ECRI Institute Says Diagnostic Errors Pose Greatest Patient Safety Challenge in Ambulatory Care

An ECRI Institute study identifies five key threats to patient safety in ambulatory care, naming diagnostic errors as the most prevalent. According to Modern Healthcare, the analysis, which includes data from ambulatory care centers, community health centers and physician practices, “found that diagnostic testing errors represented 47% of all patient safety events reported in an outpatient setting over a one-year period.” ECRI Institute Patient Safety Organization’s Carol Clark says, based on the volume and complexity of diagnostic testing in outpatient services, “there’s a lot of opportunity for error.”

In its Safe Ambulatory Care executive brief, ECRI Institute cites medication errors as the second largest cause for patient safety concern, followed by falls, HIPAA violations and security incidents. A press release issued by the organization summarizes the following recommendations and solutions for each challenge.

• Because the majority of diagnostic testing errors result from laboratory tests, providers should have decision support tools and monitoring systems for test tracking and follow-up.

• Adverse events related to medication safety often occur because of “a series of failures within a system.” Ambulatory care settings should implement standardized “medication management procedures” and create policy that directs staff on “how to report and manage safety events.”

• The majority of patient falls occur in exam or waiting rooms. Health care providers should proactively screen and identify patients that may be at high risk.

• HIPAA violations often result from “inadvertent disclosure of patients’ protected health information.” Adverse events can be reduced through improved understanding of privacy and security rules.

• Verbal or physical threats and disruptions caused by patients or visitors can be addressed through staff education on security and safety incidents and monthly surveillance rounds.

In an overview of the report, ECRI Institute says it featured ambulatory care in its eighth “deep dive analysis” on patient safety because the setting “represents the largest and most widely used segment of the healthcare system,” providing “a diverse array of services to patients, from consultation and diagnosis to treatment and intervention.” Due to the complexity of the outpatient environment, it recommends that strategies for reducing adverse events focus on teamwork, communication and collaboration, and “training, support and organizational culture must echo these goals.”

Click here to download the full report.

MLMIC offers a number of resources that can help policyholders implement effective risk management strategies for the patient safety challenges identified by ECRI:

• Breach Notification Under HIPAA – When Health Information is Compromised, a blog post highlighting common ways Protected Health Information can become compromised;

• Report: Three Major Disease Categories Account for Three-Fourths of All Serious Harms from Diagnostic Errors, a blog post on preventing misdiagnosis-related harm;

• Maintaining Patient Confidentiality, a risk management tip highlighting routine office practices that carry an inherent risk of patient confidentiality breaches;

• Prescription Medications and Patient Safety, a risk management tip on the importance of attention to detail in prescribing and monitoring the use of medications;

• Tracking Test Results, a risk management tip with recommendations for procedures related to receiving, reviewing, and addressing test results;

• Managing Medication Samples, a risk management tip on safely managing medication samples to prevent medication errors and subsequent patient injuries; and

• Communicating and Following-Up Critical Test Results, a risk management tip with recommendations for developing policies and procedures that ensure test results are received, reviewed, documented and communicated accurately.