Ashford General Hospital is a 263-bed regional hospital located in California, serving its community for more than 50 years. The hospital maintains the only 24-hour emergency department in the area and an "extended hours" urgent care clinic. Similar to other hospitals in the United States, Ashford General Hospital is encountering a nursing shortage. Sixty-eight percent of the nursing staff is over the age of 45, facing retirement. The retention rate on nurses is 61%, compared to 65% nationwide. Many of the nursing staff find the work too physically demanding and have a feeling of emotional burn-out as well. In the past two years, the hospital has used both per diem nurses and traveling nurses who sign short-term contracts to fill individual shifts and accommodate short-term staffing needs arising from staff vacations or medical leaves. This has not only driven up personnel costs but also resulted in lower scores on patient satisfaction surveys. Ashford General Hospital faces significant challenges in nurse staffing ahead as it grapples with these issues, and the hospital board is very concerned. They know there must be some changes made in order to prevent a major financial and human resources crisis in the future. As the newly hired CEO, you are asked to present a proposal in the next board meeting.