Staffing Shortages in Healthcare

 

Staffing shortages influence patient safety in various ways. One contributing factor is increased workload due to reduced staff at work thus increasing the chance of errors. For example, Griffiths et al. (2023) point out that medical errors occur while administering medication due to fatigue and hastiness, thereby threatening the lives of patients. Data indicate that understaffing is among the causal factors to sentinel events, which refer to unexpected occurrences leading to death or significant permanent loss of function of patients’ body parts or psychological dysfunction (Griffiths et al., 2023). A higher workload adversely impacts the watchfulness of healthcare workers in providing care; therefore, they are bound to miss some things due to workload and commit fatal errors at the cost of the patient's health.

Another critical factor is delayed response times to patient needs (Butler et al., 2022). Units operating with minimal staff cannot respond promptly to patients' or emergency calls. This delay leads to deteriorating patient conditions, which timely interventions could have avoided. According to the Agency for Healthcare Research and Quality, prompt responses are instrumental in preventing complications, like falls or infections, which an understaffed environment will most likely have (Rowen et al., 2022). It is hard to observe patients following an understaffed condition; this increases the risk of several adverse events that could be reduced if there were adequate staffing. Inadequate staffing levels also lead to missed care. Due to insufficient time and humans, nurses and other health professionals are compelled by the necessity to triage their daily tasks, hence omitting the non-urgent but very vital care. This omission reflects negatively on patient outcomes, such as denying preventive measures or failing to give patients necessary education that may contribute to readmission and more extended hospitalization (Shemtob et al., 2023). Missed care erodes patients' trust in the system because the patient either feels ignored or less critical if their satisfaction is not taken care of appropriately.

The risk posed by staffing shortages is further worsened due to the lack of experienced staff. Experienced healthcare providers mentor new staff and reinforce standards of care. The staffing shortage forces healthcare institutions to hire inexperienced staff and temporary workers, thus lowering the quality of care due to a lack of adequate training and experience. The high rate of staff turnover diminishes the number of experienced professionals (Pollock et al., 2020). The constant cycle of staff orientation, coupled with the reliance on temporary workers breaches the establishment of consistent high-quality care for patients. The mental health and resilience of healthcare providers are negatively impacted due to staffing shortages.  According to Pollock et al. (2020), the increased levels of stress and burnout that come as a result of excessive workload contribute to reduced job satisfaction and enhanced turnover rates.

Evidence-Based Solutions to Improve Patient Safety and Reduce Costs

A multifaceted solution is necessary to address staffing shortages. There is a need to address the question of improving nurse-patient ratios. Griffiths et al. (2023) connected appropriate nurse staffing levels with lowered mortality rates and fewer adverse medical events. For example, Griffiths et al. (2023) estimated that improving nurse staffing levels in acute hospitals was cost-effective and practical for patients. Another solution is the development of robust support arrangements for healthcare workers. To a large extent, such mental health support and resilience training will offset the adverse effects of stress and burnout. Pollock et al. (2020) mention that interventions to support the mental health of frontline healthcare workers are of utmost importance during crises like pandemics and in the time following these crises, including counseling services, peer support programs, and resilience workshops. This can be partly offset by innovative technology solutions and care models like telehealth services that reduce the number of in-person visits. Shemtob et al. (2023) recommend the adoption of electronic health records to make documentation more accessible and faster thereby increasing the time available for direct patient care.

Best-Practice Solutions to Improve Patient Safety and Reduce Costs

Griffiths et al. (2023) emphasize that improving recruitment and retention strategies by offering competitive salaries, benefits, and professional development opportunities attracts and retains skilled healthcare professionals. Institutions that invest in their staff's career growth and well-being tend to have lower turnover rates and higher job satisfaction, contributing to a stable and experienced workforce (Griffiths et al., 2023). Fostering a collaborative work environment is essential. Encouraging teamwork and communication among healthcare providers reduces errors. Interdisciplinary rounds and regular team meetings ensure that all team members are aware of the patient's status and care plan, reducing the likelihood of misunderstandings and omissions (Butler et al., 2022). Flexible staffing models help manage varying patient volumes and acuity levels by using float pools and part-time staff who are called upon during unexpected shortages to ensure that patient care remains uninterrupted (Shemtob et al., 2023).

