A new study conducted by Frost and Sullivan revealed that issues from patient safety across the US and Europe will cost a whopping $383.7 billion over the next 4 years alone.
Understanding and identifying these adverse events is the first step in mitigating them – and let’s be honest, a clinic or hospital that can ensure patient safety can help provide a better experience for everyone involved, not just the patients.
As we face the global COVID-19 pandemic, it is more important than ever for hospitals and healthcare facilities to uphold the highest standard of patient care.
In honor of World Patient Safety Day, let’s take a look at the top patient safety issues facing healthcare facilities and providers, as well as their potential solutions.
Current Patient Safety Issues
1. EHR information safety and integration
EHRs (electronic health records) are completely changing the climate of modern healthcare systems and facilities – giving doctors and nurses the ability to provide safer care.
This is accomplished by being able to make informed decisions based on data, rather than assumptions.
When doctors and nurses can seamlessly access all patient health records (say, those from a patient’s family doctor) they can gain valuable insight into the kind of care and treatment patients will need (and what to avoid, too).
And this isn’t even scratching the surface – automation and efficiency with EHRs improves wait times and can indirectly lead to better quality care.
In fact, a recent study found that doctors spend 27% of their time seeing patients and a staggering 49% doing paperwork – something isn’t adding up here.
Electronic health systems with a dynamic mix of machine learning, data and predictive analytics as well as various wellness apps can prove to be a major driver of efficiency, given the findings above. But there are a host of other benefits as well, including:
- Patient medication lists
- Care plans, guidelines and protocols
- Workflow management
- Secure data and documentation exchange
- Inventory management (prescriptions and medical devices)
- Alerts and notifications for preventative services
These benefits are not just patient-focused – they help to improve the conditions for admin work (or backlog, rather), and the delivery of care from doctors and nurses.
Data safety a growing concern
In a world of growing cyber attacks, patient safety is further compromised.
Data breaches are another threat to patient safety that hospitals have to contend with. HIPAA reports that 41% of Americans have had their protected health information exposed in the past three years.
Healthcare facilities looking to implement a robust EHR program should ensure that their provider helps them become HIPAA compliant as well, with ongoing updates and maintenance (check out this HIPAA compliance checklist)
2. Hygiene and spread of infections
The CDC reports that 1 in every 25 patients gets a healthcare-associated infection (HAI) during their hospital visit, totaling up to 722,000 infections a year. Of that number 75,000 patients die of these infections.
Even in a state-of-the-art healthcare facility, the number one prevention technique is a simple one…
Washing hands before and after patient contact is one of the basic infection control measures hospitals can enforce as a policy. Hand washing can stop the spread of bacteria, especially when all parties are diligent.
But it’s not just doctors and nurses that need to be diligent – healthcare facilities can improve infection prevention by providing resources, instructions, and reminders to patients on hand washing throughout their facility.
In the midst of COVID-19, taking additional precautions to ensure proper hygiene and mitigate the spread of the virus is essential.
While it’s not as simple as just washing hands, additional strategies can be put into place to help foster a culture of safety, including:
- Have infection-control policies on when quarantine measures should be implemented
- Identify contagions before they are widespread (based on patient symptoms)
- Use proper personal protective equipment like gloves, eye protection, gowns, and face shields, even outside of the surgical room
- Change linens more frequently and not just when they appear dirty
- Enforce a strict policy that prevents sick staff members from coming to work
- Open additional telehealth appointments, so that patients have the option to see doctors from the safety of their home and minimize potential exposure
- Ensure that any patient that enters the facility is pre-screened or tested for COVID-19. All hospital staff members should be screened, too
- Enforce physical distancing, where everyone in the facility must maintain a minimum six foot distance away from one another
- Ensure COVID-19 units in the hospital are separated from all other units, so that COVID patients receive dedicated care and all other patients are protected from the spread of the virus
- Ensure the facility is rigorously cleaned and disinfected on a regular basis
- Minimize the occurrence of elective procedures. These surgeries require PPE, which is in short supply right now and is needed for health care workers that are taking care of Covid patients.
3. Nurse staffing ratios and burnout
Plain and simple, the inability of most hospitals to maintain the right nurse-patient ratios leads to nurse burnout – with the lack of personnel to keep up with demand also leading to nursing shortages across the US.
This snowballs into poor patient care, medical errors, and other safety concerns that could reduce recovery and survival rates, especially at a time like this when hospitals and care facilities can be at capacity.
A study in the International Journal of Nursing shows that mortality rates rise by 7% with every extra patient that a nurse has to care for on their caseloads.
