Diagnostic errors pose greatest patient safety risk

Providers put patient safety at risk with diagnostic errors, which they often don't know about until after patients are discharged, according to a new report from the ECRI Institute.

The patient safety not-for-profit put diagnostic errors at the top of its list of patient safety concerns for 2018, followed by opioids across the care continuum and internal care coordination.

To improve on diagnostic errors, healthcare organizations need to be more aware of them, tracking them through malpractice and payment claims, complaints, autopsies and other sources, according to ECRI.

After gathering relevant information, the next step is putting it to use, said William Marella, the ECRI Institute's executive director of operations and analytics.

“Most important? Foster a culture that truly values learning,” he said. “Diagnostic teams can debrief after cases that go well and ones that don't.”

The organization's second concern, opioids, has been top of mind recently as the fatality rate continues to rise. There were more than four times as many deaths from opioid-related hospitalizations in 2014 than there were in 2000, according to a study published in late 2017, and data from the Centers for Disease Control and Prevention show deaths from drug overdoses rose 21% between 2015 and 2016. Earlier this year, the FDA listed reducing opioid misuse as its top priority for 2018.

The ECRI Institute recommended addressing the opioid epidemic with non-opioid or non-pharmacologic solutions. It also recommended continuously monitoring high-risk patients for respiratory depression.

In the middle of ECRI's list sits “incorporating health IT into patient safety programs.” Healthcare organizations should be able to detect health IT problems, and they should incorporate health IT safety into their safety programs.

“As the technology becomes a part of daily care, it is important to test the technology throughout its life cycle to make certain that is doing what is anticipated to be its function,” said Lorraine Possanza, a program director at ECRI Institute. “Another important piece is to know that the providers are using the technology as intended,” she said.

The institute suggested treating cybersecurity as an emergency preparedness issue, which came in as No. 7 on the list. “It's important to remember that cybersecurity events are not just IT events,” Possanza said.

Cybersecurity topped the ECRI Institute's recent list of list of technology hazards for 2018. As with other patient safety risks, cybersecurity demands employee engagement. The threat is only growing: According to HHS' Office for Civil Rights' Breach Portal, in 2016, there were 10% more breaches than in 2015.

Want to continue the conversation about opioids? Join Modern Healthcare on April 25-26 at its Opioid Crisis Symposium. To learn more and register, visit ModernHealthcare.com/CCOpioids.