Hospitals, Consumer / Employer

Report: staffing shortages and provider’s mental health are top concerns affecting patient safety

A 2022 report by patient safety company ECRI listed the top ten risk factors to patient safety and provided actionable steps to mitigate each risk.

A new report by patient safety organization ECRI found staffing shortages topped the list of factors jeopardizing patient safety. The impact of Covid-19 on healthcare workers’ mental health came in second, followed by bias and racism in addressing patient safety as risk factor number three, according to the report. Aside from outlining the concerns, the report also offered steps to address each risk area — such as offering wellness programs to healthcare workers or recruiting diverse staff.

Amidst the Great Resignation, it comes as no surprise that staffing shortages tops the top ten factors threatening patient safety. But the pandemic is not only to blame, according to the report. Prior to Covid-19, the field already faced an upcoming staffing shortage, exacerbated by nurses reaching retirement age. Case in point: In 2020 the median age of registered nurses was 52 years, the report said. As a result, the report recommends several action steps for organizations, ranging from creating flexible staffing models (such as floating nurses between units based on need) to adding tele-ICU capabilities.

As the second risk factor to patients’ health, the report cites Covid-19’s impact on healthcare workers’ mental health. This too existed before the pandemic but was exacerbated by it. As of June 2021, 29% of physicians had been treated or diagnosed with anxiety or depression, according to the report. Further, 20% reported feeling burned out and a shocking 7% reported suicidal ideation, the report said. To address this risk factor, the report recommended several action items, including providing wellness programs to workers as well as hiring professional development specialists who can share tips on mindfulness to clinicians and staff. 

Bias and racism took the third place for risk factors to patient safety. Providers do not report harmful events for minority patients as frequently as they do for white patients, the report noted. Recommended actionable steps moving forward include cultural competence trainings, taking racism allegations seriously, and recruiting diverse staff.

The fourth risk factor was vaccine coverage gaps and errors, and that includes vaccines beyond Covid-19. Specifically, giving the wrong vaccine or the incorrect dose as well as giving expired vaccines contributed to the error, the report said. To address and minimize the resulting risk, the report advocated for improved vaccine protocols and placing vaccines on shelves with the closest expiration date up front.

Cognitive biases and diagnostic errors threatened patient safety, according to the report, as they can cause a misdiagnosis. For example, patients presenting with breathing issues were often suspected of having Covid-19, even after negative test results. The report noted this resulted in delayed care and treatment for their actual diagnosis. As a remedy, the report recommends simulation training to identify illness as well as decreasing bias prompting patient descriptors, such as “drug seeking” or “frequent flyer.”

The other five risk factors were: nonventilator healthcare-associated pneumonia, telehealth issues (such as fractured adoption), international supply chain disruptions, products subject to Emergency Use Authorization, and telemetry monitoring (measuring patients’ physiologic parameters from a distance).

“Healthcare and government leaders now must aggressively manage these challenges amidst a lingering pandemic and a weakened health system by prioritizing recruitment, retention, and clinician resilience,” said Marcus Schabacker, president and CEO of ECRI, in a news release. “As leaders, their most important job is ensuring that patient health and safety are top priorities.”

Picture: Getty Images, thomas-bethge