Adequate staffing falls in the mantle of hospital administrators that have to manage constricting internal budgets and payroll that is stretched thin. Overworking nurses might seem like a solid cost-cutting measure, but research shows that it backfires with high nurse turnover and poor patient outcomes.
Patient Safety Issues in Nursing
Patient monitoring also suffers (mostly due to nurse case overload) – negatively impacting patient safety.
Improved patient monitoring can help to detect problems that arise during treatment within the care unit, and enforce rehabilitation measures before a condition worsens. Handoffs and care transitions are also a danger to the patient’s health if there is information loss in the process.
4. Antibiotic resistance
Healthcare is facing a critical problem with antibiotic resistance. New bacteria strains are emerging and spreading rapidly, limiting the ability to treat infectious diseases.
Today’s infections, such as blood poisoning, pneumonia, tuberculosis, and gonorrhea, are getting increasingly difficult to treat, and are leading to critical hospital patient safety issues.
Antibiotic resistance stems from the overuse and misuse of antibiotics, as well as a generally poor infection control and prevention strategy.
Antibiotic resistance can cause significant declines in patient safety and quality of care in hospitals. Implementing prevention measures, among other efforts to improve patient outcomes, should be a top priority for healthcare leaders.
But it’s not just healthcare facilities that need to take a part in combating this phenomenon – policymakers, the agricultural sector, and patients play a critical role. Health professionals can help to prevent and control the spread of antibiotic resistance through:
- Ensuring that the healthcare environment, their hands and instruments are clean
- Prescribing and dispensing antibiotics ONLY when they are really needed
- Reporting antibiotic-resistance to surveillance teams
- Teaching patients about antibiotic resistance; how and why they should take antibiotics correctly
- Educating patients on the importance of vaccination, safe sex, hand washing, and other prevention strategies
5. Opioid addiction
The ongoing opioid addiction and overdose crisis poses new sets of challenges for healthcare organizations.
Reducing rates of addiction to opioids is now a matter of critical concern. Prescribing characteristics are the main risk factors for opioid addiction post-surgery or post-injury treatment.
A study in JAMA Network showed that out of 46,399 opioid-free injured workers, 4% developed an opioid addiction after the injury. Long-term opioid use stemmed from receiving 20 or more days of opioids supply in the initial prescription and the liberty for prescription refilling later on.
Adopting evidence-based prescription and treatment practices can help to slow this cyclone of medication-related opioid addiction to controllable levels.
6. Physician burnout
43.9% of U.S. physicians showed signs of burnout in 2017, according to a study by AMA and Mayo Clinic. The primary source of burnout stems from the extensive data entry and related clerical work that physicians cover on a daily basis.
Close to 50% of a physician’s day is spent doing paperwork – and a mere 27% interacting with patients (according to a 2016 study in the Annals of Internal Medicine).
Poor lighting is another factor to blame for the high rate of physician burnout. Improper lighting fixtures in the operating room increases glare and eye strain for the surgeons, heightening the risk for medical errors.
Improper lighting can also interfere with the doctors’ circadian systems leading to poor sleep patterns that eventually cause burnout and poor patient care.
Using the right surgical headlight is one of the interventions against eye strain and burnout among surgeons, that can be implemented with relative ease.
Having the right lux and proper distribution of light can mean all the difference when doctors are in surgery for extensive periods – not to mention allowing physicians the ability to perform at their peak.
7. Drug and medical devices shortages
Drug and medical supply shortages are areas of focus for healthcare providers – as nationwide shortages lead to cancellation of surgeries and treatment.
Moreover, COVID-19 has affected the global supply chain and has created some shortages of medical products, due to factors such as virus outbreaks in factories, which have resulted in workers needing to be quarantined.
Lower production levels by manufacturers have also led to these dangerous shortages.
Hospital management can implement strategic inventory management in order to quickly adjust to straining inventories. The Food and Drug Administration in October 2019 issued a drug shortage report with recommendations that care providers can use to mitigate problems arising from these shortages as much as possible.
Patient Safety Issues in Hospitals – The Bottom Line
This list sheds light on the wide variety of preventable patient safety concerns plaguing the healthcare sector.
Out of these, most organizations understand what their most significant safety issues are. There is a need for discussions and priority setting both at the provider and the national level to design and dictate safety efforts and policies.
In fact, a few states have established new legislation regarding hospital staffing to address nurse/physician burnout, but much more needs to be done.
In light of COVID-19, patient safety is now top of mind for medical practitioners, hospitals and healthcare facilities and stricter policies have been put in place to ensure the health and well-being of everyone involved. The pandemic has forced hospitals and healthcare facilities to take a closer look at our medical environments to better protect us all, and in the long-run, we will be safer for it.