
In a list of patient safety concerns released by the Emergency Care Research Institute (ECRI) last Monday, staffing shortages and the mental health of healthcare workers are listed as the biggest health risk that patients currently face.
According to the report, although staffing shortages and the effect of clinical mental health on those working in healthcare have been issues plaguing the healthcare system for a while, the numerous challenges that COVID-19 presented over the previous few years have exacerbated the issue.
“Both physicians and nurses were at risk of burnout, emotional exhaustion or depression prior to 2020. The pandemic has now forced a reckoning with healthcare workers’ mental health needs,” the list said.
A survey of nurses published February 2021 also found that 35% of nurses experienced poor sleep quality, 28% had heightened anxiety during unexpected events and 24% working in dedicated COVID-19 units reported high levels of emotional exhaustion.
“Shortages in the healthcare workforce and mental health challenges were broadly known and well-documented for years,” said Marcus Schabacker, MD, PhD, 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.”
According to the list, the COVID-19 pandemic wasn’t the only thing affecting staffing shortages. A high proportion of nurses are at or near retirement age with concerns that this proportion will greatly increase over the coming years.
“Nursing schools are unlikely to be able to supply enough nurses to replace retiring nurses, much less alleviate existing gaps,” the list said. “In 2019, 80,407 qualified nursing school applicants were turned away due to insufficient resources…”
ERCI experts also said that patients could face even higher risks without intervention as healthcare workers face more challenges presented by understaffed hospitals and other healthcare settings. It may even become the new normal for the foreseeable future as staffing shortages leave many patients waiting longer for care.

“Healthcare and government leaders now must aggressively manage these challenges amidst a lingering pandemic and a weakened health system by prioritizing recruitment, retention and clinician resilience,” Schabacker said. “As leaders, their most important job is ensuring that patient health and safety are top priorities.”
The ERCI does suggest a few solutions to these problems with guidelines on how to approach managing them.
According to the list, a solution to combat staffing shortages would be to implement a flexible recruitment and retention program with flexible staffing models, a system designed to respond to staff needs, flexible action plans to deliver safe patient care during staff shortages and conducting staff surveys to improve job satisfaction.
The ERCI similarly suggested an action plan was necessary for the mental health of healthcare workers.
“Throughout the COVID-19 pandemic, many healthcare workers have sacrificed their own mental health in order to deliver care. Healthcare organizations now need to support clinician resilience,” the list said.
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