26<br> Roxanna Gapstur, Ph.D., R.N.<br> We also did a lot of state interviews and a lot of work on understanding what people needed now because as you know, you know, things evolve during Covid and lots of changes happened over those 2 or 3 years. I would say a benefit to us is that generally, our region tends to lag a little bit on things that occur. </p> <p> 00:07:12:26 - 00:07:31:27<br> Roxanna Gapstur, Ph.D., R.N.<br> So we saw surges in new Jersey and New York prior to central Pennsylvania getting those same surges. And so we were working to try and learn from our colleagues and maybe what was coming. Our way, and how we could do a better job with our teams and with our nurses. So those were some of the things we did. </p> <p> 00:07:31:29 - 00:07:40:13<br> Roxanna Gapstur, Ph.D., R.N.<br> I think later when you ask about innovation, if you do, I can talk a little bit about some of the innovations we've done in nursing that I think also made a difference. </p> <p> 00:07:40:15 - 00:07:46:00<br> Mindy Estes, M.D.<br> Well, how about we just speak a little bit about innovation right now, particularly in nursing? </p> <p> 00:07:46:02 - 00:08:11:23<br> Roxanna Gapstur, Ph.D., R.N.<br> Well, certainly virtual nursing is something that we have rolled out across our system, which has made a really big difference in the satisfaction of our nurses, both in the time they spend and documentation. But the amount of time they're able to spend with their patients. So that's one area. We've also have tiered huddles in our system. So each day, seven days a week actually we start with tiered huddles around seven in the morning. </p> <p> 00:08:11:23 - 00:08:33:23<br> Roxanna Gapstur, Ph.D., R.N.<br> And those go until nine. At 9:00 is my huddle. So every day I know by 9:00 exactly what's happening in the system, and we're able to solve problems at the right level. So we have sort of tiers one through six. A lot of things are still at tier three and below or tier four and below, but those things that can't be are elevated to the senior leaders. </p> <p> 00:08:33:23 - 00:08:50:24<br> Roxanna Gapstur, Ph.D., R.N.<br> And we put a team on it right then and there. So I would say compared to when I first arrived at WellSpan, that we solve our problems more in real time. We're more situationally aware and we're able to prevent problems from happening because we have that focus. </p> <p> 00:08:50:26 - 00:09:21:03<br> Mindy Estes, M.D.<br> Well in solving problems where they're best solved. You know, is helpful for everyone. And you go away from that huddle knowing what you need to do and how you need to go forward. I think a lot of people perceive central Pennsylvania yet as a relatively homogeneous area, but WellSpan serves a diverse community. Can you discuss how you engage these diverse groups and provide resources while respecting their cultures and their autonomy? </p> <p> 00:09:21:05 - 00:09:53:15<br> Roxanna Gapstur, Ph.D., R.N.<br> Yeah, absolutely. I think a lot of Not-for-profit health systems feel very connected to their community and have different strategies. And certainly in my other roles in other states, even, I felt that connection. WellSpan has maybe a deeper connection than any I've ever experienced. And we have different ways of showing that. So each of our counties and our regions has a healthy county coalition, and WellSpan actually leads most of those coalitions. </p> <p> 00:09:53:18 - 00:10:23:18<br> Roxanna Gapstur, Ph.D., R.N.<br> But we don't try to do the work of the experts in our nonprofit organizations. Rather, we might be a convener, we might be a partner, we might be a funder. In some instances, we're working together alongside and with and the population across central Pennsylvania, as you mentioned, are more diverse. And I realized when I first arrived here, certainly the plan community is one of our largest stakeholders, and we serve a significant number of people from that population. </p> <p> 00:10:23:24 - 00:10:52:27<br> Roxanna Gapstur, Ph.D., R.N.<br> We have special cultural liaison individuals who work with our planning community. It's really important to have those relationships, and we've done that for more than 20 years. We also have special bundle payment programs and other types of programs that fit culturally for that particular action. And I will say during Covid that Covid was difficult for that population because of the amount of family interaction they prefer to have in their health care experiences. </p> <p> 00:10:52:29 - 00:11:24:06<br> Mindy Estes, M.D.