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The Workforce Challenges Keeping Hospital CEOs Up at Night

Analysis  |  By Jay Asser  
   February 29, 2024

Surveyed leaders cited labor as the most pressing area of concern.

Above all else, hospital CEOs right now are worried about how they’re going to staff their organizations.

During a time when healthcare is susceptible to a talent drain among clinical and non-clinical employees, leaders are prioritizing addressing workforce shortages.

The American College of Healthcare Executives’ (ACHE) annual survey of hospital CEOs revealed that for the second consecutive year, workforce or personnel challenges ranked as the number one concern.

Workforce garnered an average score of 2.3 on an 11-point scale, finishing ahead of financial challenges, which ranked second for the third straight year at 2.6, and behavioral health/addiction issues, which ranked third at 5.3.

The survey fielded responses from 241 community hospital CEOs in the fall of 2023 to gauge what areas are top of mind for leaders and identify the specific concerns within each of those challenges.

Under workforce, here is how often the following issues were selected by CEOs:

Shortages of registered nurses: 86%
Burnout among non-physician staff: 79%
Shortages of physician specialists: 71%
Shortages of therapists (e.g. physical therapists, respiratory therapists): 68%
Shortages of primary care physicians: 65%
Shortages of advanced practice professionals: 32%
Managing remote staff: 27%

How CEOs can respond

Addressing these concerns requires a commitment from hospital leaders to both the people in their building and the next generation of clinical workers.

As more longstanding physicians and nurses especially get older and exit the profession, hospitals must find a way to develop talent to sustainably keep their organizations functioning.

“Longer-term solutions include strengthening the workforce pipeline through creative partnerships, such as those with colleges to grow the number of nurses and technicians,” Deborah J. Bowen, president and CEO of ACHE, said in the news release. “More immediate solutions include supporting and developing all staff, building staff resilience, organizing services to reflect the realities of the labor market and exploring alternative models of care.”

The shortage of workers is also exacerbated by burnout, which is harder to solve for without the ability to hire new staff. According to more than 200,00 physicians and more than 32,000 nurses surveyed by KLAS Arch Collaborative, improving staffing is the number one solution to addressing burnout.

However, CEOs can utilize the other methods respondents chose without having to hire more people, such as aligning leadership with physicians and nurses, providing better pay, and improving EHR efficiency.

What’s clear is that leaders will have to turn over every rock to counter workforce challenges that don’t appear to be going anywhere any time soon.

Jay Asser is the contributing editor for strategy at HealthLeaders. 


Workforce challenges ranked ahead of financial challenges and behavioral health/addiction issues as the top concern for 241 community hospital CEOs surveyed by the American College of Healthcare Executives.

Within workforce, CEOs most often selected shortages of registered nurses and physician specialists, as well as burnout among non-physician staff, as the biggest problems.

To solve or these issues, leaders must work to build a pipeline of talent and utilize solutions that go beyond simply hiring new staff.

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