ECRI Blog

Each year, ECRI publishes a list of top patient safety concerns to call attention to safety risks that need to be addressed to keep patients and staff safe. Concerns on this year’s list are heavily influenced by the top concern on our 2022 list – staffing shortages. Staffing shortages continue to plague healthcare and are contributing to challenges related to the pediatric mental health crisis, violence against healthcare staff, mismatches between assignments and competencies, and missed care treatment.

The number-one concern on this year’s list recognized that children and youth are facing a mental health crisis that has been growing for years. Rates of anxiety and depression in those 17 and younger increased by nearly 30% in 2020 compared with 2016 (American Academy of Pediatrics). The number of emergency department visits for adolescent suicide attempts increased by 39% in winter of 2021 compared with winter 2019, per the Centers for Disease Control and Prevention. 
The topics are selected based on a wide scope of data, including scientific literature, patient safety events or concerns reported to or investigated by ECRI, client research requests and queries, and other internal and external data sources. The top 10 patient safety concerns for 2023 are:

1. The pediatric mental health crisis
2. Physical and verbal violence against healthcare staff
3. Clinician needs in times of uncertainty surrounding maternal-fetal medicine
4. Impact on clinicians expected to work outside their scope of practice and competencies
5. Delayed identification and treatment of sepsis
6. Consequences of poor care coordination for patients with complex medical conditions
7. Risks of not looking beyond the “five rights” to achieve medication safety
8. Medication errors resulting from inaccurate patient medication lists
9. Accidental administration of neuromuscular blocking agents
10. Preventable harm due to omitted care or treatment
    

Changes in the supply chain, or supply chain disruptions, can happen at any time, but the COVID-19 pandemic set off a domino-effect series of shortages and delays that impacted financial, reputation, and clinical outcomes.

ECRI included supply chain disruptions in its annual list of Top Patient Safety Concerns in 2021, and again in 2022. And while 2023 may bring some improvements, challenges remain.

Healthcare leaders will continue to grapple with supply chain challenges that effect patient safety, healthcare quality, financial standing, and emergency preparedness. In fact, supply chain problems may be compounded by additional medical issues such as RSV and a rampant flu, as well as geopolitical and economic factors, such as war, inflation, spend limits, and staff shortages.

Together these factors slow the supply chain, delaying needed goods, services, and transportation. 

Influenza (flu) is a contagious respiratory illness caused by various viruses. It can cause mild to severe illness, and at times can even lead to death. Flu season started earlier than usual this season, and it has been joined by RSV and ongoing COVID-19 to form the “tridemic.” 

We know that getting the flu vaccine is the best defense against getting the flu; and even if a vaccinated person does contract the flu, the vaccine can significantly reduce symptoms. However not every eligible person is getting vaccinated, especially in communities of color.

The Centers for Disease Control and Prevention (CDC) has reported that inequities in access to the flu vaccine and misinformation about the vaccine can contribute to lower vaccination rates in minority communities.

With a vaccination rate of only 43% during the 2021–2022 flu season, Black, Hispanic, and American Indian/Alaska Native adults were more likely to get the flu and more likely to be hospitalized due to the flu. In fact, when the CDC examined hospitalizations caused by the flu, hospitalization rates were 80 percent higher among Black adults than white adults.

The tridemic is here—are you ready? By taking steps to understand the tridemic, and the effects it’s having on healthcare, your organization can better prepare for and manage the likely increase in utilization of emergency departments, pediatric practices, and inpatient hospital stays. 

What is the tridemic?

The tridemic is the unofficial name that has been given to the rise in cases of three different illnesses—influenza (the flu), COVID-19, and respiratory syncytial virus (RSV). Flu and RSV cases comprise the majority of circulating illnesses, as COVID numbers have been stable recently.

Alone, each of these illnesses can tax an already strained healthcare system. Together, they have the potential to cripple healthcare infrastructure due to worsening illness severity and sheer number of cases. 

Rising numbers in cases have been reported in Canada and in half of the United States. As the holidays and colder weather quickly approach, and with them a likely increase in indoor celebrations, experts fear that tridemic numbers will continue to rise. 

Healthcare organizations are some of the most complex and critical in the world. Supply chain disruptions in healthcare can have a ripple effect on patients, staff, and the community at large. So, whether you are running a health system, hospital network, aging services facility, or ambulatory care center, supply chain disruptions are crucial to understanding your organization as a whole. 

