Our medical staff crisis is also a patient safety crisis

Our medical staff crisis is also a patient safety crisis



With the COVID-19 delta variant sweeping the country, labor shortages affect every industry, and the impact on healthcare providers and the quality of care is imminent.

The public discussion surrounding this issue mainly focused on the increase in the cost of health care institutions, because the huge resignation hit health care. In fact, compared with 2019, so far this year, the hospitalization costs of each discharged patient have increased by more than 15%, most of which are directly related to contract temporary workers, and all and part of their costs have soared by more than 100%-time staff member.

But the downstream impact of our healthcare labor shortage has brought more direct challenges to patients and families. The University Hospital expects that the overall turnover rate will reach 17.5% this year, a record high, mainly due to the resignation of nursing and technical staff or the acquisition of lucrative agency opportunities. At the same time, our agency told us that even if we update our compensation plan to a “crisis” level, they may still be unable to meet more of our requirements.

The result is an all-out effort to equip clinicians and support staff in key departments of our hospital with sufficient staff. Our ideal level of nurse staffing in the emergency department has been difficult to achieve. Although we maintain safe staffing standards in the intensive care unit, we often have to exhaust all the options of temporary or institutional staff to do so, and we are very concerned about staffing because the census is expected to increase in the winter months. Unfortunately, our experience is not unique-this is the agenda of local and national hospital associations across the country, because it represents the biggest systemic risk to hospital performance this year.

In 2021, national workforce trends may pose a safety risk to individuals receiving care in any hospital. The shortage of nurses in key areas of the hospital increases your risk of death, cardiac arrest, rescue failure, and hospital-acquired infections, especially in the ICU. In addition, as the high-reliability framework begins to dominate us on how to best treat To achieve zero-harm collective thinking in the environment, experts agree that team training and dynamics are essential. I know with my own eyes that the basic elements of a high-functioning team—trust, psychological safety when identifying problems, and a common understanding of policies and procedures—are extremely difficult to achieve in a high turnover environment.

Although I hope that the reduction in cases after delta can alleviate the challenges of the hospital labor force, there are reasons to be skeptical. A study published by the Centers for Disease Control and Prevention in September emphasized that hospital-acquired infections have increased significantly throughout the pandemic, and the staffing challenge to respond to the increase in patient cases is a major cause. Even if COVID-19 subsides, hospitals are still busy handling patients with other diseases due to delayed or delayed care, and there are signs that the flow of people in the emergency room is now higher than before the pandemic.

From a policy perspective, we can do a lot to stop these challenges. First, the federal government should expand the recruitment and deployment of the U.S. Public Health Commission. This is a program of surgeons who are composed of health care professionals who are uniformed officers who can resemble the National Guard or military reserve personnel. Way to deploy. During the surge in cases throughout the pandemic, these professionals have done a lot to support the health system and the locality, and should be better funded.

Second, governments at all levels should increase investment in medical and health manpower channels, focusing on encouraging people from disadvantaged communities to enter the education and training track to fill key vacancies.

Third, the Department of Justice and the Federal Trade Commission should consider investigating the behavior of contract recruitment companies to ensure that most of their higher prices are passed on to employees themselves, rather than institutional profits. The impact on patient safety and quality of care requires this type of review.

Finally, healthcare leaders must focus on workforce burnout and support clinicians who have experienced unprecedented work in the past 20 months. We provide point-to-point support, pastor services, and direct mental health care for employees who need it most. This is the correct approach, but it can also greatly increase the retention rate.

As healthcare leaders, we will better formulate the healthcare labor shortage debate around the downstream impact on patients and families. This strategy is more likely to lead to solutions that our communities and our employees deserve.


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