Each year ECRI Institute* creates a list of the 10 top patient safety concerns to support healthcare organizations in their efforts to proactively identify and respond to patient safety hazards. Patients and family caregivers can use this information to be better informed – knowing what hazards are lurking can help us avoid being a victim. Don’t ignore these top safety concerns for patients – your health, and even your life, may be at risk.
Top 10 ECRI Patient Safety Concerns for 2018
Here is a brief summary of each safety concern. For more information, read the ECRI report.
#1 – Diagnostic Errors
Diagnostic errors are common, and the consequences can be serious. Patients can suffer when there are delays in much-needed treatments, or when they are treated for a disease they do not have. Miscommunication is a common cause of errors, but it’s often not the only issue.
#2 – Opioid Safety across the Continuum of Care
The impact of the opioid epidemic reaches every corner of healthcare. Hospitals and emergency departments prescribe opioids to treat pain (outpatient doctors and dentists also prescribe opioids). Opioid addiction is considered a patient safety concern because of the seriousness of opioid’s side effects.
#3 – Internal care coordination
When care is poorly coordinated, patients can suffer from medication errors, lack of necessary follow-up care, diagnostic delays and other safety issues. As with many preventable errors in healthcare, communication failures cause these care coordination issues. Providers, including multiple specialists, must inform one another throughout the care process regarding the patient’s condition, treatments, medication regimen, and medical history. When coordination falters, patients suffer.
#4 – Workarounds
Workarounds, the term used when staff bend the work rules, are pervasive in healthcare. These workarounds take place when staff try to circumvent or temporarily fix a real or perceived barrier or system flaw. Workarounds can become so commonplace, staff eventually considers them the normal way to do things, making this issue hard to detect. Staff may let an unsafe condition continue until a patient harm occurs.
#5 – Incorporating health IT into patient safety programs
Health information technology (IT) is an integral part of healthcare today. These technologies can both positively and negatively affect patient safety. However, the success of any health IT program depends on the ability of users to recognize, react to, and report health-IT-related events for analysis and action. When health IT systems are poorly designed, or when the organization’s culture fails to embrace health IT safety, patients can suffer.
#6 – Management of behavioral health needs in acute care settings
In acute care settings (as opposed to long-term care facilities) it is important for hospitals to provide appropriate care for patients’ behavioral health needs. When these needs are unmet, issues can develop including self-harm or violence toward others, patients leaving against medical advice, poor behavioral health outcomes, and interference with care of the acute medical condition.
#7 – All-hazards emergency preparedness
In 2017 there were major hurricanes, wildfires, mass shootings, and ransomware attacks. Each of these emergencies challenged healthcare facilities. Some resulted in mass casualties. Other emergencies caused power outages and/or computer shutdowns, which significantly impacted day-to-day operations. Facilities that were prepared for these disasters fared better than those that were not.
#8 – Device cleaning, disinfection and sterilization
When staff don’t follow proper protocols for cleaning, disinfecting, and sterilizing devices, patients can suffer devastating effects. To avoid outbreaks of potentially deadly diseases, hospitals must use a proactive approach.
#9 – Patient engagement and health literacy
Patients have many responsibilities in managing their health. However, hospitals don’t do a great job of engaging patients, including making sure patients understand their health and healthcare. A lack of patient engagement and understanding of health information can lead to serious patient harm.
#10 – Leadership engagement in patient safety
Successful patient safety efforts rely on leadership engagement, both intellectually and emotionally. Leadership must listen to concerns, take actions and support the efforts of those working to improve safety.
What can you do?
Hopefully the hospital(s) you use are working on improving all, or many of these safety concerns. As a patient or family caregiver, you can have an impact on your risk level for a few of these issues, but many are well beyond the scope of patient influence.
Here are some tips for a few safety concerns:
Be alert for diagnostic errors
To minimize your own risk of diagnostic error (#1), follow the tips in our blog post: How to Reduce Your Risk of a Misdiagnosis.
Reduce your risk of opioid addiction
To reduce your risk of opioid addiction (#2), be careful if doctors prescribe opioids – only take them when you really need them. Discuss your risk of addiction with your doctor and ask about how and when to stop the medication. If you want to avoid the problem altogether, ask your doctor about alternative methods for pain control. Realize that doctors often prescribe opioids out of precaution – you might not need to take any, even after some surgical procedures.
Actively participate in the process.
Stay as involved in your care, or the care of a loved one, as possible. To minimize problems associated with internal care coordination (#3), participate in bedside rounds and speak up as needed. Keep detailed notes of medications, treatments, tests and associated results, and procedures; include information on the prescribing doctors and the dates. Share this information with all members of your medical team.
Be an engaged patient or family caregiver (#9) – don’t just “sit back” and let this happen to you. Prepare questions and your “story” before each appointment. Take careful, detailed notes at every appointment, and bring all your notes with you each time. If you want to record your conversation, ask your doctor first. If you don’t understand what your doctor is saying, ask the doctor to repeat the information until you understand. Same for handouts – if you don’t understand, ask for clarification.
And most importantly, no matter the situation, it’s critical that you speak up if something doesn’t seem right!
*ECRI Institute is a nonprofit organization dedicated to using science to improve patient care.