<br> I want to skip to the notion of gun violence in workplace violence, workplace safety, community safety. You know, gun violence is a growing concern for all of us. And you've really taken an active role in addressing this issue in New York, Pennsylvania. And I really and I know our listeners would be interested in having you elaborate on when your efforts to reduce gun violence, the partners involved, the progress made thus far. </p> <p> 00:11:24:12 - 00:11:34:19<br> Mindy Estes, M.D.<br> And my sense is that this is one of these issues, that the minute you take your foot off the gas, it comes back. So talk a little bit about what you've been doing. </p> <p> 00:11:34:22 - 00:12:01:00<br> Roxanna Gapstur, Ph.D., R.N.<br> Well, I, I can't say enough about what the teams have done in this region on gun violence. It's an issue across all of our communities, but I would say probably more acute in New York County. And that's where we've done a significant amount of the work over the past three years. Probably the biggest piece of this has been understanding both our role and then what the role of others might be in helping prevent gun violence. </p> <p> 00:12:01:02 - 00:12:28:26<br> Roxanna Gapstur, Ph.D., R.N.<br> I did feel when I first came to WellSpan that there was more we could be doing as a health system in prevention, but also that we can't do it all. And so we needed the right partners. I will say that that strong partners right now have been our local police departments, certainly our judges. We have a really robust treatment court here that works very hard to prevent incarceration and to get people to the right kinds of treatment. </p> <p> 00:12:28:28 - 00:12:52:01<br> Roxanna Gapstur, Ph.D., R.N.<br> And we also have, in the last two years, a credible messenger program. This program first started on a grant and was a business partnership agreement between one of our local nonprofits and our WellSpan York Hospital, which is a level one trauma center. And the credible messengers are highly engaged individuals who support victims and families who enter York Hospital because of gun violence. </p> <p> 00:12:52:04 - 00:13:20:01<br> Roxanna Gapstur, Ph.D., R.N.<br> They work to solve some of the deeper causes of violence in the community. And so they're they're very connected outside of the hospital setting. And so far in the last three years, we've seen a 43% reduction in gunshot wound patients at our hospital and a 71% reduction in homicides in our community, which is just gives you goose bumps to think about because it's such a problem for some of the younger individuals in our community. </p> <p> 00:13:20:02 - 00:13:30:12<br> Roxanna Gapstur, Ph.D., R.N.<br> So I would say the credible messenger program in these partnerships with local non-profits have been the most impactful in addressing really root causes of gun violence. </p> <p> 00:13:30:14 - 00:13:33:16<br> Mindy Estes, M.D.<br> Question or the credible messengers? Volunteers. </p> <p> 00:13:33:18 - 00:13:56:02<br> Roxanna Gapstur, Ph.D., R.N.<br> Not the credible messengers, are paid on the grants that we received with the not for profit. But it has been so impactful that we've continued that payment, you know, after the grant. And so all of us in New York County are very invested in that program, both emotionally and financially, because we've seen such great results with it. </p> <p> 00:13:56:04 - 00:14:16:27<br> Mindy Estes, M.D.<br> Well, the success rate has it's really been extraordinary in the numbers of live saved in families saved, you know, has to be a positive for the entire community. I want to look ahead. And when we look ahead, what do you see as your biggest goal for WellSpan health and what challenges do you anticipate in achieving it? </p> <p> 00:14:16:29 - 00:14:39:27<br> Roxanna Gapstur, Ph.D., R.N.<br> Boy, that's a great question. I would say innovation is probably one of our biggest priorities. We really believe that the health care system, as great a job as we do in many things, needs some transformation and needs to meet the needs of the future. So we've worked really hard to think about people, process, and technology differently than we did in the past. </p> <p> 00:14:39:27 - 00:15:09:22<br> Roxanna Gapstur, Ph.D., R.N.