Old formulas for funding health care no longer work; health care costs continue to rise. Many organizations are focusing on cost control, which may include budget shortfalls when it comes to compensating nursing staff. More and more however health care organizations are also realizing the need to focus on adequate compensation and attention to nurses and nursing shortages. New business and health coalitions are forming in major metropolitan areas to help control costs and also attract more qualified personnel, stimulating physicians and nurses as well as other providers to work together to improve service delivery in light of new health care challenges (Heirich, 1998). .

             Future of Workforce Design and Organization.

             As health care organizations are changing in response to chronic nursing shortages so too are organizations re-evaluating workforce designs and organizational development within the health care setting. More and more the emphasis within the health care community and organization has been creating more flat organizational structures and global enterprises that encourage cross collaboration or multi-disciplinary approaches to health care delivery (Heirich, 1998). .

             Chronic labor shortages of nurses in the global workplace have encouraged healthcare organizations to adopt new strategies for attracting qualified personnel. In Britain for example, long standing labor shortages among nurses has resulted in dire efforts to recruit migrant nurses from other countries (McGann & Mortimer, 2004). Other organization's including the Illinois State Association are considering recognizing various grades of nurses, including nurses with twelve months vs. nurses with twenty seven or more months of training, in an effort to provide more and lower cost nursing care for patients (McGann & Mortimer, 2004). .

             Nursing workforce design is increasingly taking on an interdisciplinary and collaborative approach, with more nurses and health care staff trained in a diverse array of services (Clark & Drinka, 2000).