New Press Ganey findings show healthcare safety scores fell amid the pandemic

21 October 2021

A new analysis by Press Ganey finds that safety performance declined across the entire healthcare industry in 2020. These insights indicate a reversal in harm rates that, prior to the COVID-19 pandemic, had shown improvement.  

Press Ganey reviewed patient outcome data from its National Database of Nursing Quality Indicators (NDNQI^®) submitted by 11,325 units from more than 1,575 U.S. hospitals. The findings showed that COVID-19’s stress on the healthcare industry contributed to a worsening of existing safety event rates such as falls, pressure ulcers and central line-associated bloodstream infections (CLABSIs). 

Hospitals are in survival mode because of the virus, and this has driven unprecedented levels of burnout, turnover and staffing gaps.

Jeff Doucette
Chief Nursing Officer
Press Ganey

“Our healthcare workers must give their energy and almost singular focus to COVID-19, and the ripple effect has exacerbated safety lapses and drift in hospitals.” 

As a result, safety culture has suffered—and safety events have increased:  

• Since the onset of COVID-19, patient safety events increased in all seven types of units measured in NDNQI^®: adult critical care, medical, step-down, high quality, moderate acuity, surgical and med-surg. 
• Inpatient falls increased across medical, step down, surgical and med-surg units throughout the duration of 2020. 
• Stage 2 hospital-acquired pressure injuries (HAPI) increased across all seven unit types in Q4 2020. 
• CLABSI rates increased across high quality and moderate acuity units from Q2 through Q4 2020.

“These increases in patient harm validate what we know anecdotally and emphasize the effects of an industry under the immense pressure of battling a sustained crisis,” said Dr. Tejal Gandhi, chief safety and transformation officer, Press Ganey. “However, the industry’s zero harm goal cannot be put on hold until after the pandemic has passed. These findings underscore the urgent need for a recommitment to high reliability principles and safety culture now.” 

The insights from the NDNQI analysis highlight the importance of proactively detecting and avoiding drift, and creating the safest possible working conditions through several strategies:  

• Recommit to the basics. Share safety data and optimize learning and best practice implementation. Reemphasize the goals of daily safety huddles and provide refresher training. 
• Ensure safety culture starts at the top. Leader rounding and executive presence in staff meetings set the tone for organization-wide reliability. 
• Encourage and reward speaking up. Designate safety and reliability champions. Prioritize trust so those who call attention to issues feel secure that they won’t be penalized for raising a red flag. 
• Measure safety culture with routine employee pulse surveys. Gauge employees’ perceptions of safety and progress at routine intervals to detect early signals of drift and where to dedicate additional resources to improve. 
• Conduct independent safety audits to detect at-risk areas early. Use third-party audits to spot and evaluate potential harm that busy team members may not notice. 

Above all, a commitment to industry-wide learning and best practices will reduce avoidable harm and make care safer for patients and clinicians.  

National programs, such as Press Ganey’s Safety 2025 initiative promote the spread of knowledge and evidence-based practice that enables industry-wide improvements. Seventy-five leading health systems have joined Press Ganey’s Safety 2025, a national initiative for all healthcare systems to achieve an 80% reduction in patient harm by 2025.  

To join, or to learn more about Press Ganey’s Safety and High Reliability solutions, visit PressGaney.com.