Diagnostic errors and test results are the topmost safety concern

 The ECRI Institute released its list of Top 10 Patient Safety Concerns for 2019 this week. ECRI’s list of patient safety concerns does not necessarily represent the issues that occur most frequently or are most severe. It identifies new risks, how existing concerns may be changing because of new technology or care delivery models, and persistent issues that need renewed attention or that might have additional solutions. 

• Diagnostic errors and improper management of test results in electronic health records (EHRs) are the topmost patient safety challenge facing healthcare organizations.

• The 2nd most important issue is antimicrobial stewardship in physician practices and aging services. At least 30% of antibiotic use in the outpatient setting is unnecessary and contributes to antimicrobial resistance.

• Burnout and its impact on patient safety is 3rd on the ECRI list. Studies show that burnout has a consistent negative relationship with safety and quality.

• Patient safety concerns involving mobile health rank 4th in the list. While mobile health opens up a world of opportunities by transporting healthcare to the home, it also presents potential risks. The report especially highlights remote monitoring devices that communicate with providers through smartphones or computers.

• Reducing discomfort with behavioral health is the 5th safety concern in the list. Patients with behavioral health needs are present in every care setting, but healthcare providers dont necessarily recognize this or treat these patients appropriately

• Detecting changes in a patients condition and recognizing sepsis early on are the 6th and 8th biggest challenges, respectively. Health status changes are often missed during transitions of care, underlining the importance of good communications between providers during those handoffs. 

• The 7th safety concern is developing and maintaining skills. The report notes, "Patient harm can occur if staff are uncomfortable using medical equipment or performing a procedure, or are unaccustomed to an organization or care areas processes."

• The 9th biggest safety challenge is infections from peripherally inserted IV lines. As per the ECRI, it is a mistake to insert these lines without a good reason, because they expose patients to the risk for infection.

• Standardizing safety efforts across large health systems is 10th on the list. With the consolidation of some healthcare system into "nationwide mega-systems,"there is a concern that some of these giant organizations might not prioritize patient safety.

(Source: Medscape, ECRI Press Release, March 11, 2019)