Top 10 Patient Safety Concerns 2024

As medical technologies and treatments evolve this year, patient safety remains a crucial concern. Recognizing the importance of staying vigilant about emerging threats, the independent nonprofit organization ECRI has identified the top 10 patient safety concerns for 2024.

These concerns encompass a range of issues, from barriers in medical care for marginalized groups to unintended consequences of technology adoption, highlighting the need for continued vigilance and improvement in patient safety practices. In this context, this article will provide an overview of the top 10 patient safety concerns for 2024 and their implications for patient and employee safety.

1. Workarounds with Barcode Medication Administration Systems

Barcode Medication Administration (BCMA) systems ensure medication safety by verifying the patient's identity, medication, dosage, and timing. Nurses scan the patient’s wristband and medication barcode, which the BCMA system then cross-references with the electronic health record, preventing medication errors.

However, workarounds in BCMA systems, such as when barcodes are unreadable, or medications are not listed, can cause medication errors with severe consequences. These workarounds often stem from device configuration issues, system failures, or inadequate staff training, highlighting the importance of robust training and system integrity. Ensuring BCMA systems function correctly is crucial for maintaining patient safety and preventing potentially fatal errors.

In an examination of 4,446 technology-related medication safety issues reported to ECRI and the ISMP PSO in 2019, 66% were related to barcode scanning issues, making it the most frequently reported technology issue.

If BCMA errors occur, it’s essential to convene a multidisciplinary team to review practices leading to workarounds and develop modifications supporting safe workflow. Clinical leaders should collaborate with human resources to implement a just culture approach regarding staff behaviors related to BCMA workarounds.

2. Barriers to Access Maternal & Perinatal Care

In the United States, limited access to obstetric and reproductive care poses significant risks, including pregnancy-related deaths, preterm deliveries, low-birthweight babies, and infant mortality, disproportionately affecting people of color and other vulnerable populations.

The situation is worsened by the shortage of obstetricians, with a projected deficit of 22,000 by 2050, and by inconsistent reimbursement for services. This contributes to the country's high maternal mortality rate, the worst among wealthy nations, with 1,200 annual deaths and 50,000 severe complications.

Patient engagement and advocacy are key to improving maternal care. Healthcare providers should encourage patients to express concerns and discuss postpartum resources upon discharge, ensuring care is understandable and culturally sensitive. Implementing a recognition program for staff who prevent harm boosts accountability and improvement.

Additionally, implementing a good-catch reporting program is vital for recognizing staff members who identify and prevent potential harm to pregnant and postpartum patients, fostering a culture of accountability and system improvement.

3. Challenges Transitioning Newly Trained Clinicians from Education into Practice

Physicians and nursing leaders are increasingly concerned about the challenges of transitioning newly trained clinicians from education to practice, particularly exacerbated by the pandemic. Clinicians entering practice during the pandemic missed crucial learning opportunities, with studies revealing reduced procedural training in high-risk specialties like surgery, neurology, and anesthesia for medical residents.

Studies have indicated that medical residents and newly licensed nurses have faced significant disruptions in their transition to practice programs, including decreased procedural education, changes in orientation processes, and increased workloads, leading to feelings of unpreparedness among a significant portion of new nurses.

In fact, 30% of nurses with less than two years’ experience reported that they do not feel well prepared to practice on their own.

Recommendations to combat this issue include:

• Adopting a comprehensive approach to system safety
• Integrating strong safety protocols with clinical operations to address the risks posed by inexperienced clinicians effectively
• Promote collaborative partnerships between academic and healthcare institutions to enhance hands-on and simulation-based learning opportunities for interprofessional skill development
• Implement rigorous transition-to-practice (TTP) programs featuring intensive preceptorships led by experienced clinicians to provide new clinicians with essential training and confidence to meet practice standards

4. Unintended Consequences of Technology Adoption

The widespread adoption of healthcare technologies like electronic health records (EHRs) has brought about serious risks, including patient harm and provider burnout.

With physicians spending a significant portion of their time on EHRs, concerns arise as emerging technologies like artificial intelligence (AI) and machine learning become commonplace in healthcare. While AI shows promise in medical imaging, challenges such as data quality, bias, integration, transparency, and privacy raise concerns over its safety and effectiveness, potentially compromising patient safety.

Healthcare leaders should identify factors like staffing shortages, burnout, and cognitive overload that may lead to overreliance on or misuse of AI and emerging technologies. Employ clinically informed human-factors-engineering methods to assess clinical workflows, including EHR modifications, for potential impacts of new technologies.

5. Ongoing Challenges with Preventing Patient Falls

Patient falls remain a significant patient safety concern in 2024, leading sentinel events reported to The Joint Commission despite increased targeted interventions.

