Diagnostic errors, which approximately one out of every 20 adult patients experience every year, topped the list of the ECRI Institute’s top ten patient safety concerns for healthcare organizations in 2018.
Diagnostic errors can have unexpected and serious repercussions, according to the report, including care gaps, repeat testing, unnecessary procedures and patient harm.
“Diagnostic errors are not only common, but they can have serious consequences. A lot of hospital deaths that were attributed to the normal course of disease may have been the result of diagnostic error. Clinical decision support interventions can also be helpful by identifying ordered tests that haven’t been done or by flagging incidental findings that require follow-up,” ECRI Institute patient safety analyst Gail Horvath said in a prepared statement.
The Plymouth Meeting, Penn.-based Institute is a nonprofit dedicated to analyzing and researching which medical procedures, devices, drugs and processes are best to improve patient care, the group said.
Following diagnostic errors on the list are concerns about opioid safety across the continuum of care, ECRI reports.
The seriousness of side effects and addictiveness of the drugs made opioids a top concern to the Institute. ECRI said that current strategies for coping with the drugs include comprehensive patient assessments, use of nonpharmacologic modalities and nonopijoid pain medications, accounting for patients’ individual needs, opioid tolerance and comorbidities.
“Opioids are a patient safety concern because of the seriousness of the side effects. We recommend that clinicians carefully assess patients for opioid use disorder and set realistic expectations about pain,” ECRI patient safety analyst Stephanie Uses said in a prepared release.
Following opioids, the remaining top five concerns reported by ECRI are internal care coordination within healthcare settings, ‘workarounds’ in which players in healthcare circumvent rules around perceived flaws or barriers and the incorporation of healthcare IT into patient safety programs.
The bottom five points on the list included management of behavioral health needs in acute care settings, all-hazards emergency preparedness, device cleaning, disinfection and sterilization, patient engagement and health literacy and leadership engagement in patient safety.
“The list does not necessarily represent the issues that occur most frequently or are most severe. Most organizations already know what their high frequency, high-severity challenges are. Rather, this list identifies concerns that have appeared in our members’ inquiries, their root cause analyses, and in the adverse events they submit to our Patient Safety Organization,” ECRI Institute exec director William Marella said in a press release.
ECRI said it has received more than 2 million event reports and that it has reviewed hundreds of root-cause analyses in its reports since 2009.