Diagnostic errors are the top patient safety concern for the third year in a row, according to ECRI’s Top 10 Patient Safety Concerns 2020 report.

The independent nonprofit ranked the issue as number one, followed by maternal health in spot number two. The annual report aims to inform providers about the most serious challenges to patient safety across the continuum of care, and provides suggestions for addressing them.

"This is a reflection of greater awareness," Robert Giannini, patient safety analyst and consultant of ECRI, told HCB News in regard to diagnostic errors as the number one patient safety concern. "Part of this is due to the attention that the National Academy of Medicine’s 2015 report — 'Improving Diagnosis in Health Care' — brought to the topic, but availability of health information, community awareness and research have increased related to diagnostic errors. This has occurred not only in the healthcare community, but also includes the patient and family members as well."

Based on an analysis of more than 3.2 million patient safety events, the release of the report coincides with Patient Safety Awareness Week, which runs from March 8 – 14.

Diagnostic errors are characterized as missed and delayed diagnoses, and are commonly caused by communication failures of information. This prevents the right person from initiating the right action at the right time of care, and can lead to patients suffering, adverse outcomes, and death. Previous versions from 2018 and 2019 also ranked diagnostic errors as the top concern for patient safety.

Maternal health across the continuum was ranked second due to the approximate 700 women who die from childbirth-related complications each year in the U.S., with more than half of these deaths preventable.

Ranking behind it are early recognition of behavioral health needs; responding to and learning from device problems; device cleaning, disinfection, and sterilization; standardizing safety across the system; patient matching in the EHR; antimicrobial stewardship; overriding automated dispensing cabinets; and fragmenting across care settings.

The report lists different tactics for addressing each safety concern, including greater communication and collaboration among staff, as well as the implementation of various policies, programs and committees for ensuring the proper completion of tasks and smooth workflows.

"A majority of patient safety issues occur as a result of gaps in patient care delivery, especially with reference to the system or process supporting the care delivery task or function, communication, and the coordination of the patient’s care," Carol Clark, director of the ECRI Patient Safety Organization, told HCB News. "These gaps are a reflection of the complexity of healthcare today, in which there is a continuum of care that crosses acute and chronic care in many different types of settings including hospitals, outpatient care, home care and long term care, requiring collaboration, both physical and electronic, with an array of patients or residents, provider organizations and agencies."

ECRI also points out that the current Coronavirus outbreak is a concern that providers and patients should take seriously.

“While the rapidly evolving COVID-19 disease outbreak occurred after the items in this list were set, we acknowledge that it is clearly among the top patient safety concerns of the year — and ECRI is committed to helping organizations prepare and respond,” said Dr. Marcus Schabacker, president and CEO of ECRI, in the report.