In its 2018 Top 10 Patient Safety Concerns for Healthcare Organizations, ECRI Institute named diagnostic errors its No.1 concern. After all, each year, approximately 1 in 20 adults experiences a diagnostic error, according to published studies. These errors and delays can lead to care gaps, repeat testing, unnecessary procedures, and patient harm.
“Diagnostic errors are not only common, but they can have serious consequences,” says Gail M. Horvath, MSN, RN, CNOR, CRCST, patient safety analyst, ECRI Institute. “A lot of hospital deaths that were attributed to the normal course of disease may have been the result of diagnostic error.”
ECRI Institute suggests using structured tools and algorithms to help overcome cognitive biases that can lead to errors. When errors or near misses occur, organizations can capture data using a variety of methods and then develop non-punitive ways of learning from the errors.
“Clinical decision support interventions can also be helpful by identifying ordered tests that haven’t been done or by flagging incidental findings that require follow-up,” adds Horvath.
Below is ECRI Institute’s 2018 list of patient safety concerns (in numerical order):
- Diagnostic errors
- Opioid safety across the continuum of care
- Care coordination within a setting
- Incorporating health IT into patient safety programs
- Management of behavioral health needs in acute care settings
- All-hazards emergency preparedness
- Device cleaning, disinfection, and sterilization
- Patient engagement and health literacy
- Leadership engagement in patient safety
“The list does not necessarily represent the issues that occur most frequently or are most severe. Most organizations already know what their high frequency, high-severity challenges are,” says William Marella, MBA, MMI, executive director, operations and analytics of patient safety, risk and quality, ECRI Institute Patient Safety Organization.
“Rather, this list identifies concerns that have appeared in our members’ inquiries, their root cause analyses, and in the adverse events they submit to our Patient Safety Organization,” adds Marella.
It is interesting that this list is not technology centric as we usually think of it. This is even clearer when reading the full descriptions. Some involve technology utilization. Perhaps only number 8 is a more traditional design and maintenance problem, although here the relevant maintenance is not done by biomed. This may show that overall safety (at least per this list) is not strongly related to device failure, something that is not really a surprise.