ECRI’s top 10 patient safety list highlights staff shortages

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Staff shortages and worker mental health are top patient safety concerns that health system executives must tackle, according to ECRI’s annual Top Ten Patient Safety Concerns for 2022.

The report usually focuses on clinical problems like diagnostic errors or cybersecurity attacks. While those issues still exist, the pandemic disrupted health system operations during the past two years. Hospitalizations are decreasing but many in healthcare expect COVID-19 will continue as a public health crisis.

The not-for-profit patient safety organization reported that staff shortages actively threaten patient care by creating longer wait times for care.

“Shortages in the healthcare workforce and mental health challenges were broadly known and well-documented for years,” said Dr. Marcus Schabacker, 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.”

ECRI recommends health systems evaluate the impact of staffing ratios on safety and quality incidents and outcomes, and to offer more flexible work hours, use care extenders and map workloads for every shift.

Organizations can also investigate what might decrease turnover rates, and create worker satisfaction surveys. In the most dire of circumstances, hospitals may have to close units or divert patients, which many rural providers have already had to do. The cost of shortages extends to the balance sheet as well, as labor expenses have consistently risen.

The second most pressing patient safety issue is the effect of COVID-19 on healthcare workers’ mental health. ECRI cited a February 2021 survey that found a quarter of nurses working in critical care units reported high levels of emotional exhaustion and were experiencing unintended negative memories. It recommends health systems beef up wellness solutions for staff, which might include guided meditation apps, animal-assisted support or other stress-reducing tools, while suggesting that organizations avoid empty hero worship and ineffective communication.

Other concerns on the top 10 list are eliminating bias and racism in addressing patient safety, vaccine coverage gaps, diagnostic error, nonventilator healthcare-associated pneumonia, making teleheath patient-friendly, supply chain disruptions, emergency use authorized products and telemetry monitoring.

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