The recent nursing shortage has had a significant impact on patient care today. From poor patient outcomes to a diminished patient experience and even decreased revenue, hospital systems are starting to feel the impact of the nursing shortage in very tangible ways.
Jeopardized Patient Outcomes
The decrease in patient outcomes and patient experience, specifically, are causing significant clinical implications, as well as ramifications when it comes to business operations. To demonstrate these implications, the clinical piece of the puzzle must be analyzed. When a nurse is caring for double the number of patients than they used to, the amount of attentiveness to each patient will inevitably decrease. This results in patients with changes in clinical presentation going largely unnoticed.
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For example, consider a patient that is unable to get assistance from a nurse to transfer in or out of bed. This patient is more likely to attempt to do it themselves, which puts them at a much higher risk of falling in the attempt to do so. Aside from additional injuries, patient satisfaction decreases because of stressed and stretched staff. Patients and their families in these scenarios become more stressed and are unable to get enough face time with their care team to understand a meaningful update on their loved one.
Revenue at Risk
The nursing shortage also has impacted the business side of healthcare, creating significant risk to revenue due to the lack of ability to readily admit patients or transfer patients. Prior to the pandemic, a common metric that emergency departments focused on was the left without treatment (LWOT) rate. The LWOT rate is defined as a patient that checks in and registers with the emergency department only to later decide to leave after experiencing a long period of time without ever being evaluated by a healthcare provider. Should a patient make it to the treatment area and need to be admitted, there is also a significant delay in getting them to an inpatient bed.
Today, it is not uncommon for supervisors to see emergency department wait times over 40 hours for a patient to receive an inpatient bed. In these scenarios, the patients and their families grow frustrated and eventually leave against medical advice (AMA), another metric which was closely monitored by emergency departments before the pandemic.
There are also the clinical and business risks that come along with not being able to transfer a patient from one acute care facility to another. Most patient transfers are documented as a need for a higher level of care or a service not that is provided by sending facility – which ultimately means that most of the time a patient transfer is requested, it is because the sending facility cannot care for them. The previously mentioned 40 hour wait times to get into the emergency department is at least double for a patient transfer.
Catalyst for Change
The good news is that hospital systems today have many important lessons learned because of the COVID-19 pandemic exposing the ‘broken’ or more vulnerable parts of the healthcare system. The pandemic further exposed already known operational and throughput issues, and then accentuated them with severe staffing challenges. Despite the desperation of society to get back to what life used to be before the pandemic, hospital systems must not revert to how their operations were ran before 2020.
Now that circumstances are different today hospitals must do more with less. While some of the burnt-out nurses that resigned during the pandemic may eventually return to the workforce, the dilution issue remains and will only grow. The focus of hospital systems today must be on getting clinicians back to the bedside. Further developing and extending accessibility of more forms of healthcare delivery, such as telehealth, will have a significant impact.
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