ECRI Blog

According to the Americans with Disabilities Act (ADA), individuals with disabilities must be allowed to be accompanied by their service animals in all areas of a place of public accommodation. ADA requires healthcare facilities, as places of public accommodation, to modify policies, practices, or procedures to permit the use of a service animal by an individual with a disability unless the presence of the animal would compromise health or safety standards, such as in the operating room.

A facility may ask an individual with a disability to remove a service animal from the premises only if any of the following conditions apply:

• The animal is out of control and the animal's handler does not take effective action to control it.
• The animal is not housebroken.
• The animal is properly excluded.

Natural language processing (NLP) is an increasingly ubiquitous form of artificial intelligence (AI). Best described as where computer science meets linguistics, it uses computational linguistics and machine learning to analyze human language. 

NLP powers virtual assistants like Alexa and Siri, predictive text for emails, spelling and grammar checkers, and sentiment analysis in reviews. In addition to consumer use cases, NLP is used in medicine to identify risk factors, estimate risk, or predict events of disease development or readmissions across cardiovascular, endocrine, metabolic, and neurological diseases. And it’s put to work in patient engagement—with NLP-powered chatbots supporting pharmacy interactions, COVID-19 management, and primary care triage.

Does NLP have a potential role in supporting infection prevention? Let’s explore the possibilities.

​​​​​​​​Vaccinations are an important tool for building immunity to prevent illness, disability, and death resulting from infectious diseases. According to the Centers for Disease Control and Prevention (CDC), 4 million deaths worldwide are prevented by childhood vaccination each year.

As with any medication, errors can occur during the prescribing, preparation, handling, storage, or administration of vaccines. Vaccination errors can affect not only the patient receiving the vaccine but also others who are exposed to the patient if infectious diseases reemerge.

​​​​​​​​Candida auris (C. auris)—an emerging fungus considered an urgent antimicrobial resistance (AR) threat—is on the rise in the United States. According to Centers for Disease Control and Prevention (CDC) data published in the Annals of Internal Medicine, C. auris spread at an alarming rate in U.S. healthcare facilities from 2020 to 2021. In fact, the number of cases resistant to echinocandins in 2021 was about three times that in each of the previous two years.

According to the CDC’s 2022 Special Report: COVID-19 U.S. Impact on AR, there were 171 clinical cases in 2017, 329 cases in 2018, and 466 cases in 2019. In 2020, there were 754 cases—representing a 60-percent increase. The CDC has categorized C. auris as an “urgent” pathogen based on the level of concern to human health. 

​​​​​​​​Proper hand hygiene by healthcare workers is considered to be one of the most important practices for preventing healthcare-associated infections (HAIs) (CDC "Guideline for Hand Hygiene"). HAIs can happen anywhere healthcare is delivered including hospitals; outpatient settings such as doctor's offices, ambulatory surgical centers, and dialysis facilities; and long-term care facilities such as nursing homes and rehabilitation centers. They may be caused by any infectious agent, although most are caused by bacteria, viruses, or fungi (ODPHP).

​​​​Policies for managing comorbidities, as well as multimorbidity and multiple chronic conditions, vary based on the medical conditions involved; therefore, developing a uniform policy is not necessarily feasible given the differences between conditions. Approaches to comorbidity management often overlap with typical care management strategies. However, the presence of comorbidities often requires treatment adjustments based on disease-specific considerations, making individualized treatment plans the most appropriate approach. Professional organizations have developed guiding pri​​​nciples that healthcare organizations can use to tailor comorbidity management best practices. For example, see the following guiding principles for managing comorbidities developed by a working group convened by the American Geriatrics Society:

September 18 -22, 2023, marks Falls Prevention Awareness Week in the United States. Despite widespread fall prevention programs, fall incidence rates are on the rise in the United States, with an average 1.5% annual growth rate from 2016 to 2019. Although information specific to assisted living (AL) is difficult to track given the varying degrees of reporting and oversight, an overview of claims data provides a snapshot of the current state of fall-related claims in AL. According to the 2022 CNA Aging Services Claim Report:

Patient elopement is when individuals leave an area they are expected to stay within, for their safety. Elopement from a healthcare facility can have devastating consequences for a patient, including serious injury or death. 

Oftentimes, resources on elopement are specific to the aging services setting since most elopements occur among older adults who have been diagnosed with Alzheimer's disease or dementia; however, elopement can present a risk for all manner of patients, particularly behavioral health patients and patients with altered mental status. 

In recent years, more OB units in rural areas have experienced closures and maternity care deserts have grown. In response, many rural healthcare organizations are exploring creative approaches in their efforts to maintain OB and gynecology (OB/GYN) services for their patients. The National Rural Health Association describes some of the approaches hospitals and policy makers have taken to try to maintain OB services, such as addressing costs of maternity care, increasing staffing levels, and consolidating health systems.

Combining units and going "on diversion" may also be considered creative approaches to addressing staffing issues in OB units, but such efforts raise potential risks.

​​​​Healthcare providers continue to face widespread economic challenges that directly affect the supply chain—from record inflation and dwindling margins, to shortages of supplies and workers, to cost increases in labor and supplies. In a survey conducted by Kaufman, Hall and Associates, 71% of health systems reported distribution delays; 58% surveyed reported raw product and sourcing availability disruptions.¹   

ECRI included supply chain disruptions in its annual Top 10 Patient Safety Concerns in 2021 and 2022. While supply chain challenges are anticipated to remain, nonacute care facility leaders can implement proactive strategies to achieve supply chain resilience and avoid disrupting or delaying necessary patient care.