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The Emergency Care Research Institute (ECRI) recently published its 2022 report highlighting its top concerns for patient and provider safety.

ECRI partners with the Institute for Safe Medication Practice (ISMP) to review data and identify top safety concerns.  Each organization analyzes research and a wide domain of event reports as well as root cause analyses.  Following carefully selected criteria, each organization nominates topics to be added to the safety report.  The document also provides recommendations to address the concerns listed. The 2022 report includes topics not before listed and also sets forth items from other reports that remain relevant. 

The top ten list for ECRI this year includes (in order):

  1. Staffing shortages:  ECRI reports healthcare staffing shortages were adding up even prior to the pandemic.  The report cites statistics that indicate a significant portion of working RNs are over the age of 50, with 20 percent of RNs at 65 years of age or older. The report suggests nursing schools are not able to provide enough nurses to replace retiring staff.  Qualified nursing school applicants are unable to gain needed training due to inadequate educational resources.
  • Impact of COVID-19 on healthcare providers mental health:  Many healthcare providers experienced burnout and depression prior to COVID-19.  The grueling and tragic pandemic experience has only worsened the situation.  A recent survey of providers captured disturbing statistics including a high number of healthcare workers experiencing anxiety and depression, while others cannot sleep, have reported trauma, or continue to work with high-levels of emotional exhaustion.
  • Bias and racism in addressing patient safety: Racial and ethnic disparities in the provision of healthcare are nothing new. Minority groups are more likely to experience a harmful medical event or diagnostic mistake and are less likely to report it than patients who are white.
  • Vaccine errors and coverage gaps:  While COVID vaccines and boosters made big news in the last year, vaccine gaps have left children and adults lacking protection against illness. Vaccine errors take the form of administering the wrong vaccine, or vaccines given at the wrong age, time, route, or to the wrong patient. Mistakes made in providing vaccine can compromise immunity, cause harm, waste money, and damage the credibility of the healthcare system.
  • Confirmation bias and diagnostic error: Multiple types of bias pervade the healthcare system.  When physicians and caregivers are driven by their emotions, habits, or devotion to their own diagnosis—patients lose.
  • Non-ventilator healthcare-associated pneumonia: ECRI reports pneumonia is the most common healthcare-associated infection (HAI). While substantial attention is paid to ventilator-associated pneumonia, less concern is shown for non-ventilator acquired pneumonia.  In the US, 35 percent of hospital-acquired case of pneumonia are related to ventilators, while 65 percent are not.
  • Human factors in telehealth: Over 20 percent of adults in the US had some form of telehealth visit during September 2021 alone. Telehealth is a developing modality that is prone to system disruption and failure, and lack of cogent design and delivery. 
  • Supply chain disruptions:  Most of the world is painfully aware of the cost and difficulty of supply chain disruptions.  International disruptions lead to domestic shortages in healthcare products, equipment, furniture, tests, and drugs.
  • Emergency use authorization for products:  While emergent situations like the COVID-19 pandemic led to emergency authorization of products and applications, problems arise when the authorization ends and physicians continue to use products or prescribe drugs that are no longer authorized.
  1. Telemetry monitoring: Equipment that can monitor patient physiological factors at a distance are crucial to clinical understanding and response. Difficulties can quickly arise with telemetry monitoring if equipment malfunctions, loses power, or other issues such as like user error.  

These are just ten of the problems that plague the delivery of healthcare today. While medical mistakes will always occur, paying greater attention to these and other patient safety issues is an important step in decreasing the risk to vulnerable patients. 

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