Challenges are ahead for hospitals and healthcare systems in 2023.
That’s always been true, of course, as each year holds a mix of opportunity and challenge. However, 2023 will be a year in which healthcare leaders can no longer ignore long-standing problems. Staffing shortages will not magically resolve, and patient safety issues that have persisted despite a decade or more of effort must be addressed, even though short staffing curtails healthcare providers’ ability to meet patients’ needs.
We expect three trends to impact healthcare delivery in 2023:
During the COVID-19 crisis, healthcare providers did the best they could with the resources at hand. Overwhelmed by patient demand and crippled by a lack of necessary equipment and qualified staff, healthcare providers found themselves operating in crisis mode. After a brief uptick in hand hygiene, healthcare workers’ hand sanitation practices returned to baseline. Not coincidentally, healthcare associated infection (HAIs) increased in both 2020 and 2021 (the most recent year for which data is available).
Recognizing the unprecedented strain on the healthcare system, regulatory agencies eased patient safety reporting requirements. Such adaptations were reasonable and necessary as hospitals coped with the COVID-19 crisis, but with HAIs on the upswing and 1 in 4 Medicare beneficiaries experiencing harm during inpatient hospital stays, it’s time to re-emphasize patient safety.
Following pressure from the Leapfrog Group and dozens of other healthcare organizations, the Centers for Medicare and Medicaid Service (CMS) recently announced that they will publicly report PSI 90 data, a composite measure of 10 serious preventable errors including post-operative sepsis rates and in-hospital falls resulting in hip fractures. The Joint Commission has also signaled its intent to refocus on patient safety; the 2023 National Patient Safety Goals include “Use medicines safely,” “Prevent infection,” and “Identify patient safety risks.” Xavier Becerra, U.S. Secretary of the Department of Health and Human Services, also recently announced the planned 2023 launch of the National Healthcare System Action Alliance to Advance Patient Safety.
ECRI, the non-profit organization dedicated to improving the safety, efficiency, and cost-effectiveness of healthcare, listed “staffing shortages” as the number one patient safety concern in 2022, underscoring the link between staffing and patient safety.
Unfortunately, staffing challenges will persist through at least 2023. Medical practices list “staffing” as the “greatest challenge…heading into 2023,” the nursing shortage is expected to intensify, and shortages of nursing assistants, unit coordinators, technicians, and other unlicensed staff increase the workloads of available staff.
These shortages are already affecting inpatient length of stay (LOS) – one study found that 70% of surveyed hospital leaders reported an increased LOS in 2022 – and patient outcomes. Most hospitals have already increased starting salaries, implemented sign-on bonuses, improved shift differentials, and increased opportunities for remote or hybrid work schedules, yet staffing remains a challenge.
Sachin H. Jain, a physician at the US Department of Veterans Affairs and president and CEO of SCAN Group and Health Plan, says it’s time to address the underlying causes of healthcare workers’ burnout and “really fix it. By streamlining work. By eliminating unnecessary administrative tasks. By promoting and honoring people in a real and authentic way.”
Takeaway: You can’t hire your way out of the current staffing crisis. Get innovative and re-think current clinical workflows.
The pandemic accelerated the uptake of telehealth, and patients, providers, and healthcare executives are increasingly realizing that technology can improve delivery of healthcare services. Already, we’ve seen evidence that the innovative technologies can decrease HAIs, real-time locating system (RTLS)-based contact tracing is quicker and more effective than medical records review, and room cleaning robots can efficiently sanitize hospital rooms.
The need to deliver safe, effective patient care amid staff shortages necessitates adoption of technology. Experts predict that remote patient monitoring (RPM) – measuring and tracking patients’ heart rhythms, blood glucose levels, oxygen saturation, weight, blood pressure, and other variables from afar – will become commonplace, as RPM allows healthcare providers to effectively and efficiently manage patient care (while decreasing in-office visits, and perhaps, hospitalizations). Artificial intelligence (AI)-powered systems will help healthcare providers consistently adopt evidence-based best practices – and may help leaders predict and respond to surges in demand for healthcare. Virtual- and augmented reality systems and digital simulations can help clinicians develop new skills.
Yet healthcare lags behind other industries in automation of routine tasks. According to the 2022 Healthcare Performance Improvement Report by Kauffman Hall, only 16% of health system leaders reported making “significant” investments in automation technology; 46% report “modest” investments in automation.
Takeaway: Look for and invest in technologies that automate routine tasks, streamline workflow, and help healthcare workers synthesize and apply knowledge.
The coming year will be a critical one in healthcare. Health systems that attempt to return to “business as usual” will probably struggle to meet patient demand, while hospitals and healthcare organizations that adapt in light of existing challenges will likely thrive.