Cultivating a Culture of Patient Safety

Patient safety is a top concern at every healthcare organization—and should be a top concern of HTM professionals, as well

Anyone who’s read ECRI Institute’s annual “Top 10 Health Technology Hazards” knows just how stark the report tends to be. Topping the list in 2018, for example, is “Ransomware and Other Cybersecurity Threats to Healthcare Delivery Can Endanger Patients.” That’s followed at No.2 with “Endoscope Reprocessing Failures Continue to Expose Patients to Infection Risk,” No.3’s “Mattresses and Covers May Be Infected by Body Fluids and Microbiological Contaminants,” and, for example—at No.9—“Flaws in Medical Device Networking Can Lead to Delayed or Inappropriate Care.”

That last hazard, the report’s authors note, has resulted (in at least one case) in data from a fetal monitor being incorrectly displayed at a nurse’s workstation. It’s also resulted (in at least one other case) in incomplete information being transferred between a ventilator and a patient monitor—a discrepancy with “the potential to cause significant patient harm.”

The purpose of the list, according to ECRI, is to help healthcare facilities identify “possible sources of danger or difficulty” with health technologies, and to take steps “to minimize the likelihood that adverse events will occur.” It isn’t meant to be comprehensive, the report notes, but a reflection of the institute’s “judgment about which risks should receive priority now.”

One manufacturer, in particular—North Andover, Mass.-based infusion system maker Ivenix—is on a mission to improve patient safety, maintains George Gray, the company’s chief technology officer. In 2017, Gray notes, ECRI named infusion systems as the No.1 health-tech hazard, and infusion-related errors account for nearly 750,000 adverse drug advents reported annually to the FDA.

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