Preventing Burnout Reduces Recruitment Costs by 36%

Burnout remains a persistent problem in the nursing industry. It affects workers and the organizations where they work. Studies show that burnout increases nurse turnover, thus leaving nurses short staffed, which only compounds the problem. But new research from the University of Virginia (UVA) School of Nursing shows hospitals that focus on reducing nurse burnout save money on hiring and recruiting because the workers they have are less likely to leave.

The study, published in the latest issue of the Journal of Public Safety, examined the true cost of nurse burnout, and found that hospitals with designated burnout reduction programs spend 36% less on recruitment than hospitals without these programs and that nurses remain in their positions 20% longer.

Around one third of nurses reported burnout prior to the pandemic with an annual turnover rate of around 17%. After the pandemic, nurse burnout rose to around 50% and turnover rates have increased to anywhere from 20% to 30%.

The research shows a direct correlation between burnout and the frequency of assaults on healthcare workers. Other contributing factors include long working hours, lack of support, and frequent exposure to high-stress work environments.

The study was conducted by Jane Muir, a UVA Health emergency room nurse and School of Nursing doctoral student. She said that while many hospitals created successful burnout prevention programs in the wake of COVID-19, “it hadn’t been a priority until it was too late.”

She and her team compiled data from over 20 different studies and found that hospitals with burnout prevention programs spent $11,592 per nurse per year employed on burnout-related costs – about 30% less than hospitals without such programs, which spent, on average, $16,736 per nurse per year employed.

“Data don’t lie,” said Muir. “There is an economic argument to be made for properly compensating and supporting nurses.”

The study points to one example known as Wisdom & Wellbeing, which helps staff recover from burnout by addressing the various sources of “stress injuries,” a type of occupational trauma that can trigger debilitating distress, anxiety, substance abuse, and even PTSD. The group counters these effects by building peer support and increasing access to education and one-on-one on-unit counseling.

Richard Westphal, co-director of Wisdom & Wellbeing and a professor of nursing, said each “stress injury” has an emotional and financial cost. It leads to increased turnover, absenteeism, reduced worker productivity, erosion of team morale, and more sick days, which shows that health systems are bound to see a return on their investment.

“Preventing the stress-related turnover of just a few nurses or physicians more than covers the annual cost of well-being initiatives across the entire organization,” Westphal said.

UVA School of Nursing Dean Pam Cipriano said that an increase in turnover means units lose valuable expertise and experience that could be passed down to newer nurses.

The study also found that the worse the burnout and turnover, the more effective the prevention programs were. When RN burnout was greater than 20% and turnover costs exceeded $70,000, implementing a burnout prevention program cost less, the hospital retained staff longer, and few nurses reported burnout.

It also noted that burnout prevention programs tend to be the most effective when introduced to staff within the first three to five years of their practice.

Various prevention methods can include:

• Financial incentives that encourage senior staff to become mentors to newer nurses; specifically bonuses and/or vacation time
• Mandated staffing ratios for improved quality of care
• More equitable workloads across clinical groups
• Increased educational opportunities or tuition reimbursement to help RNs gain additional clinical competence 

However, Muir said too few hospitals invest in burnout reduction programs or measure its relationship to employee turnover and retention.

Exit surveys can help facilities better understand what’s causing their employees to quit. 

But Muir pointed out that many surveys lack consistency across units or hospital to hospital, and “some may not even be using validated surveys that address burnout, but instead offer more opaque reasons like, ‘I’m leaving for personal reasons,’ or ‘The hours don’t work for me,’ or ‘I feel disengaged or have a lack of self-efficacy,’” Muir explained. “We’re not asking specifically about burnout, which leaves some fundamental gaps, and these inconsistencies in measuring clinician burnout limits our ability to address the issue.”