Healthcare facilities looking to prioritize their patient safety efforts should start by focusing on diagnostic errors and opioid safety, according to the ECRI Institute.
Those measures led the organization’s list of the top 10 patient safety concerns for 2018. The ECRI Institute develops its annual list through a review of event reports and root-cause analyses from its members and intends for hospitals to use the information in support of their individual efforts to identify and mitigate patient safety issues.
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Diagnostic errors are commonplace and carry a high potential for adverse consequences, according to Gail M. Horvath, R.N., a patient safety analyst at the ECRI Institute.
“A lot of hospital deaths that were attributed to the normal course of disease may have been the result of diagnostic error,” she said.
The frequency with which diagnostic errors occur and the relative difficulty hospitals have in monitoring for such mistakes have driven recent innovations in clinical decision support systems, which Horvath recommends as a first line of defense.
Recent innovations in clinical support include a Johns Hopkins program that uses statistical analysis to help quickly identify troublesome patterns and predict symptoms likely to create issues.
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Opioid safety across the care continuum occupied the second slot on the list, echoing widespread concern about an epidemic of abuse in the United States.
“Opioids are a patient safety concern because of the seriousness of the side effects," said Stephanie Uses, patient safety analyst and consultant for the institute.
"We recommend that clinicians carefully assess patients for opioid use disorder and set realistic expectations about pain."
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Other major concerns in this year's list included elements of communication across healthcare facilities, including care coordination and emergency preparedness.
ECRI also notes issues with workarounds, which can help staff in the short run but create substantial safety issues down the line if they become entrenched.
Here, too, the organization stresses open lines of communication so staff feel empowered to discuss areas where existing rules create a barrier to care provision.
Here's the full list of this year's top 10 safety concerns:
- Diagnostic errors
- Opioid safety across the continuum of care
- Care coordination within a setting
- Workarounds
- Incorporating health IT into patient safety programs
- Management of behavioral health needs in acute care settings
- All-hazards emergency preparedness
- Device cleaning, disinfection and sterilization
- Patient engagement and health literacy
- Leadership engagement in patient safety