One of the primary goals of the Hawai‘i State Center for Nursing (HSCFN) is to
establish “an ongoing system that assists in estimating the future registered
nursing workforce supply and demand needs in Hawai‘i.” In accordance with the
mission, the HSCFN utilized forecasting models and data relevant to the State of
Hawai‘i to project future nursing needs.
Long range forecasting is described as ‘an estimate or prediction of the future’.
Forecast data are a best estimate of likely trends and are an essential
component of nursing workforce planning. In order to plan future workforce
needs, workforce demand requirements and supply availability need to be
adequately estimated, and workforce shortages or oversupply conditions need to
be predicted. Forecasting requires that past and current trends in the demand for
and supply of nursing workforce are carefully assessed. Predictors of levels and
trends in demand and supply must be identified and models created that weigh
these factors and use them to project future demand and supply. Whether these
projections prove to be close to the values observed in the future depends on the
degree to which historical trends provide a guide to the future and the influences
of unforeseen external factors.
Forecasting workforce demand and supply is a complex endeavor with many
factors potentially influencing current and future levels. An adequate forecasting
model must take into consideration as many of these factors as possible, and
must accurately estimate trends in the factors and the effect they will have on
supply and demand in the future. In addition, good forecasting models allow for
different future scenarios, since factors such as the economy (affecting supply
and demand), the nation’s health (affecting demand), funding for nursing
education (affecting supply), and retirement rates (affecting supply), can
singularly or collectively change direction over time.
The final report: 1) describes the national Nursing Supply Model (NSM) and
Nursing Demand Model (NDM); 2) describes the procedures used in updating
and adjusting the two independent models to reflect the current Hawaiian
workforce environment; 3) provides Hawai‘i specific estimates of current supply
and demand; and 4) lists model limitations and 5) potential policy initiatives to
reduce the impact of the shortage.
In this study, the National Center for Health Workforce Analysis (NCHWA)
models were used to forecast the supply and demand of registered nurses (RNs)
in Hawai‘i from 2005 - 2020. Preliminary estimates suggest that demand will
grow from a current need for about 8,411 FTE RNs to more than 10,955 over the
next 15 years. However, supply is projected to increase from an estimated 7,553
FTE RNs in 2005 to an estimated 8,286 by 2020. The models indicate that by the
year 2020, Hawai‘i will have a shortage of approximately 2,669 FTE RNs, or
about 24 percent demand shortfall.
Both immediate and long-term policy development is required to address this
growing nursing shortage. We need to address the limited educational capacity
issues faced by our nursing programs; to attract and ensure educational
opportunities for people to the nursing profession. The advantage of such
policies is that they add new nurses year after year. Thus, while the increase in
any one year may be modest, the cumulative effect can be significant. Other
factors such as reducing net annual out-migration and turnover rates; and
attracting more people to nursing will have an accumulative effect.
Policies that affect participation within the existing pool of nurses may have a
limited long-term impact while increasing the supply of nurses in the short term.
Delaying time until retirement, reducing career changes and increasing the
percentage of nurses working full time as opposed to part time are examples of
such policies.
Data suggests that no individual policy is likely to alleviate the nursing shortage.
Rather, eliminating the nursing shortage requires targeting a series of policy
initiatives to ensure nursing supply. The most effective strategy may be one that
stimulates supply among existing nursing workforce to address the current
shortage and simultaneously increase supply through nursing education to
minimize future shortages.
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