The Emergency Response Centre International (ERCI) institute publishes an annual list of the top patient safety concerns that necessitate the most attention by hospitals for the specified year. These potential safety issues come from across the continuum of patient care to include hospitals, private practice offices, emergency care, aging services, and home health.1By informing healthcare organizations of these potential safety issues the ERCI aims to help facilities proactively form strategies for identify and mitigating sources of possible danger in order to lessen the occurrence of various events involving patient harm.1
- Standardizing safety efforts across large health systems. Hospital organizations are growing at a nearly unprecedented rate.2With this expansion the ERCI warns against losing sight of the primary priority that is patient safety.The internal business structure of these larger organizations must maintain solid communication, a clear line of command, and universal strategic planning in order to promote patient safety. The ERCI strongly recommends health systems to leverage the protections provided by participation in a Patient Safety Organization (PSO).1
- Infections from peripherally inserted IV lines. Peripheral intravenous lines are commonly used items in healthcare the ERCI associates with an underreported amount of patient infections.1Health care workers should ensure whether an IV line is warranted prior to its insertion, and handle it with the same level of care they would any other form of incision into the body.1
- Early recognition of sepsis across the continuum. Sepsis is a time-sensitivehealth condition that can be difficult to detect early on. More rapid intervention methods have been shown to result in decreased instances of shock and death.3The ERCI advocates for all health care organizations to have both detection and response protocols for managing sepsis.1
- Developing and maintaining skills. Health care knowledge and technology is constantly changing to become more advanced. In order to keep up with these changes health staff should be in a consistent pursuit of continuing their education. The ERCI stipulates that simulation training closely emulating real experiences without the risk of harm to patients is an effective method for providing solid education and skills.1
- Detecting changes in a patient’s condition. Quickly and accurately identifying changes in patient condition is an ongoing, pressing issue in health care. This is especially evident during nursing transitions between shifts and when an individual is referred from one physician to another.4Effectual communication is vital for workers to be able to understand their responsibilities and their patient’s condition characteristics.
- Reducing discomfort with behavioral health. Developing the skills for effective communication with patients who have behavioral health needs is crucial. Lack of confidence in this area can lead to intensifying situations or not meeting a patient’s needs. The ERCI strongly supports building community partnerships with organizations that specialize in behavioral health.1
- Patient safety concerns involving mobile health. Mobile health technologies are on the rise to bring healthcare into the home of patients. This technology can be a useful resource, but can also become a risk if not used as intended by the patient or the practitioner. Providers need to be diligent about providing clear instructions to patients on how to properly use mobile health technology. If the patient is not matched to the appropriate device or does not use the device correctly, then this technology can lead to patient harm.1
- Burnout and its impact on patient safety. Burnout is a concern that is affecting all health care workers, and has been shown to have a negative association with patient safety and quality of care.5Workers’ concerns regarding workload and performance standards need to be heard if burnout is to be addressed effectively. Creating a work culture that demonstrates the value of the workers is essential if this issue is to be resolved.1
- Antimicrobial stewardship in physician practices and aging services. Judicious prescribing of antibiotics is needed to combat the issue of medication resistance. An antibiotic should only be prescribed if deemed appropriate for the patient’s particular condition. The unnecessary prescribing of antibiotics has lead to an increase in antibiotic resistance making future treatment options more limited, and is thus increasing the risk of patient harm.6
- Diagnostic stewardship and test result management using electronic health records. Many health care providers are utilizing electronic health records (EHRs) for compiling and communicating information between professionals and patients. This technology aids in the speed and convenience of retrieving information, but still requires the person inputting the information to do so in an understandable and accurate manner. Proper management of this technology still requires the technician to perform their own data assessment in order to arrive at an accurate diagnosis.1
Now that you have been introduced to the ECRI’s Top 10 Patient Safety Concerns list you can be aware of some of the major safety hazards hospital organization administrators should be focusing on. If these safety concerns are not addressed now then they will likely continue to be a problem leading to further instances of patient harm in the coming years as well.
- ECRI Institute. 2019 Top 10 Patient Concerns Executive Brief, (online). Available at: https://www.ecri.org/landing-top-10-patient-safety-concerns-2019. Accessed June 24, 2019.
- Creswell J, Abelson R. New laws and rising costs create a surge of supersizing hospitals. August 12, 2013. New York Times. https://www.nytimes.com/2013/08/13/business/bigger-hospitals-may-lead-to-bigger-bills-for-patients.html. Accessed June 24, 2019.
- World Health Organization. Sepsis. Who.int. https://www.who.int/news-room/fact-sheets/detail/sepsis. Updated April 29, 2018. Accessed June 25, 2019.
- Friesen MA, White SV, Byers JF. Handoffs: Implications for nurses. In: Hughes RG, ed. Patient Safety and Quality: An Evidence-Based Handbook for Nurses. Advances in Patient Safety. Rockville (MD): Agency for Healthcare Research and Quality (US); 2008. http://www.ncbi.nlm.nih.gov/books/NBK2649/. Accessed June 28, 2019.
- Poghosyan L, Clarke SP, Finlayson M, Aiken LH. Nurse burnout and quality of care: cross-national investigation in six countries. Res Nurs Health. 2010;33(4):288–298. doi:10.1002/nur.20383
- CDC: 1 in 3 antibiotic prescriptions unnecessary. Cdc.gov. https://www.cdc.gov/media/releases/2016/p0503-unnecessary-prescriptions.html. Reviewed January 1, 2016. Accessed June 25, 2019.