The Nursing Shortage & Physician Shortage: Automating and Improving Clinical Efficiency for Physicians and Nurses to Avoid Unnecessary Staff Turnover.

The nursing shortage and physician shortage are becoming a growing problem with multiple contributing factors. Technology and automation will have to play a vital role in helping the healthcare system keep up with the growing demand during the nurse shortage era. Technology is already heavily used in our healthcare systems; however, medical record systems make it exceedingly difficult to retrieve specific patient information, often with ineffective algorithms, and alarms that trigger too often, too early, too late, or not at all. This has negative consequences on patient outcomes as it significantly increases clinical workload and is helping fuel the nurse shortage. The problems were well documented in the article “Death by 1000 Clicks”. Technology platforms have been created to help with the overall efficiency of nurses and physicians using EHR systems. Many of these platforms are FDA-approved Software as a Medical Device (SaMD), but these solutions have yet to be readily adopted by most systems.

Why is the physician and nurse shortage becoming more common? What are the factors contributing to the nurse shortage, including burnout, low salaries, and a lack of resources?

The Physician and nursing shortage has become increasingly common due to several factors. One major factor is the aging population, which requires more healthcare services as the baby boomer generation ages. The prevalence of chronic illnesses has also increased, leading to a higher demand for healthcare workers. Additionally, many healthcare workers are approaching retirement age, and there are not enough new workers entering the field to replace them. Inadequate training and education programs also contribute to the nurse shortage.

Moreover, healthcare workers are experiencing elevated levels of burnout due to long work hours, high stress, and challenging working conditions. Low salaries and the lack of necessary resources in healthcare facilities also contribute to burnout and lower job satisfaction among healthcare workers. Furthermore, the COVID-19 pandemic has further exacerbated the nurse shortage (and physicians) due to increased demand and increased burnout among those on the front lines.

According to Becker’s hospital review “Emergency medicine topped Medscape's ranking of most burned out specialities in 2021 and 2022. Last year, 65 percent of emergency medicine physicians reported burnout. The joint statement from the American Academy of Emergency Medicine and other groups also acknowledged ED boarding as a challenge. In a November letter to President Joe Biden, dozens of medical groups warned that staffing shortages had brought ED boarding to a crisis point, citing the patient safety and quality risks tied to boarding.”¹

Physician and nursing shortages are becoming more common and continue to increase due to a combination of factors. Addressing these factors, such as increasing healthcare education and training programs, improving working conditions and salaries, and providing necessary resources, will be crucial in ensuring that there are enough healthcare workers to meet the growing demand for healthcare services.

The impact of the nurse shortage on patient care includes increased wait times and increased risk of medical errors.

The Physician and nursing shortage has a significant impact on patient care. One of the most visible impacts is the increased wait times for medical services. With fewer healthcare workers available to treat patients, the demand for healthcare services outpaces the supply, leading to longer lead times for appointments, and wait times for procedures, and surgeries.

Another significant impact is the increased risk of medical errors. With fewer healthcare workers available to provide care, those who remain are often overworked and have limited time to spend with each patient. This increased workload and stress can lead to fatigue, burnout, and an increased likelihood of medical errors. Medical errors can have serious consequences for patients, including injury, illness, and even death.

In addition to longer wait times and increased risk of medical errors, the nursing shortage and physician shortage also lead to reduced access to care. Patients may have to travel long distances to receive medical care, or they may not be able to receive care at all due to the nurse shortage and physician shortage in their area.

Overall, the physician shortage and nurse shortage have a significant impact on patient care, including longer wait times, increased risk of medical errors, and reduced access to care. Addressing these shortages will be essential in ensuring that patients receive the timely, high-quality care they need to stay healthy and recover from illness or injury.

Improving the work environment and working conditions, workload, and increasing support to manage the nurse shortage and physician shortage.

In addition to improving the work environment and working conditions, technology can also play a crucial role in helping all healthcare workers, including nurses and physicians, provide better patient care. Advances in medical technology can improve the diagnosis, treatment, and monitoring of patients, and can also reduce the workload for healthcare workers.

