Ten years ago, ECRI named the top 10 health technology threats of 2013; these are: alarm hazards, medication administration errors using infusion pumps, unnecessary exposure and radiation burns from diagnostic radiology procedures, patient/data inconsistencies in EHRs and other HIT systems, and interoperability failures. along with five other threats related to medical devices and healthcare IT systems and technology.
In 2014, the RAEC changed the title of this annual report to “patient safety concerns” away from health technology.
Fast forward to 2023 and the final approach of the RAEC The Top 10 Patient Safety Concerns of 2023. While technology is included on this list, the titles are more about social, mental and behavioral health than just gaming technology and devices.
The child mental health crisis tops the list of patient safety concerns for 2023. This, according to RAEC, “recognizes that children and young people are facing a real crisis. The proportion of young people with mental health problems is high and growing, but resources and access are limited. The health sector must act now to protect our youngest and most vulnerable populations,” ECRI argues at the start of the report.
For each concern, the RAEC provides a snapshot of the data and an explanation of the challenge, providing context and evidence for the issue. Following the announcement, the RAEC provides Acton recommendations that hospitals and providers can consider to address the challenge.
Here is the RAEC’s main statement on the children’s mental health crisis. The primary safety implications here are lack of access to child behavioral health providers, drug and alcohol use, gun violence, and other stressors. The risk of suicide among young people has been particularly acute, as ECRI, citing CDC data, found that 39% more U.S. youth ages 12 to 17 went to emergency departments for suspected suicide attempts in the winter of 2021. more than in 2021. in the same period in 2019
In its recommendations for action, the RAC states that health care providers cannot solve this crisis on their own, but they can take specific actions to address the child mental health crisis. These actions include leadership support and resources to shift organizational culture toward behavioral health needs, patient and family engagement tactics, and warm commitment to community child mental health services, among many other constructive recommendations.
In this sobering list of safety concerns, I will explore another challenge, number 3 on the list: the uncertainty surrounding maternal-fetal medicine.
I support RAEC’s call to address this challenge as a patient as well as provider safety issue, given the politicization of access to women’s health care that has created a national as well as state level crisis for women and the people who love us.
Here is ECRI’s discussion of the needs of clinicians in times of uncertainty in maternal-fetal medicine.
The announcement of the newspaper begins with the note of RAEK. “2022 on June 24, the Supreme Court decided that the Constitution does not guarantee the right to abortion, annulling. Roe vs. Wade. In doing so, the Court returned full authority to regulate abortion to the states,” source Dobbs’ decision.
The problem statement includes a table for some data on restrictive state abortion laws and context for safety challenges.
Security issues include resource and capacity constraints, leading to an all-time high rate of provider burnout, especially in the wake of the pandemic. In addition, patients experience delays in treatment for other conditions unrelated to reproductive services. Of course, cross-border care has complicated women’s health based on the states they live in, putting health and potentially lives at risk (see this New York Times article detailing the five Texas women who sued the state , each of which deals with difficult pregnancies and situations).
Specific Actions RAEC advises stakeholders to address uncertainties in maternal-fetal medicine, including two-way communication with front-line staff to share concerns and develop guidelines for patient care (so-called “safety-level stacks”), create patient education materials for staff at state- share with patients and families on a statewide basis, offer emotional and mental health support to physicians who experience high levels of moral distress and burnout, among others.
ECRI builds this report on the top 10 patient safety issues using its years of experience in the field; their staff are experts in healthcare, including medicine, nursing, pharmacy, risk management and, of course, patient safety and quality. The team reviews the scientific literature, evaluates event reports, root cause analyses, research questions they have received over the past year, accident investigations, and many other data sources. The top 10 risks are based on severity, frequency, breadth, insidiousness (meaning the problem is difficult to recognize or hard to fix), and profile. Does this security issue place significant pressure on the organization?
Hot spots of Health Populi. Each year, ECRI informs us of their view of the top 10 patient safety challenges. Some of the challenges persist from year to year, and are shown in the final chart of the 2023 report.
Among the dozen+ security issues are drug safety, health IT, workforce staffing, telehealth and digital health risks, infection prevention and control, and health equity, which ECRI last year named #1 in its 2021 review as “racial and ethnic inequalities”.
Clearly, patient safety challenges in 2023 transcend technology itself. Our cultures of care, concern and social health have as much to do with patient safety as technological malfunctions, cleanliness and disinfection.