As the health care industry continues to struggle with staffing shortages, some hospitals are considering offering their employees more robust child care options, including on-site care centers, to retain their nurses and other crucial staffers, Lauren Sausser writes for Kaiser Health News.

Employee expectations are rapidly evolving. Here’s how your organization can respond.

Many workers have struggled with child care during the pandemic

Throughout the pandemic, a lack of available child care has led many workers to quit their jobs. According to a benefits report from Care.com, almost half of the 4 million workers who resigned each month in the second half of 2021 cited either difficulties with child care or senior care as their reason for quitting.

Emerging idea: Informal caregiver flexible working arrangement

A significant number of those leaving the workforce have been nurses, which has led to widespread staffing shortages in hospitals. In 2021, the total supply of RNs in the United States decreased by more than 100,000—which a report published in Health Affairs called "a far greater drop than ever observed over the past four decades." Separately, a survey from McKinsey & Co. found that 32% of nurses said they may leave their current position within the next year.

According to a 2022 report from NSI Nursing Solutions, hospitals lose an average of around $46,000 whenever a bedside nurse quits, which equaled roughly $7 million in nursing turnover costs in 2021 for the average hospital.

"People are leaving the industry because they're not able to balance work and life," said Priya Krishnan, SVP of client relations for Bright Horizons, which provides employer-sponsored child care for organizations across the country.

Can child care centers at hospitals help improve retention?

Data from the U.S. Department of Labor shows that around one-third of hospitals offer child care benefits. However, these benefits can vary widely from hospital to hospital, with some providing access only to last-minute backup care.

Now, many hospitals are considering adding more comprehensive child care options, including on-site child care centers.

"Retention is the biggest reason they're thinking about this," Krishnan said, noting that many Bright Horizons' potential clients have been hospitals.

For example, Ballad Health, which has hospitals in Tennessee, North Carolina, and Virginia, recently announced it was investing $37 million to build 11 child care centers at its facilities over the next three years. According to the health system, this expansion will help increase its overall child care capacity from 200 children to 2,000.

"I look at this [child care] as being a really, really vital piece of the benefits package, especially for families with kids who are infants to school-age," said Rebecca Gomez, a clinical health psychologist at Wellstar Health System, whose two children are enrolled Wellstar's Learning Academy run by Bright Horizons. "Everything about it has made my life so much easier."

Some hospitals with robust child care options have already seen retention benefits. For example, Roper St. Francis Healthcare, which has operated a Learning Center for its employees' children for more than 30 years, found 91% of parents who use the Learning Center said it was the reason they stayed in their jobs.

In addition, Melanie Stith, VP of human resources at Roper St. Francis, said that while the system has experienced significant turnover during the pandemic, only two employees who used the Learning Center resigned. The health system is considering expanding its child care services as it builds a bigger hospital in Berkeley County, South Carolina.

Overall, hospitals hope that adding more robust child care options, including child care centers, will offer them a competitive advantage, particularly as they raise salaries to compete with other hospitals in nearby markets.

"We can't keep up with" continually raising nurses' salaries, said Tony Keck, EVP of system innovation at Ballad Health, "which is why we're trying to move as quickly as possible" on the new child care centers. (Sausser, Kaiser Health News, 8/1)