The State of Patient Safety 2024

The ever-evolving landscape of patient safety, shaped by recent challenges, learnings, and new policies, stands at a pivotal point in 2024. This article, enriched with expert insights, offers a comprehensive overview of the current state and emerging trends in patient safety as we navigate through the year.

Current State of Patient Safety

In 2023, the healthcare sector focused on rebuilding or strengthening a culture of safety. This initiative has been aimed at addressing issues like diagnostic errors and patient falls. Despite these efforts, hospitals are still seeing staff numbers and well-being decline, highlighting an ongoing struggle to maintain high safety standards.

Read on to find out where we stand.

Diagnostic Errors and Patient Falls

Healthcare’s focus in 2023 on strengthening a culture of safety was primarily directed toward reducing diagnostic errors and patient falls.

Diagnostic errors, often a result of miscommunication or misinterpretation of medical data, have been a significant concern. In a study published in July 2023 by John Hopkins Medicine, it was estimated that about 795,000 Americans die or are permanently disabled every year due to misdiagnosed medical conditions.

Similarly, patient falls within healthcare facilities, which can result in severe injuries, have been a persistent issue. Patient falls were the most frequently reported patient safety concern throughout the first half of 2023 making up 48% of reported sentinel events. Efforts to address these problems included implementing more robust procedures for diagnosis and patient care and enhancing the physical environment to prevent falls.

Decline in Patient Safety Ratings

Despite concerted efforts, over half of hospitals reported a decline in patient safety, according to the New England Journal of Medicine.

This decline could be attributed to various factors, including staffing shortages, increased patient loads, and possibly the lingering effects of the COVID-19 pandemic, which have stretched healthcare resources thin.

When comparing 2021 vs. 2023 Hospital Safety Grade reports, the most significant declines were found in communication about medicine (4.28% decline) and staff responsiveness (3.46% decline). The decline can also be seen by looking at the Leapfrog Safety Grades over the past three years.

Between 2021 and 2023, the percentage of facilities with an A rating went down 3% with 2023 standing at 29% receiving an A. The number of facilities with a C rating also rose 4% over the 3 years standing at 39% of facilities receiving a C rating.

The drop in safety ratings is partly linked to increased hospital-associated infections during the COVID-19 pandemic, highlighting the ongoing challenge of upholding high safety standards and the need for reassessing current protocols.

Healthcare Worker Safety and Violence

An additional, and increasingly prominent concern in the healthcare sector is the safety of healthcare workers themselves. Incidents of violence against healthcare workers have been on the rise, with staff facing physical and verbal abuse from patients and visitors.

The percentage of healthcare workers who reported feeling threatened or harassed by patients or others at work has more than doubled since 2018 according to the Centers for Disease Control and Prevention (CDC).

This violence not only poses a direct physical risk to healthcare workers but also contributes to stress, and burnout, and can indirectly impact patient care. Addressing this issue has become a priority, with measures such as enhanced security, conflict de-escalation training, informative literature, and policies to protect workers from aggressive behavior being implemented in many healthcare settings.

Technological Interventions

To counter these challenges, many healthcare institutions are turning to technological solutions. For example, AI and machine learning are being used to improve diagnostic accuracy, while advanced monitoring systems are being deployed to prevent patient falls.

Check out this Becker’s Healthcare article for insights from 51 healthcare leaders on how technology is the future for solving healthcare issues.

Additionally, systems to ensure the safety of healthcare workers, such as panic buttons and surveillance systems, are being adopted more widely.

Safety Trends Expected in 2024

Staff Mental Health and Wellness

One of the most pressing issues is staff burnout and personal safety concerns, which have reached new heights. According to the American Nurses Foundation, as of November 2023, 56% of nurses reported experiencing burnout.

In 2024, healthcare organizations must invest in solutions that protect their workforce, as well as take proactive action to improve staff mental health. Some hospitals are addressing burnout by shifting their overtime protocols, so nurses are not working beyond their means.

Workforce Stabilization

Health systems must develop initiatives to have a consistent and reliable healthcare workforce. This requires getting to the root of the staff turnover crisis. The healthcare industry needs to implement ways to combat staffing shortages.

It was predicted in 2022 by the United States Bureau of Labor Statistics that 500,000 nurses would leave the profession by the end of 2023 resulting in a shortage of over one million nurses across the industry.

These shortages are due to insufficient academic pipelines for nurses and clinicians, job dissatisfaction, and clinicians reprioritizing their needs. Fixing this problem will include building a talent pipeline by partnering with high schools and higher education facilities.

Another method is implementing virtual nursing to monitor vitals, patient charting, admission, and discharge processes. Some organizations have been utilizing international nursing recruitment to address shortages and enhance diversity within healthcare teams.

Health Equity in Cardiovascular Care

Disparities in cardiovascular care and treatment continue to be a concern. Efforts are being made to advance health equity in this area using interdisciplinary approaches and race-free tools for risk prediction, treatment, and outcomes.

The Centers for Disease Control and Prevention provides a Health Equity Indicators for Cardiovascular Disease Toolkit to help get organizations started. Hospital associations at the state level, quality improvement organization network agencies, and the Institute for Healthcare Improvement also offer roadmaps and resources to support organizations.

