News: ECRI lists top 10 patient safety concerns, cites documentation concerns

ECRI Institute recently published its annual list of the Top 10 Patient Safety Concerns. The goal of this list is to help facilities’ efforts for proactively identifying and responding to threats to patient safety.

ECRI notes that this list was created before the COVID-19 outbreak occurrence, and that had the list been made after that, the coronavirus strain would be among the top patient safety concerns of the year. 

This year’s list of the top 10 patient safety concerns is as follows:

1. Missed and delayed diagnoses
2. Maternal health across the continuum
3. Early recognition of behavioral health needs
4. Responding to and learning from device problems
5. Device cleaning, disinfection, and sterilization
6. Standardizing safety across the system
7. Patient matching in the electronic health record
8. Antimicrobial stewardship
9. Overrides of automated dispensing cabinets
10. Fragmentation across care settings

In regards to missed and delayed diagnoses, the report says that the “electronic health record (EHR) should be structured so that clinicians and staff can readily understand the story so far: the trajectory of the patient’s condition, examinations, and tests that have been performed, diagnoses that have been considered, and more.”

CDI professionals play a major role in improving this concern by ensuring patient records are up to date and standards with all of the clinical information needed. If such information is missing or incomplete, CDI specialists should query providers as appropriate.

Another key issue on the list is patient matching in the EHR. ECRI’s analysis points out that when patching is not successful, duplicate and overlay records are created, which can lead to errors that cause significant long-term safety effects. The ECRI report recommends that “strong matching practices should be applied in EHR systems, prescription drug monitoring programs (PDMPs), health information exchanges (HIEs), and other digital health technologies, to allow for the flow of correct patient information across the continuum of care.”

Editor’s note: The full ECRI report can be found here.