March 17, 2021

Safety first—that’s the mantra of many institutions and factories and organizations across the country. Wear your hardhat and your harness. Bend at the knees and put on your goggles. Follow the safety guidelines even if it creates a little inconvenience in the short term. After all, it’s the long term these industries are concerned with. They know that certain injuries will create greater slow-downs in productivity, not to mention expensive workers comp claims or lawsuits. The healthcare industry is preeminently concerned about safety, as a mistake in this sector will clearly lead to poor patient outcomes, adverse events and even death.

It is no wonder, then, that health-related organizations, such as ECRI, have focused on patient safety issues for decades. Back in the 1960s, its founder patented and implemented the crash cart concept after watching a young child die due to a malfunctioning defibrillator. In keeping with its ongoing mission, the non-profit firm released this month its top ten list of patient safety concerns. The items making the list were derived from its database of adverse events, as well as discussions with other industry leaders. While we cannot independently verify the statistical reliability of the ECRI list, we nevertheless thought you might find the list interesting and perhaps helpful as you update your own facility’s safety protocols.

The ECRI’s list of patient safety concerns for 2021—listed in order of ranking—are listed in bold, below, with our commentary following each.

Racial and Ethnic Disparities in Healthcare

According to the ECRI findings, there may be racial or ethnic disparities that exist in the healthcare sector that may include frequency of screening for COVID-19 or other diagnoses, disease severity, complications, and deaths. As an example that may act to support this finding, the U.S. Centers for Disease Control and Prevention (CDC) has suggested that Hispanics are three times more likely to be hospitalized and twice as likely to die from COVID-19 as non-Hispanic Caucasians.

Emergency Preparedness and Response in Aging Services

With over 570,626 confirmed cases and 112,383 reported COVID-related deaths occurring in nursing homes (as of Feb. 1, 2021), there is no doubt that finding new and innovative ways to protect our most vulnerable seniors must be a top priority.

Pandemic Preparedness Across the Health System

For years, government studies indicated that the U.S. healthcare system would be woefully unprepared for a fast-moving infectious disease outbreak. That proved to be the case with the rapid spread of the novel coronavirus, beginning in early 2020. While we have learned a great deal in addressing this kind of virus, there is still a concern about new variants of COVID-19 and perhaps other contagions that may come along in the near future. Will we be any better prepared to tackle the next pandemic?

Supply Chain Interruptions

According to ECRI, limits on exports, in addition to lockdowns in countries that manufacture and produce raw materials, have resulted in delays of essential supplies. Let’s face it, without certain supplies, hospitals cannot effectively operate. Dealing with the supply chain interruptions during the pandemic is nothing new, but it continues. Has your hospital kept abreast of the items that are currently in, or are likely to be in, short supply? Have you identified alternate avenues of gaining such supplies? Supply chain management remains a top priority, and hospital administrators would do well to have extended and recurring meetings with those in charge of procuring these essentials.

Drug Shortages

The pandemic has led to shortages in almost every drug class used for mechanical ventilation, according to the ECRI researchers. Like the supply chain issue mentioned immediately above, a shortfall in on-hand vital medications can undercut the hospital’s ability to successfully treat the infirmed. The pipeline of essential drugs must be closely monitored, and strategies for securing these drugs, to the extent possible, must remain a top priority.

Telehealth Workflow Challenges

As we’ve reported in the past, telehealth is here to stay, but it is not without its problems. Whenever ECRI received adverse reports in this area of medicine, it found that poor wi-fi, inappropriate monitoring, inadequate language services, and health privacy issues were among the contributing factors. As we all know, technology is great—when it works. The challenge for hospital IT staffs will continue to be making enhancements in capabilities while continuing the fight against bad actors, i.e., hackers.

Improvised Use of Medical Devices

According to the ECRI study, modifying certain devices, workflows or systems may lead to serious safety and regulatory compliance issues. Established protocols should be followed, and facilities may want to consider strengthening their response to usages that fall outside such protocols, to include disciplinary measures where appropriate.

Methotrexate Therapy

The weekly administration of this cancer and autoimmune drug can lead to dosing and dose frequency errors, according to the study. Hospitals should accordingly consider creating or tightening protocols for the administration of this drug, to perhaps include digital alerts prior to administrations where that functionality is available.

Others

The study also identified peripheral vascular harm and infection risk from aerosol-generating procedures as the final two patient safety concerns, noting as to the latter that the exposure risk from performing aerosol-generating procedures on suspected COVID-19 patients is very high.

In conjunction with Patient Safety Awareness Week (March 14-20), ECRI will be hosting a Top 10 Patient Safety Concerns webinar on Thursday, March 18. It is our understanding that this will be at no cost and will give hospital executives an opportunity to learn more about these issues. If you have a question for us, you can reach us at info@miramedgs.com.