Implementing comprehensive fall prevention strategies involves risk assessments tailored to individual profiles and customized care plans addressing various aspects such as patient education, environmental adaptations, and staff training. Additionally, creating a safe environment through purposeful rounding, incorporating rehabilitation exercises, utilizing incident management software, and educating patients and families are vital components in effectively reducing fall incidents.

These strategies highlight the need for comprehensive measures to reduce patient falls and improve safety.

6. Decline in Physical and Emotional Well-Being of Healthcare Workers

The COVID-19 pandemic has exacerbated the already challenging work environments faced by healthcare workers, significantly impacting their emotional and physical well-being. As of October 2023, U.S. healthcare employment remains substantially below projected levels, highlighting the ongoing strain. Furthermore, data from 2022 revealed alarming rates of burnout among healthcare workers, with a significant portion experiencing symptoms of anxiety and depression, underscoring the magnitude of the issue.

Leaders play a pivotal role in combating burnout by:

• Promoting staff well-being through destigmatizing behavioral health needs, transparency, and fostering personal connections.
• Securing board support and engaging departmental leaders to prioritize workforce well-being
• Enhancing recruitment and retention strategies to further alleviate burnout and bolster patient safety

7. Complexity of Preventing Diagnostic Error

Diagnostic errors, leading to improper or delayed treatment, adversely affect patient outcomes and inflate healthcare costs. Enhancing diagnostic accuracy amid complex medical scenarios is crucial, necessitating targeted strategies to minimize these errors within healthcare systems.

To decrease the rate of diagnostic error, healthcare organizations can:

• Utilize various mechanisms to ensure effective communication of patient data
• Prioritize interoperable health technology
• Align improvement goals with benchmarks
• Promote patient engagement and shared decision-making
• Analyze social determinants of health data to reduce disparities
• Strengthen causal analysis processes
• Share lessons learned for organizational improvement, leveraging resources from organizations like the Society to Improve Diagnosis in Medicine

8. Providing Equitable Care for People with Physical and Intellectual Disabilities

Despite the Americans with Disabilities Act (ADA) being enacted over 30 years ago, barriers to accessible healthcare for individuals with physical and intellectual disabilities persist, including communication, physical, policy, programmatic, and transportation challenges.

These barriers contribute to one in four adults aged 18 to 44 with disabilities lacking a dedicated healthcare provider.

In promoting disability-inclusive healthcare, organizations must ensure full and equitable access to services in compliance with ADA and local regulations, addressing requirements for service animals, parking, and mobility and communication devices. Patient and family engagement should prioritize assessing and documenting health literacy and consent capacity, providing ample time for understanding and collaboration on care plans, and discussing potential barriers like transportation or scheduling.

Healthcare organizations must establish robust infrastructure and systemic processes to enable clinicians to deliver equitable care to patients with disabilities and ensure that no individual is denied care.

9. Delay in Care Resulting from Drug, Supply, and Equipment Shortages

In mid-2023, the US healthcare system experienced shortages of 309 drugs—the highest number since 2014. Many of these drugs (e.g., central nervous system agents, antimicrobials, fluids/electrolytes, chemotherapy drugs, hormones) are medically necessary for critically or chronically ill patients.

These shortages can impact patient outcomes by delaying essential treatments like surgeries or diagnostic procedures. Healthcare organizations must proactively address supply chain disruptions, implement contingency plans, and collaborate with suppliers to mitigate the impact of shortages on patient care.

This may include conducting regular inventory checks for critical supplies and assessing risks to prioritize vulnerable items; advocating for transparency from suppliers regarding sourcing and alternative acquisition plans; evaluating the feasibility of transitioning suppliers to domestic or friendly-shore manufacturers to mitigate geopolitical risks; and comparing costs and benefits of sole-source and multisource agreements.

10. Misuse of Parenteral Syringes to Administer Oral Liquid Medications

The misuse of parenteral syringes to administer oral liquid medications poses a serious risk to patient safety.

Parenteral syringes are primarily designed for administering medications or fluids directly into the body through routes other than the digestive tract, such as intravenous, intramuscular, or subcutaneous injections. However, they may also be used to administer oral medications in certain situations, particularly when the patient cannot swallow or absorb medications orally.

This practice can lead to medication errors, contamination, and infections, jeopardizing patient health. To mitigate this risk, oral or enteral syringes with specially designed hubs can be consistently used for preparing and administering small-volume oral/enteral liquids, preventing attachment to standard IV lines, and reducing the likelihood of medication errors.

Ready to make care safer? 

Performance Health Partners’ incident management system is pivotal in addressing healthcare challenges by enabling real-time data analysis for targeted interventions, improving patient safety and staff well-being.

Incident reporting software helps healthcare organizations identify and prevent patient safety issues proactively, reducing adverse events while enhancing outcomes and maintaining a safe work environment.