Wayne State Proposes ‘Three Bucket’ Solution to Address Healthcare Shortage

Wayne State University officials Monday proposed to an appropriations subcommittee a three-part proposal to address the state’s “critical healthcare workforce shortage” by recruiting clinicians to work as adjunct faculty, creating a supportive nurse residency program and exploring other solutions.

Wayne State trains about half of Michigan’s healthcare professionals with the country’s largest single-campus medical school, said Dr. Laurie Lauzon Clabo, Wayne State University provost and senior vice president for academic affairs, to the House Department of Health and Human Services Appropriations Subcommittee.

Her statements were echoed by the Detroit Regional Chamber, which reported that approximately 40 percent of physicians in Michigan specifically have ties to Wayne State.

Clabo presented about programs designed to address the healthcare workforce shortage, which often focus on increasing the number of people going into healthcare, or “the (healthcare) pipeline.”

However, she said, oftentimes these programs don’t use evidence-based strategies to improve access, and end up limiting both access and retention.

Clabo, also the former College of Nursing dean, proposed a “three-bucket” initiative to improve access to the healthcare pipeline and boost retention, starting with increasing nursing faculty numbers.

She said one major limiting factor when it comes to the enrollment of additional students is a shortage of nursing faculty.

According to an American Association of Colleges of Nursing (AACN) report on 2021-2022 enrollment and graduation numbers, U.S. nursing schools turned away 91,938 qualified applicants from nursing programs in 2021 due to an insufficient number of faculty, clinical sites, classroom space and budget constraints.

“Most nursing schools responding to the survey pointed to faculty shortages as a top reason for not accepting all qualified applicants into their programs,” the AACN wrote.

Another AACN survey released in October 2022 found 2,166 full-time faculty vacancies at 909 nursing schools across the country and schools citing the need to create an additional 128 faculty positions to accommodate student demand.

The AACN also found in the same survey that the vacancy rate increased by 0.8 percent from 2021 to 2022, from a flat 8 percent in 2021 to 8.8 percent in 2022.

Clabo said less than 1 percent of nurses in the United States currently possess the credentials required to serve as a nursing faculty member in a baccalaureate or graduate program.

Of the schools surveyed by the AACN, 85 percent of vacancies required or preferred a doctoral degree, and the most common issues schools reported related to faculty recruitment were difficulty finding faculty with the right specialty mix (538 schools at 59.2 percent) and non-competitive salaries (606 schools at 66.7 percent).

Clabo said this shortage could be addressed by topping off the salaries of clinicians that also choose to serve as educators for a single day a week, allowing them to serve as adjunct faculty and provide clinical education with a reward.

For the second bucket, she proposed adopting jointly-designed academic practice residency programs, which place new nurses in residency with a faculty member and clinician, allowing them additional support when they start their career.

Nurse residency programs in general are not required for new graduates, but some Michigan hospitals offer them. Most programs in effect now are between six and 12 months long.

Clabo said as many as 40 percent of new graduates leave their job in the first year, and of those who leave, 20 percent leave the profession entirely.

Programs that pair new nurses with support personnel are shown to address turnover by over 50 percent, Clabo said.

For part three of her proposal, Clabo suggested conducting new research to address clinical education possibilities in existing nursing programs.

“We propose a rigorous program of research that would direct new models of clinical education to support our critical workforce shortage,” Clabo said.

Article courtesy MIRS News for SBAM’s Lansing Watchdog newsletter

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