Hospital churn and casemix instability: implications for planning and educating the nursing workforce

Health workforce planning is a priority for Australian governments at both state and federal levels. Nursing shortages are a significant problem and addressing these shortages is likely to be a component of any workforce plan. This paper looks at the case of hospital nursing and argues that casemix, workforce and management instability inhibit workforce planning for hospital nursing. These issues are related and any efforts to objectively plan the hospital nursing workforce must seek to address them in order to succeed.

What is known about the topic? Multiple Australian jurisdictions are looking at the issue of health workforce planning. The nursing workforce is a major component of the health workforce and nursing shortages are a problem affecting many healthcare systems and hospitals, and present significant challenges to planning for the nursing workforce.

What does this paper add? This paper explores the barriers to health workforce planning with regard to acute-care hospital nursing and identifies three inter-related instabilities that are obstacles to objective health workforce planning for this group of health professionals. In addition, the paper sets out strategies to address these instabilities, most specifically in relation to the role and preparation of acute-care nurses .

What are the implications for practitioners? The paper provides insight into the factors that affect workforce planning and the relationships between them, and the implications of these factors for nurses’ skill and educational requirements.