Quality and Cost of Travel Nursing: Real-World Studies Refute Common Misconceptions

A common perception in the healthcare industry is that travel nurses’ quality of care is lower than staff nurses, while their costs are higher. This belief persists despite a growing body of research showing that it is inaccurate.

Travel nursing is a fast-growing option for healthcare organizations, particularly due to the growing shortage of nurses overall. Growth in travel nursing was projected at 7% for 2018, which is slower than the torrid growth of recent years but still at a record high in terms of market size.

Continued high demand for nurses, particularly experienced and specialty nurses, is expected to sustain growth in utilization of travel nurses at healthcare facilities for the foreseeable future.

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Considering that patient-care quality and cost-containment are the top priorities in the healthcare industry, an accurate understanding of the quality and cost of travel nurses could be valuable to clinical and executive leaders at healthcare organizations.

Plenty of research evidence exists showing that temporary nurses are equal to staff nurses in cost and quality:

National Surveys

  • A survey of 40,356 registered nurses at 665 hospitals concluded that higher use of supplemental nurses does not affect patient mortality.
  • A UK study of the National Health Service found that quality scores were no different between units with only permanent staff and units with both permanent and supplemental staff.
  • A 2012 study found that supplemental and permanent nurses have similar levels of education and experience, and that supplemental nurses are more culturally diverse.
  • A 2015 study of 427 hospitals concluded that use of supplemental nurses does not detract from patient satisfaction.
  • A 2017 survey of U.S. senior hospital executives found that the hourly cost of a full-time, permanent nurses is approximately $6 more than travel nurses.

Single-Hospital Studies

  • A study of a large academic medical center found no statistical difference between the hourly cost of supplemental nurses and overtime pay for permanent nurses.
  • A two-year analysis of units using varying levels of travel and staff nurses at a busy, medium-large hospital found no significant differences in the quality of patient care using HCAHPS scores and NDNQI.
  • Another two-year analysis at the same hospital found that staff overtime costs were higher in three of the four units when compared to travel nursing bill rates. In two units, staff costs were nearly 10% higher.

A significant and growing body of research, ranging from analyses of national datasets to studies of patient-care units at a single hospital, establishes that the quality and costs of supplemental nurses, including travel nurses, are equivalent to staff nurses. Healthcare leaders and managers should reconsider past assumptions about the quality and costs of travel nurses in strategic staff planning and when filling staffing gaps.

Marcia Faller

Marcia Faller
Marcia Faller, PhD, RN, is the chief clinical officer for AMN Healthcare. Throughout her tenure with AMN, Faller has championed the development of consistent quality standards for credentialing and competency evaluation of healthcare professionals.

Marcia Faller

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