ECRI Institute on Monday released its annual list of the 10 biggest patient-safety concerns in 2020, with misuse of surgical staplers ranking No. 1.

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How ECRI made the list

ECRI is a nonprofit organization that studies how to improve patient care by addressing safety concerns "across the continuum of care," according to the institute.

For this year's list, ECRI engineers, scientists, clinicians, and other experts selected top health technology concerns based on a review of its incident investigations, medical device testing, and public and private incident reporting databases. ECRI also analyzed thousands of health-technology problem submitted to its Problem Reporting Network.

All topics selected for the list are "to some degree... preventable," according to ECRI.

The list does not represent the most frequently reported hazards or the ones with the most severe consequences. Instead, the list "reflects [ECRI's] judgment about which risks should receive priority now," ECRI said in the report. Marcus Schabacker, president and CEO of ECRI, explained the list could help "hospitals and other medical institutions to be in a better position to take necessary actions to protect patients from harm" and minimize the chance that adverse events will occur.

The 10 patient-safety concerns

According to ECRI, the top 10 patient-safety concerns for health care organizations for 2020 are:

1. Surgical stapler misuse;
2. Insufficient oversight of point-of-care ultrasound;
3. Sterile processing errors in medical/dental offices;
4. Central venous catheter (CVC) risk in at-home hemodialysis;
5. Unproven surgical robotic procedures;
6. Alarm, alert, and notification overload;
7. Connected home health care security risks;
8. Missing implant data and MRIs;
9. Medication timing errors in EHRs; and
10. Loose nuts and bolts in devices.

According to Schabacker, "Injuries and deaths from the misuse of surgical staplers" were found to be "substantial and preventable." The report stated that most surgical stapler incidents were linked to human error, with providers choosing the incorrect size or misapplying the staple, potentially resulting in "intraoperative hemorrhaging, tissue damage, unexpected postoperative bleeding, failed anastomoses, and other forms of harm." ECRI recommended that providers practice the safe use of surgical staplers with hands-on experience (Cheney, HealthLeaders Media, 10/8; ECRI, release, 10/7; ECRI report, 10/7).