ECRI Blog

According to the Centers for Disease Control and Prevention, 6 in 10 American adults have one chronic disease, such as heart, lung, or kidney disease; cancer; Alzheimer's disease; and diabetes, and 4 in 10 have two or more. These patients see more physicians across care settings, experience more transitions of care, and suffer more adverse events than those without chronic conditions.  

Care transitions and coordination can be a vulnerable time for patients, and many find themselves relying on patient navigators or advocates to help them manage their care.  

According to a 2020 survey published in the Journal of General Internal Medicine, nearly 40% of respondents reported at least one gap in care coordination and nearly 10% reported at least one preventable outcome such as repeat tests, medication interactions, and emergency department visits.​​  

In response to this concerning trend, ECRI addressed the consequences of poor care coordination for patients with complex medical conditions in its Top 10 Patient Safety Concerns for 2023. 

Patients often have multiple providers involved in their care. According to a 2019 study published in the Annals of Internal Medicine, 30% of older Americans can see at least five different doctors in a year.  

On the one hand, patients are able to receive specialty care to help manage multiple, complex medical conditions. On the other hand, such fragmentation in care may lead to medication errors from inaccurate or incomplete patient medication lists. In response to this concern, ECRI addressed inaccurate medication lists in its Top 10 Patient Safety Concerns for 2023. 

As stewards of their patients' care, it is essential that primary care providers take steps to review and reconcile each patient's medication list to avoid errors or adverse drug events, and organizational leaders must ensure that systems are in place to support these efforts.  

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. 

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.