Hospitals and health systems are likely to face a nursing shortage in the next two years. This could increase potential risk and liability.

• Clinicians will be treating more acute patients who have put off healthcare services for financial reasons.

• New pathways for delivering care could introduce new risks.

• Artificial intelligence will make more inroads into healthcare but should be adopted cautiously.

The new year will bring nursing-related liability risks that involve the aging labor force, the changing healthcare industry, and technology, says an industry analyst. Risk managers should anticipate these issues and be ready to respond to new risks.

The aging labor force in nursing will create more potential liability for healthcare organizations, says David Griffiths, senior vice president for program management with consulting firm Aon in Fort Washington, PA. About a half-million nurses will retire over the next two years, he says, at the same time the industry has an increased need for nurses with expanded skill sets.

Sicker Patients for Fewer Nurses

“There is the added demand and we just don’t have enough nurses coming in. We’re looking at a labor shortage in the next couple of years,” he says. “You add the expanded roles of nurses to that, the way we’re asking more of nurses now, and the problem only gets worse. A shortage of skilled nurses can only increase the potential liability for healthcare organizations that will have to find a way to care for patients despite the shortage.”

Increasing healthcare costs and continuing difficulty with the insurance market are making patients put off healthcare, Griffiths says, and that means their conditions are more acute when they do seek treatment.

“Nurses will be faced with more acute cases at the same time they are in short supply,” he says. “Fewer nurses will be taking care of sicker patients. That is not a recipe for success.”

New Pathways for Care

The mergers of big companies like CVS and Anthem to create new pathways for delivering healthcare will bring uncertainty into many facets of the industry, putting nurses in new care settings with unknown potential for liability, Griffiths says.

“Those mergers and new companies will change the dynamic of how healthcare is managed, with nurses in those new settings that are not physician offices and not hospitals, with new exposures and risks surrounding that,” he says. “It’s going to be an interesting world for nurses in the future, and an interesting world often brings the potential for new risks and exposures.”

Technology also will continue to change the role of nursing, with machine learning and artificial intelligence helping to improve nurse diagnosing, Griffiths says.

“I think we’re going to see more of that in small waves in 2019. The implications for risk management is really unknown because the impact on nurse diagnosing is unknown,” he says.

“We have seen some examples in which artificial intelligence was a great aid to nurse diagnosing in an emergency setting, but we have not had enough experience with the technology to know the potential for good or bad.”

Griffiths advises risk managers to proceed cautiously when artificial intelligence is introduced to a clinical setting.

“Introducing artificial intelligence to the diagnosis of patients, from a risk management standpoint, has incredible upside opportunities. But I would roll that out in a very closely monitored scenario rather than just plug and play,” he says.

“Any technology that helps reduce the administrative burden, however, could work to reduce risk and exposure because you could then leverage the resources and capabilities of the nurse to a more efficient use.”


• David Griffiths, Senior Vice President for Program Management, Aon, Fort Washington, PA. Email: david.griffiths@aon.com.