<br> And we've spent the last two years setting up for our next strategic plan, which is WellSpan 2030. An innovation and transformation will continue to be a big part of learning how we can use people, process and technology differently together. And, you know, I think all of us were a little taken by surprise a couple of years ago with the, generative AI changes, the Pandora's box that can kind of open as we think about how we might have safer care, more efficient care, etc.. </p> <p> 00:15:09:27 - 00:15:38:05<br> Roxanna Gapstur, Ph.D., R.N.<br> And I would probably call out to that we've been heavily involved in. One is using artificial intelligence to improve the speed and accuracy of our radiology exams. WellSpan has deployed over 14 different applications for the last five years in radiology. I think we're leading the pack, and in terms of how we've deployed and how engaged our radiologists are with artificial intelligence. </p> <p> 00:15:38:07 - 00:16:06:11<br> Roxanna Gapstur, Ph.D., R.N.<br> And as you know, Mindy, artificial intelligence requires a lot of work and effort and process in order to make it the most useful for care teams. Our teams have done that work, and we've seen 81% faster traditional review of our exams with our radiologists using using AI. And our physicians who read scans are 98% engaged with the applications. </p> <p> 00:16:06:13 - 00:16:30:25<br> Mindy Estes, M.D.<br> That's very exciting. And I think you've you've enabled your radiologists to be part of the process because, you know, I think ultimately will help us make smarter decisions, faster decisions, but does not replace the physician. I think once we understand how to use that, and we're still learning and the technology is evolving, you know, we'll see more and more of it. </p> <p> 00:16:30:27 - 00:16:46:29<br> Mindy Estes, M.D.<br> We are just about out of time, believe it or not. And I want to thank you for sharing your insights. Your leadership at WellSpan health clearly demonstrates how engagement can drive meaningful change and sustainable change. </p> <p> 00:16:47:02 - 00:16:55:11<br> Tom Haederle<br> Thanks for listening to Advancing Health. Please subscribe and rate us five stars on Apple Podcasts, Spotify or wherever you get your podcasts. </p> </details></div> Wed, 05 Mar 2025 00:36:47 -0600 Nurses /news/headline/2025-01-31-obituary-renowned-nursing-leader-linda-burnes-bolton <p>Linda Burnes Bolton, former president of AHA’s American Organization for Nursing Executives (now known as the American Organization for Nursing Leadership), and chief nursing officer at Cedars-Sinai Medical Center in Los Angeles, <a href="https://www.cedars-sinai.org/newsroom/a-tribute-linda-burnes-bolton-drph-rn-faan-1948--2025/">died</a> this month at age 76. She was known for inspiring a generation of nurses while shaping health care policy and advocating for greater equity among all medical professionals, with the goal of improving patient care. <br><br>“Linda Burnes Bolton’s extraordinary leadership and vision made significant contributions to advancing healthcare and the nursing profession, not only at Cedars-Sinai, but across the nation,” said Tom Priselac, Cedars-Sinai president and CEO emeritus. “She brought revolutionary approaches to patient-centered care, nursing education, community health education and healthcare policy that affected thousands of nursing professionals and millions of patients.” Priselac is a former chair of the AHA Board of Trustees. <br><br>Burnes Bolton was very active with the AHA and AONL. She was a recipient of AONL's Lifetime Achievement and Prism awards. In 2016, she was a recipient of the AHA's Trust Award honoring individuals who exhibit visionary leadership in health care and symbolize the Health Research and Educational Trust's mission to use research and education to improve health care quality in policy and practice. <br><br>Burnes Bolton’s career began at Cedars-Sinai in 1971 as a staff nurse. She became the first advanced practice nurse at Cedars-Sinai. In addition to CNO, she also served as Cedars-Sinai's senior vice president and chief health equity officer, and held the inaugural James R. Klinenberg, M.D., and Lynn Klinenberg-Linkin Chair in Nursing. <br> </p> Fri, 31 Jan 2025 14:07:15 -0600 Nurses /role-hospitals-northwestern-memorial-hospital-employees-get-free-nursing-training <div class="container"><div class="row"><div