Incident Reporting as a Catalyst for Change

As healthcare continues to prioritize patient safety, there's an emerging focus on the importance of a robust incident management system. The ability to report, track, and analyze safety incidents is crucial for understanding and mitigating risks quickly and accurately.

In 2024, it is anticipated healthcare organizations will leverage sophisticated incident reporting software more extensively. These systems not only facilitate a more effective response to incidents but also contribute to a culture of safety and continuous improvement.

By ensuring that all staff are trained in the use of these systems and understand the importance of incident reporting, healthcare organizations can enhance their ability to prevent and manage patient safety events, leading to improved outcomes and reduced harm.

Infection Control and Safety

The sharp drop in patient safety and infection control witnessed during the pandemic remains a critical area of concern. The CDC found higher increases in healthcare associated infections (HAIs) such as central line-associated bloodstream infections (CLABSIs), catheter-associated urinary tract infections (CAUTIs), and methicillin-resistant Staphylococcus aureus (MRSA) bacteremia in 2021 compared to 2019.

Notably, ventilator-associated events (VAEs) saw the highest surge, with a peak of a 60% increase in the third quarter of 2021. Addressing these issues requires a crucial emphasis on increased safety practices and patient monitoring.

Quality Care Through Data Analytics

There is a growing emphasis on using data analytics to bridge the gap in healthcare safety culture. Healthcare systems are increasingly integrating financial, operational, and clinical data to develop actionable insights for quality improvement measures.

Cost Control

To alleviate constrained budgets, facilities need to have effective cost control in place. In 2024, it is expected that more organizations will partner with managed services providers (MSP) to better manage their costs. MSPs allow for lower bill rates, consolidated services, and cost control over dollars. This partnership allows facilities to better control their expenses and spend less time having management working on administrative tasks.

Improving & Advancing Patient Safety

A coordinated effort by all stakeholders is needed to reduce preventable harm. This includes establishing safety processes across the entire healthcare continuum and anticipating risks to proactively achieve safer care. Much of this innovation will come in the form of technologies such as:

• Artificial Intelligence and Machine Learning: AI and machine learning are crucial in predicting potential health issues and patient falls, thereby enhancing patient safety and allowing healthcare workers to prioritize care and prevention strategies effectively.
• Remote Patient Monitoring (RPM) Tools: RPM technologies, particularly wearables and home monitoring devices, play a vital role in ensuring patient safety by continuously tracking vital signs and health conditions, which also reduces the exposure of healthcare workers to potential health risks. In a poll of 141 healthcare executives and clinicians, 46% said they expected to increase their remote patient monitoring budget for 2024. Additionally, 73% said remote patient monitoring programs are generating a positive return on investment and 70% reported higher patient satisfaction.
• Augmented and Virtual Reality With advancements in augmented and virtual reality technology, an expanding opportunity arises for their integration within the healthcare sector. Some real-world use cases have already been explored, including an AR system that overlays medical images onto a patient during an operation to help guide the surgeon’s technique or the use of VR to help veterans with post-traumatic stress disorder.
• Electronic Health Records (EHRs) with Enhanced Security: Secure and advanced EHRs are essential for protecting sensitive patient data from breaches, ensuring patient confidentiality, and providing healthcare workers with reliable information for safe and informed patient care. According to a cybersecurity report done by Critical Insight, in the past, EHR breaches were nonexistent but more recently, a growing percentage of breaches have involved EHRs, leading to the exposure of millions of patient records. Enhanced security in the EHR systems is going to be needed as hackers become more sophisticated in gaining entry to these systems.
• Telemedicine Platforms: Telemedicine significantly improves patient safety by facilitating remote consultations and reducing the risk of infection transmission, while also safeguarding healthcare workers by minimizing direct contact with potentially contagious patients. Telemedicine also saves money for patients, as seen in a study done by a National Cancer Institute–Designated Comprehensive Cancer Center. They found that telehealth was associated with saving up to $186 per visit as well as saving patients an average of 2.9 hours of driving time and 1.2 hours of in-clinic time per visit.
• Digital Hospitals: As healthcare undergoes continuous innovation and technological advancements, the digitization of hospitals becomes the next logical progression. A notable example is the monitoring of ICU beds, where OSF Healthcare demonstrated significant results. By monitoring 200 ICU beds, they increased capacity without additional staff, leading to a 27% decrease in ICU mortality and a 20% reduction in ICU length-of-stay.

Patient Experience and Satisfaction

Patient experience remains closely tied to safety, with an increasing emphasis on patient-centered care and satisfaction. This involves not only clinical care but also aspects like hospital administration and patient support services. With the importance of the internet today, customer satisfaction and views are extremely important.

Three out of four people have searched online to find a doctor and 61% say they would not even consider a provider that had an average star rating lower than 4 out of 5.

In conclusion, patient safety in 2024 is shaped by a combination of ongoing challenges and innovative solutions. Key areas of focus include workforce safety, health equity, data-driven quality care, and systemic approaches to improving patient safety and value. As the healthcare industry evolves, these trends will play a crucial role in shaping the future of patient safety.

This article was written and contributed by Cindy Chamness, MBA, RN, CPHQ, CPPS, a seasoned healthcare operations executive with over three decades of experience. Cindy currently works as a Patient Safety and Healthcare Tech Advisor, leveraging her extensive knowledge in quality performance, patient safety, and risk management.