ECRI top 10 patient safety concerns

Recently, the good folks at ECRI revealed their report on the Top 10 Patient Safety Concerns for 2024. I don’t know that anyone would be surprised at what made the list, though I am surprised that one consideration did not show up (more on that in a moment). At any rate, the list rolls out a little something like this:

  1. Challenges transitioning newly trained clinicians from education into practice
  2. Workarounds with barcode medication administration systems
  3. Barriers to access maternal and perinatal care
  4. Unintended consequences of technology adoption
  5. Decline in physical and emotional well-being of healthcare workers
  6. Complexity of preventing diagnostic error
  7. Providing equitable care for people with physical and intellectual disabilities
  8. Delay in care resulting from drug, supply, and equipment shortages
  9. Misuse of parenteral syringes to administer oral liquid medications
  10. Ongoing challenges with preventing patient falls

As you know, this space (in all its glory) focuses on the management of risk in the healthcare physical environment, with a side of emergency management (which transcends the environment, but it’s kind of where it all started), so I was looking very carefully at how the list manifests itself as a function of the environment. Certainly, the general tenets of a culture of safety pervade the list and I like to think that, as a going concern, the culture of safety dovetails very nicely with the management of risk in the environment. And, I know there are environmental considerations that come into play when looking at the physical and emotional well-being of healthcare workers, as well as preventing patient falls (resource and asset shortages may have a link to the environment, but I don’t think, in this context, that’s as clear cut). But what surprised me is there’s really no mention of infection control as a function of the environment.

Clearly, as is evidenced in any number of regulatory surveys, the “new” sticking point in the environment is ensuring that the environment is maintained in a manner that supports/promotes the management of infection control risks. Any imperfection that can impact infection control is ripe for citation (e.g., on-intact surfaces, improper use of disinfectants, inconsistent application of disinfection processes, etc.). I suppose, when formulating any Top 10 list, there’s got to be something at number 11 and beyond, and perhaps infection control and prevention is so well-established as a concern that highlighting it doesn’t have the curb appeal that these types of lists tend to generate. I’m not sure, but (at the very least), I suspect there’s a fair likelihood that questions regarding this Top 10 list and how those concerns are being addressed might find their way into the survey process, particularly in assessing the effectiveness of leadership in modern healthcare.

About the Author: Steve MacArthur is a safety consultant with Chartis Clinical Quality Solutions (formerly known as The Greeley Company) in Danvers, Mass. He brings more than 30 years of healthcare management and consulting experience to his work with hospitals, physician offices, and ambulatory care facilities across the country. He is the author of HCPro's Hospital Safety Director's Handbook and is contributing editor for Healthcare Safety Leader. Contact Steve at