ECRI recently published our Top 10 Patient Safety Concerns for 2024 Special Report—the annual guide that calls attention to pressing patient safety concerns facing the healthcare industry.

For this report, we draw on evidence-based research, data, and expert insights from ECRI and the Institute for Safe Medication Practices (ISMP). But we do more than highlight where concerns exist; we also provide encouragement and education to support organizations in addressing them with a Total Systems Safety approach. 

#1 Patient Safety Concern: Clinicians’ Transition to Practice

Two years ago, we identified staffing shortages as the most pressing concern. Topping the list in 2024 is another staffing-related issue: challenges transitioning new clinicians from education into practice.

For newly trained clinicians, employment prospects remain strong. For example, 96% of new nurses find work compared to 53% of new graduates with degrees in other disciplines. On the surface, this is promising news. However, closer examination reveals growing concern among physicians and nursing leaders about how new clinicians are transitioning from classroom to bedside.  

From nurses to medical residents, clinicians who started practicing during the COVID-19 pandemic missed significant learning experiences. At the same time, clinicians are being asked to do more and work longer—often without enough senior colleagues available to provide guidance and mentorship.

Without sufficient preparation, support, and training as they transition into practice, clinicians can experience loss of confidence, burnout, and reduced mindfulness around culture of safety. Numerous pieces of evidence suggest this is already happening:

• Newer clinicians lack confidence. Among nurses with less than two years’ experience, 30% reported that they do not feel well prepared to practice on their own.
• Newer clinicians are working in understaffed environments. Twenty-eight percent of the time a patient enters an acute care setting, they are likely entering a unit nurses believe is lacking the appropriate staff to provide quality care.
• Newer clinicians speak up less often. Only 33% of clinicians who had worked less than one year in their work setting had voluntarily reported one or more safety events. By contrast, 50% of those with 6 to 10 years of experience had made such reports.

These challenges reflect deficits at the system level and not on the part of individual clinicians. With a shared responsibility to help new clinicians navigate the transition to practice, educational institutions and healthcare organizations can consider some of the recommended actions we share in this year’s report.

The Full List of Patient Safety Concerns

Here’s the full list of the Top 10 Patient Safety Concerns for 2024:

1. Challenges transitioning newly trained clinicians from education into practice
2. Workarounds with barcode medication administration systems
3. Barriers to access maternal and perinatal care
4. Unintended consequences of technology adoption
5. Decline in physical and emotional well-being of healthcare workers
6. Complexity of preventing diagnostic error
7. Providing equitable care for people with physical and intellectual disabilities
8. Delays in care resulting from drugs, supply, and equipment shortages
9. Misuse of parenteral syringes to administer oral liquid medications
10. Ongoing challenges with preventing patient falls

Tackling Issues with Total Systems Safety

In the report, we offer strategies to support continuous improvement and provide specific action recommendations and additional resources for each of the Top 10 Patient Safety Issues. We’ve framed the recommendations around the four foundational drivers of Total Systems Safety: Culture, Leadership, & Governance, Patient & Family Engagement, Learning System, and Workforce Safety & Wellness.

Download the full Top 10 Patient Safety Concerns for 2024 Report.