Final - HCA 364

3

Staff Shortage and High Turnover in Healthcare: A Strategic Plan

Dominica Thomas

Grand Canyon University

HCA 364

Professor Ashley Hartman

19 April 2026

The Health Care Issue: Staff Shortages and High Turnover

The healthcare organizations in the United States are still deep into the workforce crisis, in which the staff shortage issue and the high levels of employee turnover persist. These issues are not just isolated but structural issues, which jeopardize patient safety, substandard care, and place healthcare administrators in the unsustainability quandary of running their operations. Li et al. (2024) found that turnover intention was high among the primary healthcare workers who were overworked, experienced emotional burnout, and did not receive institutional support. Al-Rjoub (2025) also noted that there is a correlation between the latter trend and attrition being caused by all of the factors, such as ineffective leadership communication, ongoing understaffing, and a lack of opportunities to improve their professional development. The effects of staffing levels go beyond staffing levels: Randa et al. (2021) validated that high turnover in critical care units leads to direct negative effects on patient care, causing delays, lowering the quality of care, and risking patients. Lack of an organized, evidence-based strategy plan places healthcare organizations at risk of creating a chain of workforce instability that could endanger the well-being of their staff and the safety of patients.

Resources required and Stakeholders

The staff shortage/high turnover would necessitate an all-around allocation of human, financial, and informational resources and involvement of key stakeholders at all levels of the organization. The stakeholders, such as healthcare administrators, clinical nurse educators, human resources personnel, frontline nurses, and department managers, are important. All of them have a different role in the strategic plan. Executive sponsorship and budgets for recruitment, onboarding, and retention efforts are offered by administrators. Nurse teachers develop and provide leadership development programs and continuing education tracks. Competitive pay reviews and programs are practiced by human resources personnel, as well as structured onboarding programs. Frontline nurses provide firsthand experience of workplace obstacles, and they are involved in surveys of satisfaction, which are used to change policy.

Funds are also imperative. The building blocks of a sustainable retention strategy are recruitment and onboarding budgets, training and development budgets, and grant funds to consider workforce programs. Administrators can make evidence-based decisions with the help of informational resources, such as workforce data and turnover analytics, and employee satisfaction survey results. Xie et al. (2025) revealed that turnover among nurses during perioperation is minimized greatly when organizations invest in the quality of leadership, professional development, and flexible scheduling, and thus the necessity of strong resource distribution in these three areas. On the same note, Li et al. (2024) have found career development and support by the manager as crucial to the process of nurse staffing, and that human and financial investment should be conscious and continuous.

The essence of a Good Healthcare Leader

A competent healthcare leader is an important contributor in combating staff shortage and turnover. The leader must be an individual who is regarded as trustworthy, promotes communication, and provides a psychologically secure work environment. Some of the key features would include: good communication skills, empathy, an ethical foundation, and the ability to represent the staff and patients. In the study conducted by Hayward et al. (2016), in situations where nurses voluntarily leave their jobs, they cited bad leadership support, work interactions, and lack of communication as some of the factors that prompted them to leave their jobs. This fact highlights the idea that effective leaders ought to take the initiative to create an open communication channel, frequent mentorship, and career development.

The strategic plan possesses a good leader who is an architect and custodian. They are to perform quarterly surveys to determine the level of employee satisfaction, develop ethics workshops, and ensure that the strategic decisions are aligned with organizational values and regulations. Again, Al-Rjoub (2025) has established that a failure of leadership, particularly ineffective communication and failure to assist nurses to develop their careers, are among the primary causes that contribute to turnover. Thus, the leadership position is not only managerial but more of a relationship: the creation of the culture of belonging, responsibility, and constant enhancement. In terms of the Christian worldview, such a leadership approach is a reminder of the call to give primacy to the dignity and welfare of the people under his/her care and put the needs of the staff and patients first instead of institutional convenience or personal promotion.

Compliance Requirements and Regulatory Considerations

The shortages of staff should be dealt with by using a strategic plan that is aligned with the key legislative and regulatory frameworks. The key legislation that will apply to this case is the Occupational Safety and Health Act (OSHA). The health care industry has been required by OSHA to offer environments to work without known hazards, including hazards that are induced by understaffing. When staff-to-patient ratios are below the safe staff-to-patient ratios, workplace injury, burnout, and medical errors become exponentially more hazardous, and the organization may be at risk of failing to meet OSHA standards. A review of systems of occupational safety and health management carried out on a global scale by Johanes et al. (2023) demonstrated that the positive attitude towards the implementation of OSHA systems helps a great deal in the reduction of the risk in the organization and enhancement of the well-being of the employees.

On top of OSHA, there is the Fair Labor Standards Act (FLSA) that controls the payment of workers and overtime and is thus directly connected to staffing decisions. The pressure to fill the gaps by subjecting current workers to excessive workloads of overtime could also expose organizations to lawsuits under FLSA and quick burnout and turnover. On the internal front, institutional policies on the nurse-to-patient ratios, credentialing policies, and human resources policies should also be included in the strategic plan. Liddle et al. (2024) demonstrated the impact of staffing instability and the absence of respect for the workforce priorities on the quality of care and the loss of trust in the community, which proves that compliance cannot be addressed outside of the context of ethical organizational practice.

