Choose Nursing in Vermont

Outpatient Provider Office Nursing
and Emloyee Pilot Study 2003

WHY WAS THIS SURVEY DONE?

One factor in assuring access to quality health care for all Vermonters is an ongoing and current knowledge of the state’s health workforce resources. To this end, the Office of Nursing Workforce Research, Planning and Development created the Health Workforce Assessment Team (HWAT)1. This team was charged to develop a new system to assess Vermont’s health care workforce, including new ways to measure the state’s need for various health care positions. The following is a report of the 2003 pilot survey of outpatient provider offices. Adjustments will be made to the survey instrument based on this pilot study.

WHO WAS SURVEYED?

In February 2003, the Vermont Health Workforce Survey was sent to the office manager in 252 outpatient provider offices. The response rate was 56% (n=141).

WHAT WAS LEARNED?

Statewide Vacancy Rate2 %

Nurse Practitioner/ Physician Assistant

6%

Registered Nurse

6%

Licensed Practical Nurse

3%

Scheduler

3%

Medical Assistant

2%


Statewide Turnover Rate3 %
Medical Assistant 18%
Scheduler 14%
Licensed Practical Nurse 10%
Registered Nurse 8%
Nurse Practitioner/ Physician Assistant 7%

Recruitment Incentives:

  • 22% of outpatient provider offices report a pay differential for RN educational preparation (ADN vs. BSN).
  • 27% of outpatient provider offices report a pay differential for credentialed RNs (e.g. RNC).


  • Average time to fill position for offices reporting difficulty

    RN

    13 weeks

    LPN

    11 weeks

    Medical Assistant

    5 weeks

    Nurse Practitioner

    5 weeks


    IMPACT OF SHORTAGES

    Never

    Several times a year

    Monthly

    Weekly

    Daily

    Missing or n/a

    Curtailed plans for acquiring new technology

    85%

    9%

    2%

    1%

    2%

    1%

    Reduced service hours
    81%
    10%
    4%
    1%
    2%
    2%

    Increased wait times to surgery

    72%

    7%

    2%

    1%

    19%

    Canclled surgeries

    75%

    5%

    1%

    19%

    Mandatory staff overtime

    60%

    17%

    7%

    8%

    4%

    4%

    Decreased patient satisfaction

    58%

    22%

    8%

    6%

    3%

    3%

    Increased patient complaints

    57%

    27%

    6%

    6%

    2%

    2%

    Decreased staff satisfaction

    40%

    34%

    8%

    10%

    6%

    2%

    Curtailed plans for facility expansion

    Yes 9%

    No 86%

    5%

    Discontinued clinical programs

    Yes 6%

    No 90%

    4%

     

    Percent Fulltime by Office Position

     

    Types of health care professionals reported as needed but not available (frequency reported):

    RN (6), Float RN (1)
    Licensed Practical Nurse (6)
    Physician Assistant (5)
    Nurse Practitioner (4)
    Medical Assistant (4)
    Receptionist (3)
    Certified Diabetic Educator (3)
    MD (2).
    Medical bookkeeper (2)
    Triage (2).
    Lactation Consultant (1)
    Ultrasound Technician (1),
    Manager (1)
    Rehabilitation Specialist (1), Disease specific educator (1)
    Ob-gyn RN (1), Pediatric RN (1)
    Dietitian (1), OR (1), IV RN (1)
    Research knowledge (1)
    PA with abortion skills (1)

    Conclusions:

    Vacancy and turnover rates are the lowest in outpatient provider offices when compared to the hospital, home health, and long term care settings. A greater number of RNs work fulltime in the office setting compared to other settings. Nurses with a variety of skills are needed to provide outpatient services. Some impact of health care worker shortages has been experienced in the areas of staff and patient satisfaction and patient complaints.