For example, electronic health records (EHRs) can help healthcare workers manage patient data more efficiently and accurately. This can reduce the time spent on administrative tasks and allow more time to focus on patient care. Telehealth and remote patient monitoring technologies can also help healthcare workers monitor and treat patients from a distance, reducing the need for in-person visits and increasing access to care.

Artificial intelligence (AI) and machine learning (ML) can also help healthcare workers make more accurate diagnoses and treatment decisions. These technologies can analyze large amounts of patient data, identify patterns and trends, and provide healthcare workers with insights and recommendations for treatment. Many industries including technology, finance, and retail have successfully used AI and analytics-based technologies to significantly reduce the time it takes to gather, analyze and make decisions using complex information. Many of these types of tools can be used to improve and reduce the time it takes to provide good and effective patient care.

Technology plays a crucial role in helping healthcare workers provide better patient care, reducing workload, and improving job satisfaction. Adopting and integrating these new technologies into healthcare systems are crucial to addressing the physician shortage and nursing shortage and improving patient outcomes.

Enhancing the use of technology and automation in healthcare facilities to combat the nurse shortage and physician shortage.

Enhancing the use of technology and automation in healthcare facilities is crucial to improving patient care, reducing the workload for healthcare workers, and addressing the physician shortage and nursing shortage. Here are some strategies to enhance the use of technology and automation in healthcare facilities:

Invest in new technologies: Healthcare facilities should invest in new technologies that help improve patient care and reduce the workload for healthcare workers. This should include digital health tools above and beyond the EHR such as clinical decision support tools, data visualization tools, telehealth for acute care and remote patient monitoring technologies, autonomous patient monitoring and alerting, artificial intelligence (AI) and machine learning (ML), as well as wearable technologies.

Training and education: Healthcare workers need to be trained in how to use innovative technologies effectively. Healthcare facilities should provide ongoing training and education to help healthcare workers adapt to new technologies and integrate them into their daily routines.

Standardize technology use: Standardization of technology across all departments and locations is important. Healthcare facilities interpreting standardization as a call to build it in the EHR would be a mistake. Innovative technologies will help ensure that healthcare workers are using solutions in a consistent and efficient manner, driving clinical efficiency, reducing the risk of errors, and improving patient outcomes.

Data analytics: Healthcare facilities should use data analytics to measure the effectiveness of technology and automation in improving patient care and reducing workload. Data analytics can help identify areas for improvement and guide decision-making around future technology investments that will combat both the nurse shortage and physician shortage.

Collaborate with technology vendors: Healthcare facilities should collaborate with technology vendors to ensure that they are using the latest and most effective technologies. Vendors can provide insights into best practices and help healthcare facilities optimize their technology use.

Address cybersecurity concerns: Healthcare facilities should prioritize cybersecurity to protect patient data and prevent cyber-attacks. This can include implementing firewalls, antivirus software, and other security measures to prevent unauthorized access to patient data.

Enhancing the use of technology and automation in healthcare facilities is essential to improving patient care and addressing the physician shortage and nursing shortage. By investing in new technologies, providing training and education, standardizing technology use, using data analytics, collaborating with technology vendors, and addressing cybersecurity concerns, healthcare facilities can optimize their use of technology and improve patient outcomes.

What are the technological solutions on the market that alleviate nursing shortages and physicians? Where do they fall short?

There are several technological solutions in healthcare that aim to alleviate staffing shortages. Many of these solutions are telemedicine-based:

Telemedicine: Telemedicine allows healthcare providers to consult with patients remotely through video conferencing, phone calls, or other digital communication channels regardless of location (ambulatory or acute). This technology will help reduce the need for in-person consultations or in-person monitoring, freeing healthcare providers to focus on other tasks.

Wearable technology: Wearable devices such as smartwatches and fitness trackers can monitor patients' vital signs and provide real-time updates to healthcare providers. This technology can help healthcare providers monitor patients remotely and intervene if necessary. Electronic health records (EHRs): EHRs provide a centralized database of patient information that with the proper digital health tools can be accessed by healthcare providers from anywhere. This technology can help reduce the amount of time healthcare providers spend on administrative tasks, allowing them to focus on patient care.

