ECRI Names Top 10 Patient Safety Concerns

Electronic medical records systems can provide clinicians with reams of patient information, but the management of EHR data leads the list of concerns raised by healthcare provider organizations.

Timely access to and correct use of electronic medical records for patient information management tops the list of concerns that the ECRI Institute has identified in its 2017 Top 10 Patient Safety Concerns for Healthcare Organizations.

Lorraine B. Possanza, program director for ECRI's Partnership for Health IT Patient Safety, says the troves of patient information now available have created a new set of challenges for providers.

"The object is still for people to have the information that they need to make the best clinical decision," Possanza said in a statement released by ECRI. "Health information needs to be clear, accurate, up-to-date, readily available, and easily accessible."

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This year's list of top patient safety concerns:

1. Information Management in EHRs
2. Unrecognized Patient Deterioration
3. Implementation and Use of Clinical Decision Support
4. Test Result Reporting and Follow-Up
5. Antimicrobial Stewardship
6. Patient Identification
7. Opioid Administration and Monitoring in Acute Care
8. Behavioral Health Issues in Non-Behavioral-Health Settings
9. Management of New Oral Anticoagulants
10. Inadequate Organization Systems or Processes to Improve Safety and Quality

ECRI uses its Patient Safety Organization event data to compile the list, which is based on concerns raised by healthcare provider organizations.

"The 10 patient safety concerns listed in our report are very real," says Catherine Pusey, RN, associate director, ECRI Institute PSO. "They are causing harm—often serious harm—to real people."

No. 2 on the list, unrecognized patient deterioration, remains a top concern, despite improved clinical protocols, training and education for providers, and public awareness campaigns that have enabled speedier recognition of, and response to, stroke and ST-elevation myocardial infarction.

"People have seen how well the campaigns have worked for stroke and STEMI and how much they've improved outcomes," says Patricia N. Neumann, RN, senior patient safety analyst and consultant, ECRI Institute.

"What if those same principles could be applied to other conditions that require fast recognition and management? We could have a big impact on improving outcomes."

No. 3 on the list, implementation and use of clinical decision support systems, encompasses "tools that we use to ensure that the right information is presented at the right time within the workflow," says Robert C. Giannini, and ECRI patient safety analyst and consultant. If implementation or use is suboptimal, however, opportunities for CDS to aid decision-making may be missed, care could suffer, and patient harm could result.

The list and guidance are designed to help providers identify priorities and create corrective action plans. ECRI Institute says provider organizations should adapt relevant patient safety interventions to meet each care setting.