Healthcare News & Insights

Top 5 patient safety concerns all hospitals should review

179994446Patient safety should be a No. 1 concern at all hospitals. But when it comes to the topic, there are so many aspects to address. What should your facility look at first? 

To help facilities decide where to focus patient safety efforts, ECRI Institute has developed a list of the top 10 patient safety concerns for healthcare organizations.

Top 5 patient safety concerns

The list was compiled from a database of 300,000 events that were voluntarily submitted to ECRI’s patient safety organization. It’s based on recurring trends that were identified from the data. It’s intended to be a guide for hospitals to create their own list of patient safety priority initiatives. Review it and see which ones apply the most to your organization.

While ECRI’s list has the top 10 concerns, here’s a sneak peak at the top five:

1. Data integrity failures. Due to the push from the federal government to adopt electronic health records (EHR) systems, their use has more than tripled since 2009. And these systems are managing a lot of information. Properly designed systems are very beneficial to improving patient care, but poorly designed systems can be detrimental to patient care.

Missing data, data entry errors, copying and pasting errors, and so much more can compromise patient data. To safeguard against such errors, hospitals should:

  • assess the clinical workflow to see how front-line staff use the data
  • test the system to verify it’s working as intended
  • provide training and support, and
  • have a system in place for users to report problems.

2. Care coordination. Patient care coordination is up to all of the patient’s providers. It’s a shared responsibility. But in so many instances the ball is dropped by someone — say, for example, important discharge information isn’t transferred from a hospital to a skilled nursing facility, or between a hospitalist and a primary care physician.

Often, however, staff in hospitals are overwhelmed trying to identify all of a patient’s providers. That’s why it’s important that patients be involved in their own care, and physician practices post phone and fax numbers on their websites.

Another way to improve care coordination, especially in smaller communities, is for providers to install EHR systems that are compatible with the areas’ hospitals.

3. Test results reporting errors. Ten percent of all 2,420 events reviewed for the analysis were test result reporting errors. These can include a delay or a failure in getting the results to the proper provider, and data being entered wrong.

While EHR systems are a big help in reporting test results, they aren’t foolproof. That’s why all facilities have to have policies and procedures in place to guide the reporting of test results, and provide staff with training on the policies.

Make sure your policy addresses:

  • Who gets the test results?
  • What’s the process for reporting abnormal findings?
  • Is there a designated backup providers if the ordering physician is unavailable?
  • How long does a provider have to review the test results?
  • How are the results communicated to the patient?

4. Drug shortage. Hospitals should create a proactive plan for managing drug shortages. One hospital contacted the PSO and wanted to know if it was OK to use its remaining supply of expired drugs, since they were unable to replenish its supply of an injectable unit-dose medication stored on its crash carts for patient resuscitation.

As you know, not all drugs are available at all times. Organizations need a plan to be alerted when there’s a drug shortage. That’s why you should have someone responsible for tracking shortages that affect your organization’s supplies.

Two good resources for alerts on drug shortages are the U.S. Food and Drug Administration ( FSDS) and the American Soceity of Health-System Pharmacists’ (ASHP).

In addition to tracking, make sure you document drug shortages, approve alternatives and document all adverse drug events to determine if they may have been caused by shortages.

5. Failure to handle behavioral health patients. From reports to ECRI’s PSO, doctors, nurses, security officials and ancillary staff have a difficult time handing patient with behavioral issues — especially psychiatric issues — in an acute-care setting. Often these patients are violent and cause harm to themselves, other patients and staff.

Especially in the emergency room, educate staff warning signs of possible behavioral issues such as: shouting, demanding behavior, physical restlessness and tension, excessive fear or paranoia, cursing, insulting remarks or resisting treatment.

This is one area where more attention needs to be paid, noted the ECRI report. Historically there’s been a gap between acute care and behavioral health care. Facilities need to increase healthcare staff’s understanding of behavioral health symptoms that can appear anywhere throughout the care spectrum.




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  1. Barry Elliot says:

    Patient safety is a serious issue. While sentinel events continue to
    happen in healthcare, the bottom line is no one wants patients getting
    hurt. Linda Butler, MD, chief medical officer at Rex Hospital in
    Raleigh, N.C., says the key to reducing harm is taking on responsibility
    to change: “As healthcare providers, we track many [sentinel] events
    and strive to have rates that approach zero. The use of technology and
    safety systems have lowered some of our rates and improved our outcomes.