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3 Initiatives That Helped Pennsylvania Hospitals Cut Turnover by 28%

Analysis  |  By Jay Asser  
   February 15, 2024

Efforts to improve pay and benefits, talent development, and worker safety have been effective.

A multipronged approach to addressing the workforce has allowed Pennsylvania hospitals to reduce turnover for direct care positions by an average of 28% over the past year.

The results were driven by strategies to attract, develop, and protect workers, according to a report by the Hospital and Healthsystem Association of Pennsylvania (HAP), which surveyed 99 hospitals in the state from October 17 to November 27, 2023.

While staff turnover has improved from pandemic levels, Pennsylvania’s hospitals continue to deal with high average vacancy rates, such as 19% for nursing support staff and 14% for registered nurses.

Here are three areas where Pennsylvania hospitals have focused their efforts to strengthen the workforce:

Compensation and benefits

To improve recruitment and retention, surveyed hospitals are investing in their staff by bolstering pay and benefits.

Since 2022, nearly all facilities report implementing increases in base compensation (97%), flex work schedules (95%), and professional development/tuition reimbursement (89%). Many others have instituted sign-on, schedule/shift-based, and/or referral bonuses (56%), retention bonuses (49%), and provision of children services (39%).

Other reported strategies include performance rewards, paid parental leave, and student loan repayment.

This is consistent with a nationwide trend of hospitals upping their incentives to attract and keep talent. According to a recent survey by Aon, 70% of hospitals implemented or increased sign-on bonuses in the past year, while 59% raised new hire pay, 54% upped their minimum wage scale, and 52% increased or added referral bonus programs.

Workforce development

Pennsylvania hospitals are also investing in the next generation of workers to create a pipeline of talent.

Working with schools is one of the primary strategies, which includes partnerships with four-year colleges/universities (99%), community colleges (99%), and high schools (92%).

Partnerships are also reaching trade/technical schools and/or community organizations for more than half of hospitals (55%) and middle schools for a quarter of respondents (25%).

Developing new talent is crucial as more and more experienced workers leave the field. According to 82% of respondents, finding qualified individuals is one of their top three barriers to employing staff.

Workplace safety

One of the factors spurring turnover at hospitals is workplace violence, which must be an area of emphasis for leaders to keep their staff safe.

To address rising violence targeting professionals, almost all Pennsylvania hospitals have implemented staff education on safety protocols (97%), enhanced security measures (95%), de-escalation training (95%), and promotion of respectful behavior (93%).

Meanwhile, most hospitals are using no-tolerance notices (76%) and metal detectors/artificial intelligence (61%).

Keeping workers safe is one of several ways hospitals can support their staff, increasing the likelihood of employees wanting to stay in their role and organization.

Jay Asser is the contributing editor for strategy at HealthLeaders. 


The Hospital and Healthsystem Association of Pennsylvania’s workforce report revealed that Pennsylvania hospitals curbed turnover rates by 28% in 2023.

Surveyed hospitals reported implementing increases in base compensation and flex work schedules, as well as measures like staff education on safety protocols.

Nearly all hospitals also report having partnerships with schools like colleges or high schools to create a pipeline of talent.

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