Tennessee hospitals are facing an unprecedented staffing crisis that is projected to last well into the next decade. With an expected shortfall of more than 15,000 in-demand positions by 2035, decision-makers must do more than “bridge” the workforce gap — we must mend it.

3 Key Professions with Projected Shortfalls through 2035

Population Growth and Significant Increase in Aging Population Contribute to Shortfall.

The population of Tennessee is expected to grow 9.7% through 2035. The 75 and older population is expected to increase 54.1%. This group uses both EDs and inpatient services at higher rates than other age groups, which will have an impact on the needed supply of hospital workers.

As our healthcare system buckles and sways under the strain of ongoing shortages in nursing, respiratory therapy, and other essential staff, we must focus our energy on bold changes rather than quick fixes. ​

​It’s our responsibility, as stakeholders and healthcare providers, to do the hard work of finding and implementing the right solutions, right now — for the health of our patients, our staff, and our communities. Together, we can mend the gap for good.

In 2022 THA conducted a long-term health workforce supply and demand study that provides an assessment of the current and future demand, supply and supply adequacy of key healthcare occupations, as well as analysis of reasons for workforce shortages and programs that might help alleviate them. The study will be used to:

  • Support advocacy efforts related to training health professionals or other initiatives to improve overall supply adequacy
  • Inform strategies of hospitals and other stakeholders to improve recruiting and retention
  • Support efforts to improve care delivery and overall efficiency of healthcare delivery in Tennessee

Bold Change Starts with Bold Initiatives

As we strive for a healthy, whole future for Tennessee’s hospital system, we’re focusing on three key areas of impact:


Explore innovative care models that improve operational efficiency and increase patient and staff satisfaction. 



Attract more people to healthcare professions and promote the benefits of working in a Tennessee hospital.  


Identify strategies to ensure hospital careers are competitive, focus on employee well-being, and provide opportunities for learning and growth.

  • Implement team-based approaches to care that maximize patient care hours and allow clinicians to function at the top of their license.

    Advocating for regulatory changes with the Board of Nursing to support broader use of LPNs in the acute care setting. Use of EMTs and patient care techs in some hospital settings.

  • Utilize technology to support and supplement inpatient care teams.

    Virtual nurses performing admission assessments and discharge teaching.  Baptist Memphis tele-ICU nurses and virtual nurses used as extra eyes to support rural facilities, newer nurses, etc. Implementation of virtual support services such as patient sitters, interpreter services, specialty services (behavioral health, neurosciences, pediatrics). Technology that alerts hospital staff when a patient is at risk of falling.

  • Establish creative staffing schedules and options to support nurses and other healthcare staff in designing their preferred work options, flexibility and work-life balance. 

    Vanderbilt University Medical Center’s employment options, including internal travel pools, per diem options. Ballad Health and University of Tennessee Medical Center are other systems redesigning their employment models to attract and keep nurses. 

  • Create opportunities to identify successful workforce strategies and share innovative approaches across hospitals and health systems.

    THA has launched a webinar series that showcases best practices in workforce recruitment and development from among our member facilities and outside partners. Check out the webinars here.

    THA’s Workforce Council. THA’s Nursing Workforce Innovation Design Sprint event and report. Governor Bill Lee’s Tennessee Rural Health Care Task Force work and report.

  • Create a statewide recruitment campaign aimed at middle and high school students to highlight the benefits of hospital careers and the variety of hospital jobs available.

    It Happens in a Hospital Campaign and Toolkit.

  • Engage with middle and high school students at schools, conferences and career fairs, and offer hands-on virtual healthcare experiences to provide early exposure to healthcare careers.

    HOSA conferences, school visits, hospital-high school partnerships

  • Enhance collaboration between hospitals and nursing schools to increase clinical placements and nursing school capacity.​

    THA academic- hospital collaborative meetings, externship/internship models, dedicated education units, academic partnership models. Shared employment of bedside nurses as clinical faculty. Support to schools for dedicated clinical faculty within a facility. Dedicated clinical placement agreements for full-time clinical staff.   Introduction of legislation that would address the nursing instructor shortage by boosting nursing school enrollment and facilitating clinical placements.

  • Promote college scholarship opportunities for students entering health professions.

    Mary Layne Van Cleave Achievement Award for HOSA Students: Scholarships for Tennessee high school seniors pursuing a college degree for a healthcare profession.

  • Provide residency incentive programs that offer financial assistance in exchange for hospital service commitments and/or service commitments in underserved areas of the state. ​

    TCWD Residency Incentive: Financial incentive offered to medical residents in exchange for a multi-year service commitment working with Tennessee’s rural/underserved populations.

  • Develop hospital and nursing school partnerships aimed at better preparing students and retaining graduates in Tennessee and in the hospital setting.

    UTMC partnership with UT Nursing School – involved in setting admission criteria, act as site for all clinical training, pay tuition in exchange for work at UTMC following graduation.

  • Provide education and support for hospital staff to address worker safety, well-being and resilience.

    CHI Memorial support program on the website that uses art, drama and music; Maury Regional Medical Center and University of Tennessee Medical Center use of trained security dogs that patrol hospitals to heighten workforce safety; Vanderbilt University Medical Center and others well-being services for employees.THA webinars on mindfulness and resilience.

  • Support career pathways for ongoing professional development and career advancement. ​

    HCA, Ascension models to advance care techs, LPNs to RN with scholarships and education support; Vanderbilt University Medical Center program to identify medical assistants and other entry level staff to clinical roles; University of Tennessee Medical Center program to establish a RN career path for advancement while staying at the bedside. Explore healthcare apprenticeship-like programs that offer “earn while you learn” opportunities. ​

  • Evaluate employer benefit and incentive packages to ensure hospital careers remain competitive.

    Market review to compare salaries. Sign on and retention bonuses. Offering additional benefits beyond traditional benefit packages.