Nurses’ Role in Coordinating Care

Nurses contribute by serving as care coordinators whereby they ensure that all aspects of a patient's care from admission to discharge are addressed by coordinating with various departments and professionals to create a comprehensive care plan that meets the patient's needs (Griffiths et al., 2023). Nurses are patient advocates, ensuring that patients understand their treatment plans and receive the necessary support to follow them. By educating patients and their families about medications, lifestyle changes, and follow-up care, nurses help prevent readmissions and complications, thereby reducing overall healthcare costs (Rowen et al., 2022). Nurses are at the forefront of implementing and monitoring quality improvement projects aimed at reducing errors and enhancing patient outcomes. Their hands-on experience provides valuable insights into practical and effective strategies for improving care delivery (Pollock et al., 2020).

Key Stakeholders in Enhancing Safety

Healthcare administrators hold the reins of decision-making about staffing levels, resource allocation, and policy implementation hence their support is essential for the success of the quality improvement initiative. It is upon the healthcare administrators to efficiently allocate resources and ensure that the staffing level is commensurate with the demands of patient care(Griffiths et al., 2023). It is in their best interest that appropriate working conditions be provided to the nursing staff so proper care can be delivered to patients. By ensuring adequate staffing, administrators can reduce one of the major causes of the problem: nurse burnout. Ensuring a work environment that supports continuous professional development and job satisfaction is critical; it rests upon the administrators to retain nursing staff. Human resources staff are significant players in the recruitment, hiring, and retention of staff. They devise plans to increase qualified applicants and decrease turnover rates (Shemtob et al., 2023).

Physicians and other healthcare providers are very critical stakeholders because their collaboration with nursing staff is significant for coordinated care, assuring that patient care plans are comprehensive and that the execution of intervention plans is effective (Butler et al., 2022). This interprofessional collaboration brings out the best in patient care and makes its delivery smooth and effective. Physicians are dependent on nurses for information about critical patients and for help in initiating treatment. Communication and teamwork become essential elements that help health professionals meet their patient's needs promptly and appropriately.  Physicians understand how nurse shortages affect the quality and safety of care.

Patients and their families are stakeholders whose involvement enables better care practices because Rowen et al. (2022) note that patient satisfaction is enhanced when patients are engaged in care planning and decision-making. The involvement of institutions involved in the training of health professionals is critical because they are the door through which graduates get into the job market. Collaboration between healthcare institutions and educational programs can help align training with current healthcare needs and standards (Pollock et al., 2020). Policymakers and regulatory bodies are also important to legislate change in the healthcare system. They will address the roots of shortages through legislation supporting adequate levels of staffing and funding workforce development. Their role in setting standards means that healthcare providers work to the best possible level while maintaining high standards for quality patient care. Collaborative participation of all stakeholders will drive systemic changes that benefit the healthcare workers and patients. Read more about investigating burnout in nurses with the PICOT framework.

References

Butler, R., Webster, B., & Diekema, S. (2022). Staffing crisis capacity: a different approach to healthcare resource allocation for a different type of scarce resource. Journal of Medical Ethics, medethics-2022-108262-. https://doi.org/10.1136/jme-2022-108262

Griffiths, P., Saville, C., Ball, J., Ora, C., Meredith, P., Turner, L., & Jones, J. (2023). Costs and cost-effectiveness of improved nurse staffing levels and skill mix in acute hospitals: A systematic review. International Journal of Nursing Studies, 147, 104601–104601. https://doi.org/10.1016/j.ijnurstu.2023.104601

Pollock, A., Pollock, A., Campbell, P., Cheyne, J., Cowie, J., Davis, B., McCallum, J., McGill, K., Elders, A., Hagen, S., McClurg, D., Torrens, C., & Maxwell, M. (2020). Interventions to support the resilience and mental health of frontline health and social care professionals during and after a disease outbreak, epidemic or pandemic: a mixed methods systematic review. Cochrane Database of Systematic Reviews, 2020(11), CD013779–CD013779. https://doi.org/10.1002/14651858.CD013779

Rowen, D., Powell, A., Hole, R., Aragon, J., Castelli, A., & Jacobs, R. (2022). Valuing quality in mental healthcare: A discrete choice experiment eliciting preferences from mental healthcare service users, mental healthcare professionals and the general population. Social Science & Medicine (1982), 301, 114885–114885. https://doi.org/10.1016/j.socscimed.2022.114885

Shemtob, L., Asanati, K., Pahl, N., & Majeed, A. (2023). What needs to be done to address staffing shortages in health and social care? British Journal of General Practice, 73(728), 102–103. https://doi.org/10.3399/bjgp23X732045