class="col-md-9"><div class="row"><div class="col-md-7"><img src="/sites/default/files/2024-12/ths-northwestern-nurse-training-700x532.jpg" data-entity-uuid data-entity-type="file" alt="Northwestern nursing program participants practice their skills on each other" width="700" height="532" class="align-left"><p><em>Photo credit: Northwestern</em></p></div><p>Kiana Smith and Austin Garcia are among the employee success stories of Northwestern Medicine’s Basic Nursing Assistant Training Program. Kiana transitioned from a security guard to a patient care technician, while Austin moved from a health unit coordinator to a PCT. After spending every Friday evening for four months with their classmates in classroom, lab and clinical instruction, both plan to pursue further nursing education, highlighting the program’s impact on career advancement and personal growth.</p><p>“We learned, we laughed and we cried, but most importantly, we endured every obstacle thrown our way. Take that drive with you into the next phase of your life and career. If it doesn’t challenge you, it doesn’t change you,” Kiana told the graduation cohort.</p><p>The Basic Nursing Assistant Training Program at Northwestern Medicine is designed to help Northwestern Medicine employees in nonclinical roles transition into PCT positions by earning a certified nursing assistant certification. This 16-week, no-cost program includes classroom, lab and clinical instruction and is approved by the Illinois Department of Public Health. Graduates are eligible to take the Illinois Nurse Aide Competency Certification Exam, which can lead to PCT roles and further nursing education. The program aims to address the nursing shortage by creating a pipeline to nursing careers.</p><p>“Your direction is more important than your speed, so don’t ever feel like you’re left behind. Go at your own pace,” Austin told his class during graduation ceremonies.</p><p><a href="https://news.nm.org/as-the-nursing-profession-continues-to-face-shortages-a-new-program-at-northwestern-medicine-is-working-to-change-that--and-it-starts-with-their-own-employees/">Learn more about the program</a>.</p></div></div><div class="col-md-3"><div><h4>Resources on the Role of Hospitals</h4><ul><li><a href="/workforce-home">Workforce</a></li><li><a href="/roleofhospitals">All Case Studies</a></li></ul></div></div></div></div> Tue, 17 Dec 2024 11:46:20 -0600 Nurses /role-hospitals-east-alabama-health-invests-workforce-lpn-program-employees <div class="container"><div class="row"><div class="col-md-9"><div class="row"><div class="col-md-7"><img src="/sites/default/files/2024-11/ths-east-alabama-health-lpn-700x532.jpg" data-entity-uuid data-entity-type="file" alt="East Alabama Health LPN program participants" width="700" height="532" class="align-left"><p><em>Photo credit: East Alabama Health</em></p></div><p>East Alabama Health, like many health systems, is facing a shortage of nursing professionals. To address the problem, EAH didn’t have to look far – just to their own employees.</p><p>The first 14 students at East Alabama Health’s new LPN program began their classes in August; they’ll graduate in August 2025 and become vital additions to the nursing workforce in eastern Alabama.</p><p>Classes are led by Chattahoochee Valley Community College instructors but plenty of the instruction is done on site. The students, who are all current EAH employees with at least one year of service, get paid while enrolled and will maintain their employment while they study. The collaboration is the first of its kind in the region.</p><p>“There is a critical need for more nurses throughout the health care industry, and with the rapid growth of our community, it was vitally important for us to identify ways to address this need,” said Susan Johnston, East Alabama Health’s vice president of Human Resources. “By investing in our employees through on-site training, we can meet this need head-on and better serve the needs of our community.”</p><p>Read more <a href="https://www.eastalabamahealth.org/news-and-media/east-alabama-health-launches-new-lpn-school-collaboration-chattahoochee-valley">here</a>.</p></div></div><div class="col-md-3"><div><h4>Resources on the Role of Hospitals</h4><ul><li><a href="/workforce-home">Workforce</a></li><li><a href="/roleofhospitals">All Case Studies</a></li></ul></div></div></div></div> Tue, 12 Nov 2024 13:04:05 -0600 Nurses