ECRI's 2020 Top patient safety concerns: diagnostic errors, maternal health

ECRI, an independent nonprofit organization improving the safety, quality, and cost-effectiveness of care across all healthcare settings worldwide, has released its Top 10 Patient Safety Concerns 2020, naming diagnostic errors and maternal health in the top two spots. The annual report helps organizations identify looming patient safety challenges across the continuum of care, and includes suggestions and resources for addressing them. The launch was in conjunction with Patient Safety Awareness Week, March 8-14.

"Unsafe healthcare delivery harms millions of patients," said Marcus Schabacker, MD, PhD, president and CEO, ECRI. "Our annual patient safety report provides a roadmap to help healthcare leaders know what goes wrong and how to prevent harm."

ECRI's Top 10 Patient Safety Concerns relies on the analysis of more than 3.2 million patient safety events in its Patient Safety Organization reporting program, as well as the judgment and experience of its interdisciplinary patient safety and medication safety experts. This list identifies areas that are high priorities for a variety of reasons, such as new risks, existing concerns that are changing because of new technology or care delivery models, and persistent issues that need focused attention or pose new opportunities for intervention.

ECRI's list of patient safety concerns for 2020:

1. Missed and Delayed Diagnoses
   —Diagnostic errors are very common. Missed and delayed diagnoses can result in patient suffering, adverse outcomes, and death.
2. Maternal Health across the Continuum—
   Approximately 700 women die from childbirth-related complications each year in the U.S. More than half of these deaths are preventable.
3. Early Recognition of Behavioral Health Needs—
   Stigmatization, fear, and inadequate resources can lead to negative outcomes when working with behavioral health patients.
4. Responding to and Learning from Device Problems—
   Incidents involving medical devices or equipment can occur in any setting where they might be found, including aging services, physician and dental practices, and ambulatory surgery.
5. Device Cleaning, Disinfection, and Sterilization—
   Sterile processing failures can lead to surgical site infections, which have a 3% mortality rate and an associated annual cost of $3.3 billion.
6. Standardizing Safety across the System—
   Policies and education must align across care settings to ensure patient safety.
7. Patient Matching in the EHR—
   Organizations should consistently use standard patient identifier conventions, attributes, and formats in all patient encounters.
8. Antimicrobial Stewardship—
   Overprescribing of antibiotics throughout all care settings contributes to antimicrobial resistance. 
9. Overrides of Automated Dispensing Cabinets (ADC)—
   Overrides to remove medications before pharmacist review and approval lead to dangerous and deadly consequences for patients.
10. Fragmentation across Care Settings—
    Communication breakdowns result in readmissions, missed diagnoses, medication errors, delayed treatment, duplicative testing and procedures, and dissatisfaction.

The full Top 10 Patient Safety Concerns report provides detailed steps that organizations can take proactively to prevent adverse incidents. 

In keeping with its mission of effective, evidence-based healthcare globally, ECRI launched a publicly available COVID-19 (Coronavirus) Outbreak Preparedness Center to help hospitals protect healthcare workers and patients as the threat of coronavirus rapidly spreads across the globe.