Severe staffing shortages have plagued healthcare organizations over the past several years, and between factors like COVID-19 burnout, an aging workforce, and the Great Resignation (in the United States, 4.3 million people quit their jobs in January 2022 alone), the problem is only getting worse.
Organizations are short-staffed, workers feel stretched thin, and hospitals are often slammed with patients who are sicker than ever before due to delayed care during the pandemic. However, safety goals are unchanging and must continue to be met. It's a paradox without an easy solution, but healthcare organizations shouldn’t let staffing shortages affect patient safety.
Luckily, patient safety and incident management technology can help fill in the gaps and provide a safety net for workers and patients alike, and create a path to improvement.
Having appropriate and adequate nurse staffing is one of the basic elements of healthcare organization management and for good reason. Nurses not only provide care to multiple patients per shift, but nurse teams are the sentinels of healthcare safety, monitoring patients 24-hours a day and responding to their needs in real-time. Such responsibilities require constant vigilance from nurses who have the right skills to handle the kinds of patients they're caring for and their particular needs.
Appropriate nurse staffing is complicated and involves many variables, from nurse skill mix to patient acuity, but at its most basic, having enough nurses at the bedside to effectively monitor and respond to patients and their needs is imperative for quality management. Because of this, it makes sense that research has tied so many safety and quality indicators to nurse staffing. Nurse-to-patient ratios and overall nurse workload are linked to safety factors like medication errors, pneumonia, and even in-hospital mortality.
Despite the ongoing need for adequate staffing, the healthcare workforce shortage is reaching a critical peak—and safety and quality management are getting harder to maintain.
In fact, ECRI named staffing shortages among its top 10 patient safety concerns of 2022, underscoring that clinical and non-clinical staff shortages have been a problem since before the pandemic and that it's only getting worse. For instance, it cited data showing that in 2020, hospital registered nurse turnover was 18.7% (U.S.).
ECRI points to multiple factors as contributors to the nurse staffing emergency:
The staffing problem isn’t limited to nurses only. ECRI's report noted shortages of medical, laboratory, and other technicians, as well as nursing assistants, pharmacists, physicians, and other clinicians.
No matter the industry, having fewer employees available to do the same amount of time-sensitive work will not only make the work take longer, but will cause the quality of that work to suffer. That, in turn, raises the alarms about safety for both patients and staff.
In the healthcare industry, lower-quality work can have devastating outcomes. Numerous studies show the impact of staff shortages in healthcare settings on quality management.
Nursing shortages not only impact healthcare in general, it also impacts patient safety. Again, numerous studies show the impact of nursing shortages on patient safety:
Other nurse-sensitive patient outcomes strongly impacted by inadequate staffing include the length of stay, patient dissatisfaction, poor quality of nurse-delivered care, and readmission, another literature review found.
Fixing staffing shortages in healthcare requires a long term plan. ECRI, an independent, nonprofit organization improving the safety and quality of worldwide care, published multiple recommendations on how to tackle staffing issues. According to them, organizations must implement a flexible recruitment and retention program. A few points to take into consideration:
Clearly, adequate and appropriate staffing is one key to ensuring patient safety, but it's also important to provide tools to help nurses and other staff members stay on top of incident management and near-misses that occur, especially when healthcare and nursing organizations are already short-staffed.
Reporting incidents is important for ensuring quality for many reasons, including keeping staff members and organizations hypervigilant about their daily operations, helping to understand when and why incidents occur, and providing actionable data that can predict and prevent future incidents.
Although incident reporting has often been met with resistance by nurses, it's important for healthcare leaders to provide a non-punitive environment for their staff, to be honest when incidents or near-misses occur. Leaders should clearly communicate that incident reporting will not lead to punishments.
Another reason incidents and near-misses are sometimes underreported is the administrative burden involved with reporting. That's why many organizations turn to incident management software, which allows reports to be made seamlessly on a digital platform.
Incident management software can also take the work of reporting even further. By digitally compiling incidents and near-misses, healthcare and nursing organizations not only have the capacity to collect and compile the reports, but also analyze them. It allows leaders to notice trends, anticipate issues, and put actions in place to ensure that the incidents don’t happen again. It can also analyze incidents in different ways, such as determining whether a system or human error caused the problem.
When incidents require follow-ups or specific actions, electronic tools provide needed alerts or ensure that the information gets to the right database or person. Each of these functions helps staff stay on top of keeping patients safe, which is especially important when healthcare organizations face staffing challenges.
Adequate and appropriate staffing is critical to keep patients safe. Providing incident management resources that are mobile-first gives staff members another tool in their toolbox for providing the best care possible.