ECRI Blog

Across industries, the topic of worker shortages has dominated conversations because the COVID-19 pandemic contributed to the “great resignation.” And healthcare is no exception. But in healthcare, the stakes are greater than other industries because patient safety directly correlates to adequate staffing. Issues such as quality of care, medication errors, patient satisfaction, higher patient mortality, overcrowding, and more all can be linked to adequate staffing. With patient safety in mind, ECRI’s Top 10 Patient Safety list names staffing shortages as the number one challenge of the year.

An important part of maintaining patient safety is establishing the shared belief that despite the high-risk environment in healthcare, patient safety is possible, and it’s everyone’s responsibility. Creating awareness of common problems and opening a dialogue about prevention, learning, and solutions can help.

To that end, ECRI annually publishes a list of its top 10 patient safety concerns, and we are pleased to share the 2022 list with you here. ECRI analyzed 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.

Like it has done to almost everything else in the world, the COVID-19 pandemic has shaped this year’s list. The annual list is usually topped by clinical issues caused by device malfunctions or medical errors. But this year, staffing shortages and healthcare workers’ mental health top a list of patient safety concerns released by ECRI. Inadequate staffing is jeopardizing patient safety. Due to staffing shortages, many patients are waiting longer for care, even in life-threatening emergencies, or simply being turned away.

Healthcare workers are known to suffer slip and falls, needle sticks, and back pain, but unfortunately, they also can face violence on the job. Recent shocking headlines include: Nurse Found Dead from Self-Inflicted Gunshot Wound after Allegedly Setting Colleague on Fire; Maine Nurses Face Increased Levels of Physical, Verbal Abuse by Patients; Nursing Assistant Gunned Down by Coworker Left Behind Three Children… And while workplace violence has been a dangerous risk among healthcare workers for years, experts believe the COVID-19 pandemic, and its added stresses and mental health challenges, have exacerbated violence.

In the halls of government, school board meetings, and neighborhood shopping centers across the world, debates continue about the value of masking for protection against COVID-19 infections. But ECRI experts and other healthcare leaders stress that now is no time to let our guard down nor shed our PPE masks.

Rather, let’s take what we’ve learned about PPE during this pandemic, and use it to better protect ourselves against COVID-19’s omicron variant, which is estimated to be two to four times more contagious than earlier strains of the virus. We know that masks work, wearing a mask reduces the speed of virus transmission, and not all masks are created equal.

"Communication failures cost 1.5 times as much as claims without communication failures, and were more than twice as likely to result in a payout of more than $1 million," the Journal of Patient Safety study noted.

Roughly 20,000 malpractice claims are filed annually in the U.S. alone, and half of all physicians will be sued sometime during the course of a career. During the pandemic, lower numbers of claims were reported from some institutions, but others, such as those in aging services, continue to face this challenge without relief. And even with some reduction in occurrences, malpractice insurance rates continue to rise. Most importantly, claims are tied to patient care and safety, the metric most important to those who work tirelessly to provide care during what is now the third trying year of this pandemic.

Newly published information reveals ineffective and non-existent communication as significant threats to patient safety. You might ask, “How can communication be such a problem when we work closely together, huddle, and meet often?” It’s a oversimplified example, but we all remember the childhood game of “whisper down the lane,” where the original message never matched the message received by the last person in the line.” Communication can be incomplete, misinterpreted, or flat-out incorrect. The good news is, there are ways to improve communications and subsequently improve patient safety and reduce medical malpractice claims.

ECRI’s Top 10 Health Technology Hazards for 2022 ranks supply chain shortages among the top three risks facing healthcare organizations. The ranking is for good reason: patient lives may be at risk if essential medical supplies and equipment are unavailable. This risk increases as global supply chain disruption continues to impact healthcare organizations. According to an October 2021 report on healthcare performance, at least 80 percent of hospitals reported supply shortages.

Shortages can stem from the impact of the pandemic, which has sometimes brought manufacturing to a halt. Others are the result of vulnerabilities in traditional supply chain planning, such as keeping limited amounts of products in storage and relying on fast delivery. Weather events and other force majeure incidents also play a role. Together, these create a cascade effect that causes many healthcare organizations to struggle to locate, purchase, and obtain supplies:  

• Raw material shortages increase prices and reduce output. For example, shortages of resin impact the availability of plastic and magnesium shortages affect the availability of aluminum – causing issues for manufacturers.
• Suppliers who rely heavily on offshore manufacturers that have been disrupted by the pandemic or global weather events need to find supplies elsewhere.
• Supply chain practices and other pressures reduced organizations’ stockpiles of critical supplies. “Just-in-time’ supply chain models, designed to reduce the need for physical inventory, are upended when products can’t be sourced or delivered on time.  
• Logistical challenges, such as ongoing trucking, shipping, and delivery issues brought on by the pandemic, delay delivery of critical supplies.  

Refresh your evidence assessment knowledge of important topics discussed at ECRI's Evidence boot camp event: Effective Methods for Rapidly Assessing the Best Available Evidence. 

Healthcare payers, providers, and other audiences gathered this past fall to gain strategic insights in discussion about clinical evidence assessment of healthcare technologies. The event was backed by an experienced team consisting of multi-disciplinary experts across ECRI–PhD-level analysts and directors from Clinical Evidence Assessment, Clinical Excellence, Evidence-based Practice Center; Master-level Librarians; and guest panelists, who made the event interactive and informative.

Key learning objectives included:

• Demonstrate key clinical evidence concepts

• Understand considerations for choosing The Evidence Bar™, an at-a-glance visual representation of the balance of benefits and harms, in ECRI’s rapid clinical evidence assessment reports about healthcare technologies

• Identify real-world evidence examples and considerations in clinical evidence assessment and decision-making

• Recognize the highest standards and evolving tools employed in ECRI’s rapid assessment of the best available evidence

Two full years after the coronavirus disease (COVID-19) caused by the SARS-CoV-2 virus first appeared, the world is still grappling with this highly contagious, infectious disease. The state of the virus has ebbed and flowed: periods of declining spread are followed by the emergence of new variants; the delta variant dominated 2021, and in just the past month, the omicron variant was classified by the World Health Organization as a "variant of concern."

Perhaps the most hopeful development in protecting individuals from severe illness related to COVID-19 has been the advent of several vaccines. They are especially important for those at greatest risk for the worst outcomes of COVID-19, such as the elderly or immunocompromised, as well as healthcare workers whose jobs place them at increased risk of exposure. And yet, vaccine hesitancy remains a challenge in the United States and worldwide. 

We’ve all heard the idiom that one should “compare apples to apples; not apples to oranges. But what if you are not calling all of your apples by the name apple, or oranges by the name orange?

Or, here’s another way to think about it: Having mismatched data is like having an unorganized closet—you can’t find anything when you need it, you waste time searching, lose money in new purchases, and the closet gets messier as time goes on.

In recent years, efforts to reduce HAIs have been successful, with annual cases dropping more and more each year. However, in 2020, there was an increase in HAIs, causing healthcare leaders to examine the reasons behind this spike and if the increase was related to the COVID-19 pandemic and the burden it placed on healthcare facilities and staff.