ECRI Blog

1. Improved patient outcomes: Predictive replacement planning (PRP) can help facilities determine when medical equipment has reached the end of its lifespan, ensuring equipment failures do not negatively affect patient care.  
2. Cost-savings: PRP can help hospitals avoid unplanned equipment replacements, reducing operational costs associated with emergency replacements.  
3. Effective resource management: With PRP, hospitals can schedule equipment maintenance and replacements based on actual usage data, ensuring that resources are not wasted on over-maintenance. 
4. Increased efficiency: With the ability to predict equipment failure, hospital staff can proactively arrange for equipment maintenance or replacement, freeing up time to focus on patient care. 
5. Improved equipment standardization: PRP will help hospitals standardize equipment, thereby reducing operational costs by improving efficiencies and lowering costs due to savings in service contracts, clinician training, and parts inventories. Hospitals can also realize capital savings by grouping like purchases to a single vendor and reducing administrative efforts.

​An ECRI member recently asked for information regarding support for healthcare providers navigating the death of a pediatric patient. In our response, we discuss strategies and provide relevant resources for healthcare staff confronted with the death of a child. 

Although patients and their families are obviously at the center of adverse patient safety events, a ripple effect often occurs, turning the involved healthcare providers into "second victims," who may require or benefit from organizational support. A survey of over 100 healthcare professionals regarding their grief after the death of a child found that the majority of second victims turned to others to talk about the child and their emotions (85%), used positive reframing (80%), sought emotional support (75%) or self-distraction (57%). Other strategies included seeking religious guidance (55%), meeting with the patient's parents (43%), and attending the patient's funeral (19%). More than half (53%) believed that turning to coworkers, friends, or family helped them the most to overcome their grief. The second most useful strategy was spending time alone (19%). However, 31% wished they had more emotional support from their colleagues, and while 8% received organized support from their workplace, 40% would have appreciated more "official" support. 

As described in ECRI’s white paper, Mismatched Needs and Services Can Lead to Harm: A Systems REThinking Approach, organizations should systematically evaluate the scope of services they offer to meet resident needs and determine their staffing, infrastructure, and technology needs to fulfill these obligations.  

In the modern healthcare environment, healthcare workers often experience job-related fatigue, which can have a negative effect on patient and staff safety and well-being. In addition, worker fatigue is associated with lost workdays, an increase in occupational injuries (e.g., needlesticks), liability issues, and increased turnover. 

Healthcare organizations must address the effects of fatigue on healthcare workers and, whenever possible, reduce duty hours to allow workers more recovery time. However, even the best schedules and optimal staffing cannot eliminate the circadian disruption associated with night work and long hours. Healthcare organizations should implement fatigue management strategies as part of their system-wide efforts to increase patient safety and reduce medical errors. A good fatigue management plan should address the following: 

• Education and training on the effects of fatigue 
• Strategies to increase alertness and mitigate fatigue 
• Opportunities to identify and treat any medical conditions that may affect alertness or fatigue, such as sleep disorders 
• Scheduling policies 
• Adverse event, medical error, and occupational injury investigations 

Healthcare organizations may also wish to consider developing a fatigue risk management system—data-driven sets of management practices for identifying and managing fatigue-related safety risks—as a subset of their overall safety management system. ​ 

Additional resources that may be helpful include the following: 

When compared to ten other developed nations, the United States has the highest maternal death rate. Yet, according to a recent maternal mortality review committee report by the Centers for Disease Control and Prevention, 84% of pregnancy-related deaths are preventable. This maternal health crisis has been shaped, in part, by socioeconomic inequities and inconsistent insurance coverage policies, which limit healthcare access by underserved populations. So what tools are available now to help reduce preventable harm among childbearing women? Clinical evidence suggests that telehealth could be one solution. 

A member recently asked about liabilities associated with the utilization of data from nonprescription consumer wearable devices that track various health statuses (e.g., heart rate, blood pressure, activity levels, glucose levels). In our response we discuss the potential risks of utilizing such data and provide information and resources to consider.

The wearable medical device market is rapidly expanding—Deloitte Global predicts that nearly 440 million consumer health and wellness wearable devices will ship worldwide by 2024, and around one-third of individuals own one. However, laws and regulations regarding their use remain unclear. While some physicians support their use as a way to encourage patients to track lifestyle habits that contribute to overall healthcare, others are concerned about associated risks. Many nonprescription commercial wearable devices available to the public are not approved or regulated by the U.S. Food and Drug Administration (FDA), and all have varying degrees of accuracy, usability, privacy protections, and interoperability with existing healthcare technology (e.g., electronic health records, remote patient monitoring systems prescribed by providers). Research on the predictive quality of wearables for health outcomes is also lacking. A 2018 JAMIA literature review found only eight studies of at least moderate quality that supported a significant association between data from wearables and the tracked outcome.

Sepsis is the body's overwhelming response to infection and can lead to tissue damage, organ failure, and death. According to the Centers for Disease Control and Prevention, anyone can get an infection, and any infection can lead to sepsis, including bacterial infections such as Staphylococcus aureus and Escherichia coli, as well as viral infections such as COVID-19 or influenza. 

According to the Sepsis Alliance, more than 1.7 million adult Americans develop sepsis each year, and approximately 30% of those diagnosed with severe sepsis do not survive. Among survivors, up to half develop postsepsis syndrome, leading to a shortened life expectancy, impaired cognitive function, and diminished quality of life. Yet it is estimated that 35% of adult Americans have never heard of sepsis. 

Recall management remains challenging for healthcare providers, as the number of hazard alerts involving medical devices, pharmaceuticals, and other products continues to increase. From cybersecurity vulnerabilities involving complex medical technologies, to sterility issues with various consumables, to shortages across the industry, managing product recalls and corrections becomes more complex every year. 

An analysis of 2022 data from the ECRI Alerts Workflow system, which facilitates efficient recall and technology risk management for medical equipment, supplies, and pharmaceuticals, highlights the scale of the challenge that providers are facing:

The mental health of children is currently in crisis. According to an investigation reported in 2021 in JAMA Pediatrics, one in four children globally is experiencing elevated depressive symptoms and one in five is experiencing elevated anxiety. In the United States in 2020, anxiety diagnoses for children aged 3 to 17 years increased 29% and depression diagnoses increased 27% compared with 2016, according to a 2022 investigation in JAMA Pediatrics. This equates to 5.6 million children with anxiety and 2.7 million with depression—numbers that are far too high.

Pediatric mental health was already a concern during the 2010s, but the COVID-19 pandemic exacerbated an expanding crisis as children who were experiencing the mounting pressures of social media, increasing gun violence, and other stressors now had to cope with social isolation, disruption to education and other daily activities, and fear and uncertainty surrounding the novel virus. 

ECRI highlighted the pediatric mental health crisis as its number one item in its Top 10 Patient Safety Concerns for 2023.  

Caring for this population’s mental health needs to begin long before these children present to emergency rooms for psychiatric treatment or suicide attempts. While some solutions to the current crisis may fall outside the pediatric primary care office, steps can be taken to protect our youngest and most vulnerable population.