Study: Illinois’ Union Hospitals Were Better Prepared for COVID-19

Data Links Nurses Unions with Better Workplace and Patient Care Outcomes

La Grange:  Illinois’ unionized hospitals have dramatically lower staff vacancy and turnover rates, safer workplaces, and more robust infection prevention and control systems while enabling registered nurses to devote substantially more time to care for individual patients, according to new research by the Illinois Economic Policy Institute (ILEPI).

Read the Report, “Pandemic Preparedness in Illinois: Illinois’ Union Hospitals Were Better Positioned for the Public Health Crisis.”

“The global coronavirus pandemic has put new strain on Illinois’ hospitals and a nursing workforce that was already facing severe shortages,” said study co-author and ILEPI Policy Director Frank Manzo IV. “This report shows that unionized hospitals in Illinois were far better prepared to absorb the impacts of COVID-19. Our findings have important implications for the future of hospital staffing and how we manage public health crises.”

Specifically, the report reveals significant differences between the state’s unionized and non-unionized hospitals in the wake of COVID-19, including:

  • Union hospitals have nurse turnover rates that are up to 14% lower.
  • Unionized hospitals have nurse vacancy rates that are up to 45% lower.
  • Unionized hospitals report 15% fewer OSHA violations and 29% fewer serious violations.
  • Unionized hospitals employ more infection prevention and control staff—particularly in Cook County which has seen two-thirds of the state’s COVID-19 caseload.
  • Nurses at unionized hospitals are able to devote 1 to 4 more hours of care to each patient, on average.

“For caregivers and patients, these differences can literally mean the difference between life and death,” added study co-author and ILEPI Researcher Jill Gigstad. “Our hospitals are the frontlines of this pandemic, and it is important to understand which staffing and care models are likely to deliver the best outcomes.”

Despite their weaker staffing and care outcomes, the report notes that the state’s non-unionized hospitals have received 16% more funding per bed than unionized facilities from federal pandemic relief measures such as the CARES Act.  All told, Illinois’ hospitals have received at least $1.1 billion, and small Illinois hospitals with under 100 beds have received more than four times the per-bed funding than their larger unionized counterparts.

Prior ILEPI research had documented that Illinois’ hospitals faced a shortage of 20,000 registered nurses before the COVID-19 pandemic, with half of its nursing workforce over the age of 55 and more than three-quarters of the state’s nurses warning of insufficient staffing levels. A proposed “safe patient limits” nurse staffing law– which would have required Illinois’ hospitals to hire more nurses and has been linked to better patient outcomes, including lower fatality and readmission rates for certain respiratory conditions and improved nurse retention, at minimal impact on the financial performance of hospitals– has been pending in the Illinois General Assembly for nearly two years.

According to the Illinois Department of Public Health, more than 9,500 of the state’s healthcare workers have been infected with COVID-19, and more than 60 have died.  Another 3,600 have come out of retirement or volunteered from out-of-state to help Illinois deliver care during the pandemic.

“While the strain of COVID-19 has again highlighted the importance of addressing the state’s acute shortage of registered nurses, it has also revealed the comparative strengths and weaknesses of the staffing models currently in practice at Illinois’ health care facilities,” Gigstad added. “Ultimately, the data suggests that unionized hospitals are more resilient and better equipped for the demands of public health crises.”

The Illinois Economic Policy Institute (ILEPI) is a nonprofit organization which uses advanced statistics and the latest forecasting models to promote thoughtful economic growth for businesses and working families.