Adverse health events and instances of patient harm rose in 2021 during the past year-long reporting period in Minnesota hospitals, ambulatory surgical centers and community behavioral health hospitals, according to a report by the Minnesota Department of Health.

Before 2021, the overall number of events had been stable, but 2021 saw an increase in events, primarily due to new challenges and increased care associated with the COVID-19 pandemic.

Clinicians were forced to adapt in real time as hospitals and health systems took care of sicker, higher acuity patients with multiple health concerns. Increased patient complexity due to COVID-19 led to longer hospital stays and other complications arising from delays in seeking care.

The length of stay in intensive care units more than doubled from 2017-21. Longer hospital stays can lead to an increase in skin breakdown (pressure ulcers) by increasing the time a patient is lying down or using a medical device.

“The pandemic tested our health care system and our health care providers in an unprecedented way in 2021,” said Minnesota Commissioner of Health Jan Malcolm. “The pandemic also showed the value of our adverse health events reporting system. By having this system, we were able to track the effects of this extraordinary event on patient safety, and we can use these results to work with Minnesota’s providers to increase our resiliency and ability to confront future challenges.”

Other pandemic-related factors included increased time for staff to put on personal protective equipment before being able to care for a patient and potentially prevent a fall, and higher caseloads.

The adverse health events report provides an analysis of the data collected from health care providers from October 2020 to October 2021. Though the number of deaths remained stable, there was a significant increase in the number of events and subsequently injuries. The increases were in categories likely to be impacted by longer stays, namely, falls and pressure ulcers.

“The global pandemic pressed every patient, family and health care team into extraordinary circumstances,” said Dr. Rahul Koranne, president and CEO, Minnesota Hospital Association. “This statewide reporting and learning system affirms Minnesota’s hospital and health system culture of transparent reporting and commitment to providing high quality, safe care.”