Staffing Shortages Seen as Top Patient Safety Concern

The top patient safety concerns in the US used to revolve around device malfunctions and medical errors, but now health care worker shortages and the impact of COVID-19 on health care workers’ mental health top the list. To develop its annual report, ECRI (ecri.org) and its affiliate, the Institute for Safe Medication Practices (ISMP), analyzed a wide variety of data, including scientific literature, patient safety events or concerns reported to or investigated by ECRI or ISMP, client research requests and queries, and other internal and external data sources. Of note, ECRI says that health care worker shortages have been a simmering concern.

“Shortages in the health care workforce and mental health challenges were broadly known and well-documented for years,” says Marcus Schabacker, MD, PhD, president and CEO of ECRI. “Both physicians and nurses were at risk of burnout, emotional exhaustion, and depression prior to 2020, but the pandemic made both issues significantly worse.”

According to ECRI, the turnover rate for registered nurses in hospitals in 2020 was 18.7 percent. Nursing staff is greying, with nearly one in five nurses age 65 or older. And the nursing pipeline is limited. The organization cites data showing that in 2019, 80,407 qualified nursing school applicants were turned away due to insufficient resources, such as faculty, clinical sites, classroom space, clinical preceptors, and budget.

As with staffing shortages, ECRI says that COVID’s effects on health care workers’ mental health highlights a pre-existing condition. Medscape’s Physician Burnout and Depression Report 2022 finds that 47 percent of physicians overall report burnout, up from 42 percent last year. More than half (54 percent) of physicians who report burnout say it has a strong or significant impact on their life. The rate of burnout among plastic surgeons is 40 percent, while the rate among dermatologists is 33 percent.

Bias and racism in addressing patient safety rounds out the top three safety threats in the current report. ECRI cites data indicating that patients from ethnic and racial minority groups are more likely to experience adverse events in the hospital setting, but providers are significantly less likely to report harmful events for minority groups. The AMA in 2020 recognized racism as a public health threat, and increasing attention has been focused on the impact of racism on the delivery of patient care.