Real-time Clinical Decision Support Systems and Smart Patient Record Viewers and Dashboards: These technologies use AI/ML, autonomous monitoring and alerting of conditions and bundle element delivery, leveraging FDA Class II Clearance to aid nurses and physicians in effectively using the massive amount of information in the EHRs. These platforms automate and present the most effective information and workflow at the correct time helping eliminate the “Death by 1,000 Clicks” syndrome.

Automated prescription dispensing systems: Automated dispensing systems can help reduce the workload of pharmacists and pharmacy technicians by automating the process of filling prescriptions.

Cost: For all technology selections, compare the costs of the technology, including consulting hours required for implementation, to the verifiable ROI the solution will deliver.

Training: Some technologies require significant training to effectively use these technologies. The most effective technologies are designed to be intuitive and easy to use.

Data security: Some of these technologies may pose risks to patient privacy and data security if not implemented and managed properly. Overall, while technological solutions can help alleviate staffing shortages in healthcare, they must be implemented thoughtfully and carefully to ensure they are effective and safe for patients and healthcare providers alike and deliver verifiable ROIs.

While these technologies will help alleviate staffing for both the nursing shortage and physician shortage, the selection process should include steps to ensure the technologies that are implemented will make the clinical workflow process easier and more efficient for the clinical staff.

Ambient Clinical Analytics Solutions combats the nursing shortage and physician shortage.

Ambient has achieved FDA Class II Clearance, CE Marking, and ISO 13485:2016 Certification on the AWARE™ platforms. AWARE Patient Surveillance™ provides remote patient monitoring, patient surveillance, autonomous alerting of patient conditions and bundle delivery status, with indicative and predictive analytics. Combined with a novel clinical decision support interface it reduces provider fatigue, and increases provider efficiency, reducing errors and saving lives. Created by clinicians for clinicians, AWARE™ delivers real-time virtual ICU & virtual acute care surveillance, situational awareness, and actionable information to the entire care team, improving outcomes and reducing costs in critical care and general acute inpatient areas.

In addition to providing virtual ICU and acute camera functionality, AWARE’s (Ambient Warning and Response Evaluation) Patient Surveillance™ and virtual ICU and virtual acute solution is designed to provide bedside and remote patient monitoring from anywhere using data visualization and clinical analytics. The AWARE™ Multi-Patient Viewer (MPV) and Single-Patient Viewer (SPV) allow all nurses and physicians to view a patient through the eyes of an intensivist regardless of location. Critical and acute care requires turning massive amounts of raw data into actionable knowledge and many of the current EHR tools at your disposal make this much more complicated than necessary.

The combination of effective predictive analytics and advanced real-time clinical decision support tools helps to reduce errors, improve patient outcomes, reduce the cost of care, and deliver best-care practices for ICUs and other acute care areas including skilled and long-term nursing and hospital-at-home. AWARE’s predictive analytics system provides a “smart view” via data visualization of Electronic Health Record data that reduces the risk of medical errors and improves patient outcomes with high-reliability healthcare. It works with your EHR/EMR and bedside monitors to present only relevant information for care delivery. This minimizes information overload, which is a leading cause of medical errors and results in a lower cost of care. By facilitating quick access to a patient's information at the point of care and in remote patient monitoring centers using AWARE’s Clinical Control Tower™, Ambient aids interventional decision-making and is proven to reduce the incidence of cognitive errors by 50%.

In conclusion, the physician shortage and nursing shortage are continuing to grow with multiple contributing factors that cannot be solved without the help of innovative technology. Technology and automation play a vital role in helping healthcare systems keep up with the growing demand for technology. Poorly designed and ineffective algorithms trigger alarms either too often, too early, too late, or not at all, causing negative effects on patient outcomes, and adding significantly to clinical staffing needs. Implementing FDA-compliant solutions like Ambient increase the accuracy of these systems, reduce errors, improve patient outcomes, and improve clinical staff effectiveness to help put the joy back into patient care.

¹Becker’s Hospital Review, Most burned-out specialty sees record number of unmatched residency positions, https://www.beckershospitalreview.com/hospital-physician-relationships/most-burned-out-specialty-sees-record-number-of-unmatched-residency-positions.html?origin=BHRE&utm_source=BHRE&utm_medium=email&utm_content=newsletter&oly_enc_id=6899D9320367E8A, March 15, 2023