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
    

Supporting Total Systems Safety

Change that creates a meaningful and sustainable impact requires that organizations think differently about how they redesign the environment, systems, and processes in which healthcare is delivered (Kaplan et al.). It demands the cross-stakeholder collaboration necessary to solve safety problems (NSC). In its National Action Plan to Achieve Patient Safety, the National Steering Committee for Patient Safety describes four interdependent foundations that are essential to achieving total systems safety (NSC):

• Cultivating leadership, governance, and cultures that reflect a deep commitment to safety
• Engaging patients and families as partners in designing and producing care
• Fostering a healthy, safe, and resilient environment for the workforce
• Supporting continuous and shared lessons learned to improve safety and quality of care and reduce the risk of harm

This annual Top 10 report is grounded on these four pillars. It shares lessons from ECRI and ISMP’s analysis of a wide range of data sources and offers strategies to support continuous improvement in healthcare, emphasizing the roles of culture and leadership, patient and family engagement, and workforce safety. This report also illustrates ECRI and ISMP’s deep understanding of how systems can contribute to harm—or drive safety.

We'll be delving deeper into each of these concerns in the coming weeks and how the concerns impact providers across all care settings. Be sure to read our upcoming blogs for information and resources that can help your team improve patient and staff safety.

Download our Top 10 Patient Safety Concerns for 2023 Special Report to identify safety challenges in your organization and learn how to address them.