What’s New in the Patient Safety World

May 2018

ECRI Top 10 Patient Safety Concerns for 2018



Every year ECRI Institute publishes its list of the “Top 10 Patient Safety Concerns for Healthcare Organizations”.


The list for 2018 (ECRI 2018):

  1. Diagnostic errors
  2. Opioid safety across the continuum of care
  3. Internal care coordination
  4. Workarounds
  5. Incorporating health IT into patient safety programs
  6. Management of behavioral health needs in acute care settings
  7. All-hazards emergency preparedness
  8. Device cleaning, disinfection and sterilization
  9. Patient engagement and health literacy
  10. Leadership engagement in patient safety


All 10 topics are ones we’ve covered in numerous columns. As usual, we’ll only comment on a few of this year’s topics and let you go to the ECRI document for details of these and all the others.


It should be no surprise that diagnostic errors head the list, though they were not on last year’s Top 10 list. ECRI emphasizes that diagnostic errors are the result of cognitive, systemic, or a combination of cognitive and systemic factors. ECRI acknowledges that diagnostic errors often go undetected by clinicians and healthcare organizations but data on diagnostic errors and near misses might be captured from multiple sources, such as event-reporting systems, malpractice and payment claims, patient complaints, patient surveys, autopsies, and record reviews.


Miscommunication is a common factor contributing to both diagnostic errors and internal care coordination (#3 on the list). ECRI discusses use of standardized handoff tools, checklists, and safety huddles to improve internal care coordination.


We’re glad to see workarounds on the list (#4 on the list). We’ve done numerous columns on the impact or workarounds. We encourage discussion of workarounds on Patient Safety Walk Rounds (see our February 27, 2017 Patient Safety Tip of the Week “Update on Patient Safety Walk Rounds”). Whenever you see a workaround, there is virtually always an underlying system problem that led to the use of a workaround. That system problem needs to be addressed.


The report also has links to ECRI’s many fine resources for each topic.


We’ll let you go to the full ECRI list for details. Click here to go to the ECRI Institute site where you can download the list.


Another “Top 10” list worth mention is Becker’s Hospital Review’s “10 Top Patient Safety Issues for 2018” (Vaidya 2018). Becker’s list:

  1. Disparate HER’s
  2. Hand hygiene
  3. Nurse-patient ratios
  4. Drug and medical supply shortages
  5. Quality reporting
  6. Resurgent diseases
  7. Mergers and acquisitions
  8. Physician burnout
  9. Antibiotic resistance
  10. Opioid epidemic

See the Becker’s link for details.


The lack of more overlap of these lists is striking but it’s hard to argue with either list. These are all patient safety concerns that pose significant threats to all healthcare organizations.






ECRI (ECRI Institute). ECRI Top 10 Patient Safety Concerns for Healthcare Organizations 2018; ECRI Institute 2018; March 2018




Vaidya A, Zimmerman B, Bean M. 10 top patient safety issues for 2018. Becker’s Hospital Review 2018; January 09, 2018






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