Strategy and Organization Development Plan

The strategic development plan would be designed according to the logical model framework, with the input flowing into activities, outputs, and long and short-term outcomes. During the short-term, the organization will run competitive compensation reviews and create systematic onboarding programs to enhance recruitment and initial retention. Hewko and Clow (2022) found that the most effective retention strategies that can be adopted in healthcare organizations are managerial support, workload, and career development. On this basis, the plan will also launch leadership development programs and continuous learning programs to establish a talent pipeline of talent who can be promoted in the company.

Quarterly surveys of employee satisfaction and ethics workshops in the medium-term will establish feedback mechanisms by which administrators will be able to react dynamically to issues of the workforce. The HR policy manuals will be revised based on the OSHA and FLSA guidelines and exit interview summaries will be systematically analyzed with an aim of identifying the persistent drivers of turnover. Li et al. (2024) discovered that a mix of the hospital-level policy, department workload, and patient acuity influences staffing, which confirms that multi-level interventions need to be undertaken simultaneously to achieve a strategic impact. The long-term outcomes of the strategy are the long-term reduction of turnover rates, the high patient safety outcomes, the reduction of medical errors, and the culture of organizational ethics that is more justice-service-oriented and human-dignity-oriented. This aspect, specifically, is significant in the institutions that involve a Christian worldview, when the concept of stewardship and compassion is perceived as the main feature of all leadership judgments.

Communication Strategies of the proposed plan

Effective communication is a success factor of this strategic plan. The communication plan will be multi-directional, and all the vital stakeholders, like the executive leadership, department managers, frontline clinical staff, and external regulatory bodies, will be targeted. The plan is to be officially introduced by having an all-staff town hall meeting, which will be led by senior administrators, during which the logic, objectives, and timeline of the initiative in phases will be introduced. This transparency will be instrumental in creating the level of trust that will bring about the concept of staff buy-in, particularly given that the majority of nurses and other clinical staff may not be keen on believing in the promises of the institutions, which have not supported them well throughout the years.

On-going communication will be maintained on the monthly departmental briefings, use of electronic messages via the Intranet platform of the company, and there will be a special feedback form where employees will be requested to write their concerns or suggestions without any names attached. Frontline staff will be kept updated and involved at all levels of implementation by the department managers, who will be the liaisons of communication. Transparency in managerial communications is one of the most efficient forecasts of staff retention, and this plan brings this fact into action, integrating formal communication points into the entire organization levels. The compliance updates of the OSHA and FLSA will be dispatched in the form of information sessions provided by HR, and the entire staff will be acquainted with the regulatory environment in which staffing will be determined. Lastly, the culture of communication, which will be open, responsive, and promote ethical transparency, will be a retention of its own, which will send a message to the personnel that management listens to them and is also accountable.

References

Al-Rjoub, S. (2025). When leadership drives nurses away: Empirical research qualitative on high turnover rates reason. EBSCO. https://research-ebsco-com.lopes.idm.oclc.org/c/ws2dot/viewer/html/uh6nadpyy5

Hayward, D., Bungay, V., Wolff, A., & Macdonald, V. (2016). A qualitative study of experienced nurses’ voluntary turnover: Learning from their perspectives. EBSCO. https://research-ebsco-com.lopes.idm.oclc.org/c/ws2dot/viewer/html/pwzn7elod5

Hewko, S., & Clow, S. (2022). High turnover in clinical dietetics: A descriptive analysis. EBSCO. https://research-ebsco-com.lopes.idm.oclc.org/c/ws2dot/viewer/pdf/pvjouiar3r

Johanes, M., Mark, M., & Steven, J. (2023). A global review of implementation of occupational safety and health management systems for the period 1970-2020. International Journal of Occupational Safety and Ergonomics, 29(2), 821-836. https://doi.org/10.1080/10803548.2022.2083811

Li, G., Wang, W., Pu, J., Xie, Z., Shen, T., & Huang, H. (2024). Relevant factors affecting nurse staffing: A qualitative study from the perspective of nursing managers. PMC. https://pmc-ncbi-nlm-nih-gov.lopes.idm.oclc.org/articles/PMC11363875/

Li, X., Wang, J., Wang, N., He, L., Li, C., & Xie, Y. (2024). Turnover intention and influential factors among primary healthcare workers in Guangdong province, China: A cross-sectional study. DOAJ. https://doaj.org/article/142958820f8c42d9a6c0dbfadba6828f

Liddle, Z., Fitts, M., Bourke, L., & Murakami-Gold, L. (2024). Attitudes to short-term staffing and workforce priorities of community users of remote Aboriginal community-controlled health services: A qualitative study. International Journal of Environmental Research and Public Health, 21(4). https://doi.org/10.3390/ijerph21040000

Randa, M., & Phale, J. M. (2021). The effects of high nurses’ turnover on patient care: Perspectives of unit managers in critical care units. ScienceDirect. https://www.sciencedirect.com/science/article/pii/S2214139123000550

Xie, A., Xu, H., & Duff, J. (2025). Factors influencing perioperative nurses’ retention and turnover decisions: A qualitative analysis. ScienceDirect. https://linkinghub-elsevier-com.lopes.idm.oclc.org/retrieve/pii/S2405603025000445