A supply chain is a complex network of individuals and companies that design, manufacture, distribute, and consume healthcare products. Because supply chains are so complex, it's easy for disruptions to occur. Some disruptions are due to labor strikes, transportation issues such as weather-related traffic jams or port closures, supplier bankruptcies, and product recalls. Other reasons could be that a company is sourcing products from a region that's experiencing political instability or if they rely on a limited number of suppliers. 

This can leave you without the necessary supplies or medications that you need to provide the level of care your patients deserve. That being said, there are ways that providers and healthcare facilities can prepare for these disruptions. If you're looking to navigate supply chain changes more effectively, keep reading for tips on preparedness and management strategies you can employ.

ECRI this year named Bias and Racism in Addressing Patient Safety as number three on its annual list of Top 10 Patient Safety Concerns. Racial and ethnic disparities have been well documented, and while some progress has been made, the problem is pervasive, persistent, and damaging.

These disparities affect:

• Patient access to care
• Patient safety
• Quality of care and clinical outcomes
• The frequency and consistency with which reports of adverse events are filed
• The level of responsiveness when adverse events are reported
• Patient health, well-being, and life expectancy

Research shows that patients who are members of racial and ethnic minority groups experience barriers that limit their access to care, and affect the quality of their care, more frequently than non-minorities; this includes having an increased risk of being uninsured or underinsured, lacking access to care, and experiencing worse health outcomes for conditions that are treatable and even preventable. 

When working in aging services facilities, ambulatory care, or hospitals, accidents can happen during patient treatments, in the patient environment, or in other scenarios. However, accidents need not become commonplace, compromising your healthcare facilities and the level of care you provide. Instead, by taking time to learn from these accidents and discover the right solutions, you can keep patients safer and further your organization's goals.

What types of accidents might your patients encounter? How can you work to reduce these accidents and foster a greater culture of safety for your patients? Let's examine some of the most common hospital accidents, how you can avoid them, and how ECRI can support you in your journey to better healthcare.

Medical incident reports are essential to improving patient safety and correcting medical errors that could cause harm to future patients. Today's healthcare establishments, such as hospitals, aging care services, and ambulatory care facilities, need an incident control and management system in order to gain further insight into these medical incidents and to conduct effective risk management procedures. Although the concept of recording healthcare incidents and taking action to prevent them might seem relatively straightforward, staff members could have many questions. See below for what healthcare providers need to know about filing incident reports to make the process easier for everyone involved.

The what, when, and why of filing incident reports

When you have the proper management system, filing an incident report becomes easier. However, you need to identify the essential elements that go into filing a report before you integrate these systems into your existing processes. Whether the incident involves an adverse event, problems with patient care, or serious injury, here are a few helpful instructions for healthcare organizations about how to ensure that reports are filed correctly.

When a patient comes to your facilities for healthcare, they expect that you can effectively address the issue quickly and with ease and expertise. Now, imagine that this same individual ends up receiving an infection while under your care. The spread of infection in healthcare environments, as well as how it affects both your patients and your healthcare workers, is an important topic to evaluate, especially if these types of incidents happen frequently. Below, we'll dive deeper into insightful statistics regarding infection in healthcare facilities, how infections spread and how they can be addressed, and why reaching out to hospital infection control consultants can help you improve your approach to infection control and prevention.

Why is infection control so important? The statistics behind hospital-acquired infections.

Hospital-acquired infections (HAI) or healthcare-associated infections may occur more frequently than expected, perhaps because patient care might not be as satisfactory as many healthcare professionals believe. The United States Centers for Disease Control and Prevention (CDC) estimates that approximately 1.7 million patients contract HAIs annually while receiving treatment for issues unrelated to the infection that they've contracted. Even more troubling, approximately 98,000 of these individuals (about 1 in 17) die as a result of their infection. 

Regardless of the type of healthcare facility you manage—a hospital, an assisted living center, or an ambulatory care establishment—incident management for patient safety should be a primary focus of your organization. By taking time to assess patient safety, produce incident reports when accidents or infections occur, and understand the causes of various accidents, you can offer a better quality of care over time. That being said, it's important to know what you can gain by finding the proper incident reporting and management system for your organization. If you want to provide better healthcare for your patients and support risk managers, clinicians, and other healthcare professionals, consider the many benefits of an effective incident management system.

1. It allows you to identify trends in common medical errors

There are certain accidents that might only occur once, becoming an outlier in your organization's medical history; however, it's more common for specific types of incidents to occur repeatedly. An effective incident management system allows you to identify trends in common medical errors as your staff inputs incident reports. Whether you encounter medication safety issues, healthcare-associated infections, or even safety issues such as frequent falls among older adults, incident reporting and management can help you identify these trends so that you can take action.