As the nation marks one year since the start of COVID-19 restrictions, ECRI names racial and ethnic disparities in healthcare as its top patient safety concern for 2021. ECRI’s Top 10 Patient Safety Concerns for 2021 report relies on the analysis of more than 4 million patient safety events and the judgment of its patient safety and medication safety experts. This year’s annual report is being released in conjunction with Patient Safety Awareness Week, which takes place from March 14-20.

The coronavirus pandemic is exposing gaping disparities in care and outcomes for people of color. Hispanic and Latinx persons have been three times more likely to be hospitalized and twice as likely to die from COVID-19 as white non-Hispanic people, according to the Centers for Disease Control and Prevention.

“Clearly, racial disparities will not disappear overnight,” says Marcus Schabacker, MD, PhD, president and CEO of ECRI, the nation’s largest patient safety organization. “By profiling this issue, we are calling much-needed attention to this public health crisis.”

Of the 10 topics in the report, eight are related to or exacerbated by COVID-19. In addition to health disparities, others include emergency preparedness in aging care facilities, disease outbreak preparedness, supply chain shortages, telehealth, the improvised use of medical devices, and aerosol infection prevention. Each concern is coupled with strategic recommendations to avoid or counter it.

ECRI’s full list of patient safety concerns for 2021 includes:

  1. Racial and Ethnic Disparities in Healthcare: Differences may include frequency of screening for COVID-19 or other diagnoses, disease severity, complications, and deaths.
  2. Emergency Preparedness and Response in Aging Services: Over 570,626 confirmed cases and over 112,383 deaths occurred in nursing homes as of Feb. 1, 2021.
  3. Pandemic Preparedness across the Health System: Government investigations, congressional reports and pandemic preparedness reviews warned that America’s healthcare system was woefully unprepared for a fast-moving infectious disease outbreak.
  4. Supply Chain Interruptions: Limits on exports, plus shutdowns in countries that manufacture and produce raw materials, resulted in delays for much-needed supplies.
  5. Drug Shortages: The COVID-19 pandemic led to shortages in almost every drug class used for mechanical ventilation.
  6. Telehealth Workflow Challenges: Event reports cited poor wi-fi, inappropriate monitoring, inadequate language services, and health privacy issues.
  7. Improvised Use of Medical Devices: Modified devices, workflow, or systems may lead to serious safety and regulatory compliance issues.
  8. Methotrexate Therapy: The weekly administration of this cancer drug—also in use for autoimmune diseases—leads to dosing and dosing frequency errors.
  9. Peripheral Vascular Harm: Severe cases of injury and infection can lead to extended lengths of stay and antibiotic treatments—even death.
  10. Infection Risk from Aerosol-Generating Procedures: The exposure risk from performing aerosol-generating procedures on suspected COVID-19 patients is very high.

ECRI’s Top 10 Patient Safety Concerns for 2021 provides detailed steps that organizations can take proactively to prevent adverse incidents and is available for public download. ECRI is also hosting a complimentary Top 10 Patient Safety Concerns webinar on Thursday, March 18, to explain how the list can be used to enhance safety in healthcare organizations across all care settings.