Each year the nonprofit ECRI Institute highlights its top 10 patient safety concerns for the year. For 2019, diagnostic errors and improper management of test results in electronic health records (EHRs) topped the list.
Released in conjunction with National Patient Safety Awareness week, ECRI’s Top 10 list noted that “when diagnoses and test results are not properly communicated or followed up, the potential exists to cause serious patient harm or death. Providers have begun relying on the electronic health record (EHR) to help with clinical decision support, to track test results, and to flag issues.”
“We have to recognize the limits of current technology and ensure that we have processes in place to close the loop on diagnostic tests,” said William Marella, executive director of operations and analytics for the ECRI Institute Patient Safety Organization (PSO), in a prepared statement. “This safety issue cuts across acute and ambulatory settings, requiring teamwork across the health system.”
The Plymouth Meeting, Pa.-based ECRI Institute is designated an Evidence-based Practice Center by the U.S. Agency for Healthcare Research and Quality. ECRI Institute PSO has received more than 2.7 million event reports and reviewed hundreds of root-cause analyses since 2009.
Other topics identified involve the EHR as well. For instance, the report notes that the EHR is a contributing factor to provider burnout, but the issue goes beyond frustrations with documentation. “Healthcare is evolving rapidly and keeping up with the changes can be a challenge, the report says. “Time pressures are intense. Providers are caring for an increasing number of patients with complex medical conditions, drawing on limited resources.”
The report also raises questions about patient safety concerns involving mobile health, noting that many devices are released without U.S. Food and Drug Administration testing. “Healthcare organizations must ensure the safety and validity of any device they recommend to a patient and be certain the device will work when the patient leaves the healthcare facility,” the ECRI report states.
ECRI stresses that its 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.
Other topics of concern include:
• Antimicrobial Stewardship in Physician Practices and Aging Services;
• Reducing Discomfort with Behavioral Health;
• Detecting Changes in a Patient’s Condition;
• Developing and Maintaining Skills;
• Early Recognition of Sepsis across the Continuum; Infections from Peripherally Inserted IV Lines; and
• Standardizing Safety Efforts across Large Health Systems.
