- Patient engagement and patient health literacy have ranked among the top patient safety issues on ECRI Institute’s 2018 Top 10 Patient Safety Concerns for Healthcare Organizations.
Patient engagement and patient safety ranked nine out of the 10 items. Topping the list were diagnostic errors, opioid misuse and safety, and care coordination within a healthcare setting.
Patient engagement and patient health literacy can have a considerable influence on organization-wide patient safety initiatives. An engaged and well-educated patient can serve as a protective barrier to patient safety incidents and can support providers who are trying to prevent medical errors.
For example, patients with high health literacy will be able to communicate with their providers about their current healthcare concerns as well as potential treatment plans. Patients who are involved in the care team will know when something doesn’t sound quite right, or when a drug name is not familiar because it is not actually a part of a treatment protocol.
However, healthcare professionals are currently falling short on this front, ECRI Institute said in the 2018 report.
“We don’t do a great job of engaging patients and making sure they understand their health and healthcare,” said Josi Wergin, CPHRM, CPASRM, ELS, risk management analyst at ECRI Institute. “And we underestimate how often those failures lead to serious harm.”
Fundamentally, it is important that patients and their family members are involved in all levels of care, ECRI Institute recommended. When family members understand a treatment plan, they too will be able to catch potential medical errors.
Healthcare professionals must use the correct language when engaging patients and family members. Using simple vocabulary and laymen’s terms will help patients of all health literacy levels understand medical information. When complex medical jargon is necessary, medical professionals must explain those concepts to patients.
It would be helpful for healthcare professionals to use the patient teach back method to assess patient understanding of these educational sessions.
Clinicians can use bedside rounding, daily goal sheets, and patient coaching as opportunities to engage the patient in patient safety activities. Wergin suggested eliciting patient goals and connecting those goals to the care plan as an essential step in patient engagement.
Healthcare organizations can also partner with community outreach organizations and government agencies to better assess the social determinants of health and other barriers to full patient engagement and health literacy.
Healthcare professionals should also lean on health technology to fully engage the patient in patient safety initiatives. Adequate use of health technology came in as the fifth patient safety concern on ECRI Institute’s 2018 list.
While tools like EHRs and clinical decision support can help prevent providers from making medical mistakes, extending patient access to health technology can also prevent errors. Patients who have patient portal access, for example, can spot inaccuracies in their medical histories or medication lists. Amending these errors could be life-saving and keep patients from receiving care that is not consistent with other treatment protocols or taking a drug that will cause a life-threatening allergic reaction.
ECRI Institute did not compile this list by ranking the most dangerous or the most prevalent patient safety concerns, the organization explained.
"The list does not necessarily represent the issues that occur most frequently or are most severe. Most organizations already know what their high frequency, high-severity challenges are," said William Marella, MBA, MMI, Executive Director of Operations and Analytics of Patient Safety, Risk and Quality at ECRI Institute PSO.
“Rather, this list identifies concerns that have appeared in our members' inquiries, their root cause analyses, and in the adverse events they submit to our Patient Safety Organization," Marella added.
The full patient safety concern rankings include diagnostic errors; opioid safety across the continuum of care; care coordination within a setting; workarounds; incorporating health IT into patient safety programs; management of behavioral health needs in acute care setting; all-hazards emergency preparedness; device cleaning, disinfection, and sterilization; patient engagement and health literacy; and leadership engagement in patient safety.
ECRI Institute released these rankings as a part of National Patient Safety Week, a movement which focuses on awareness of patient safety risks as well as the strategies organizations can use to care for patient safety.