Health IT Issues Top ECRI’s List of Patient Safety Hazards

| April 7, 2015 |

Alarm hazards and data integrity issues are among the top patient safety concerns for health care organizations this year, according to a new report from the ECRI Institute, Modern Healthcare reports (Rice, Modern Healthcare, 4/6).

Report Details

The report, which is the second annual patient safety list compiled by ECRI, is based on patient safety reports that health care organizations voluntarily sent to the institute over the past year (Walsh, Clinical Innovation Technology, 4/7). Since 2009, ECRI has collected over 500,000 adverse-event reports from more than 1,000 hospitals.

Report Findings

Health IT issues topped ECRI’s patient safety list with alarm hazards cited as the top issue, followed by data integrity issues related to missing, incomplete or incorrect data in electronic health records.

The list also included:

  • Care coordination during medication reconciliation, which can be comprised by an overreliance on EHRs;
  • Reprocessing of endoscopes and surgical instruments; and
  • Medication errors related to pounds and kilograms, which can occur when EHRs are set to default settings (Modern Healthcare, 4/6).

The report noted that alarm hazards are not limited to alarm fatigue and that most alarm-related adverse events stem from configuration issues.

Rob Schluth, senior project officer at ECRI said, “In our experience, alarm‐related adverse events — whether they result from missed alarms or from unrecognized alarm conditions — often can be traced to alarm systems that were not configured appropriately” (Clinical Innovation Technology, 4/7).

Bill Marella, executive director of operations and analytics for ECRI, said that technology is “enabling us to do things we couldn’t do before … but as with any disruptive technology, it also can have unintended consequences.” He added, “It’s time to take stock and look at whether good systems are in place to prevent these kinds of problems” (Modern Healthcare, 4/6).


To address the health IT-related patient safety issues, the report recommended that health care organizations encourage staff to report all health IT problems and to increase training to help staff better understand how the technology can lead to errors (Baum, MedCity News, 4/6).

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Category: Medical Technology

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