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Patient Safety is the Most Important Workforce Issue, HR and Nursing Leaders Agree

Analysis  |  By Carol Davis  
   April 26, 2023

Strengthening employee engagement and retention ranks second in critical issues that need to be addressed.

Human resources (HR) leaders and chief nursing officers (CNOs) rate quality and safety as the most critical issue to address at their organization, according to a report released Tuesday examining issues and trends affecting healthcare talent.

Other priorities include optimizing the workforce, boosting productivity, conducting strategic workforce planning, and improving recruitment. Further down the list were maintaining compliance, reducing costs, leveraging technology, and building the brand.

Of the 50 HR leaders and 72 CNOs surveyed nationwide, 84% rated quality of care and patient safety as the most critical issue, followed by strengthening employee engagement and retention (77%) and improving the caregiver experience (73%), according to the report released by Cross Country Healthcare Inc., a tech-enabled workforce solutions platform.

However, only slightly more than half of these leaders indicated their organization has effectively improved employee recruitment (53%) or strengthened employee engagement and retention (51%), the research shows.

But healthcare organizations are moving forward to address the staffing crisis, according to the survey, with leaders reporting that their top priorities include improving the efficiency and effectiveness of the hiring process, strengthening employee engagement and retention, and improving employee attraction and recruitment.

“Between mass talent shortages, burnout and resignations, health leaders are aware that they must adapt to a changing workforce landscape,” said Hank Drummond, Cross Country’s chief nursing officer. “Prioritizing work-life balance, mental health and appropriate staffing is critical to ensuring that healthcare workers have the support they need to provide care to their patients. Staff wellness trickles down into the quality of patient care.”

Other key findings from the study include:

  • HR leaders are investing most in improving the caregiver experience, followed by improving employee recruitment.
  • CNOs are investing most in employee recruitment, followed by optimizing and managing the workforce.
  • HR leaders (64%) feel they are most effective at maintaining staffing levels and employee development, while CNOs (54%) are most effective at employee engagement and retention.
  • Comprehensive workforce plans were completed by 56% of HR leaders and 43% of CNOs.
  • Hiring efficiency and employee engagement are the top areas for strategizing, while recruiting is getting the most investment to develop innovative solutions.
  • In examining which technologies the leaders want to adopt in the year ahead, onboarding, training and development, and workforce management topped the list.

Searching for solutions

Talent shortages, burnout, and resignations are requiring HR and nurse leaders to explore new staffing models. HR leaders prioritize workforce optimization in their staffing plan, while CNOs prioritize reducing reliance on staffing agencies, the report says.

“Health leaders must reimagine their approach to their workforce,” said Daniel J. White, Cross country’s chief commercial officer. “They must be nimble and innovative and explore new models to help maximize their most valuable asset—their people.”

But that’s not without challenges, said surveyed leaders who shared some of those barriers to their workforce strategy.

From HR leaders:

  • “Buy-in from leadership is hit or miss; it is hard to sell it to staff after all the changes recently.”
  • “It is keeping staff. A lot of people don’t want to work nowadays, and it’s hard to keep people interested, especially in healthcare. So, I try and make it as exciting as possible.”

From CNOs:

  • “Having enough RN staff available to hire. We are doing great within hiring to some extent, but at the same time still have the younger work force choosing to leave for ‘better hours,’ ‘better life balance/blend,’ etc.”
  • “A lack of future-ready skills in the workforce, like data literacy or multidisciplinary literacy, is caused by factors like the COVID-19 pandemic and digitalization.”

Carol Davis is the Nursing Editor at HealthLeaders, an HCPro brand.


Quality and safety ranks highest as the most critical issue to address, HR and nurse leaders say.

Healthcare organizations are moving forward in addressing the staffing crisis.

The current state of the workforce is requiring HR and nurse leaders to explore new staffing models.

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