Medical and nursing school graduates' training issues during the COVID-19 pandemic could lead to major safety challenges in 2024, according to nonprofit patient safety organization ECRI.
About 400,000 new nurses passed their licensing examination over the course of the pandemic as the industry grappled with a lack of mentors and training programs, according to the National Council of State Boards of Nursing. ECRI worries inexperienced, ill-prepared clinicians could contribute to cases of preventable patient harm.
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ECRI’s list of top patient safety concerns for 2024, released Monday, outlines how gaps in clinical training could lead to worse care outcomes like medication errors or patient deterioration. Many clinicians who graduated in the last three to four years dealt with dramatic shifts in the healthcare field, including the exodus of teachers and mentors, a rise in the use of technologies like artificial intelligence and higher patient loads, said Dr. Marcus Schabacker, president and CEO of ECRI.
“All those factors are making it dramatically more difficult for these new clinicians to get the necessary experience in a supervised controlled environment,” Schabacker said. “So they're often thrown in the midst of it and have to figure it out. That causes pretty significant stress and safety concerns from our perspective.”
Plus, most had at least some part of their education compromised by the pandemic, he said.
The Agency for Healthcare Research and Quality found newer clinicians are less likely to bring up safety issues, as well. Only 33% of clinicians with less than one year of experience voluntarily reported safety events in 2022, compared with 50% of clinicians with six to 10 years of experience, according to AHRQ data.
“It is very concerning to us that these less experienced clinicians seem to lack the confidence or an understanding of the importance of reporting safety events,” Schabacker said.
ECRI's report recommends that facilities: collaborate with academic institutions to create more opportunities for both hands-on learning and simulation-based learning; develop robust transition to practice programs with intense preceptorships; and include patient safety training as a primary educational component for new healthcare professionals.
Akin Demehin, senior director of quality and patient safety policy at the American Hospital Association, said health systems are implementing more structured orientation processes to check in with recently graduated clinicians periodically throughout their first year and make sure they have the necessary resources to succeed. New clinicians also need to learn facilities' processes for reporting safety issues and delivering high quality care, he said.
“Giving those who are new to organizations a strong foundation and support as they transition is a real priority for hospitals and something that they work at through orientation programs,” said Demehin.
Also included in ECRI’s 2024 list of patient safety concerns—which stems from recent studies, patient safety databases and in-depth conversations with health system and patient safety leaders—are technological issues, maternal care deserts and diagnostic errors.
