How ECRI made the list

To create the list, ECRI and the Institute for Safe Medication Practices (ISMP) proposed potential patient safety concerns to be evaluated, supporting their proposals with information and evidence from scientific literature, event reports, casual analyses, and more. ECRI and ISMP also asked the public and members to nominate the patient safety issues that concerned them the most.

After receiving the proposals, a cross-disciplinary team of experts from ECRI and ISMP analyzed the supporting evidence and evaluated each topic on the following criteria:

• Severity: How seriously would patients be harmed if this safety issue occurred?
• Frequency: How likely is this safety issue to occur?
• Breadth: How many patients would be affected if this safety issue occurred?
• Insidiousness: Is this issue difficult to recognize or challenging to address once it occurs?
• Profile: Would this safety issue put significant pressure on an organization?

Using these criteria, the team chose and ranked the top 10 patient safety concerns.

The top 10 patient safety concerns for 2026

According to ECRI and ISMP, the top 10 patient safety concerns for 2026 were:

1. Navigating the AI diagnostic dilemma
2. Reduced access to rural healthcare increases health risks and disparities
3. Increasing rates of preventable acute diseases in communities and healthcare settings
4. Effects of federal funding cuts on healthcare operations and patient safety
5. Lack of recognition and reporting of harm events
6. Structural and systemic barriers that inhibit equitable pain management for women
7. Persistent workforce shortages that continue to burden staff and restrict access to care
8. The impact on system improvement when a culture of blame hinders learning
9. Emergency department boarding that contributes to worse patient outcomes
10. Persistent gaps in manufacturer packaging and labeling design that continue to undermine medication safety efforts   

According to ECRI, other safety concerns in the report highlight broad systemic challenges in the healthcare sector. For example, 195 rural hospitals have either closed or switched their inpatient services to other healthcare services since 2005, and another 757 (34% of) rural hospitals are at risk of closing, with 321 being at immediate risk. Rates of preventable acute diseases are also increasing, in part due to declining vaccination rates, difficulties with infection prevention, and misinformation.

"Rural communities are losing access to essential healthcare services. At the same time, falling vaccination rates are driving a troubling rise in preventable diseases. Vaccines are foundational to patient safety, and we are seeing decades of hard-won progress in public health erode in the fight against diseases like measles and whooping cough," said ECRI president and CEO Marcus Schabacker. "Now more than ever healthcare leaders must be proactive and creative to tackle these challenges."

ECRI also highlighted the impact of organizational culture and workforce turnover to patient safety issues. Persistent staffing shortages and a culture of blame that discourages healthcare workers from reporting safety concerns both undermine improvement efforts.

"When frontline clinicians do not feel psychologically safe reporting concerns, early warning signs of risk can be overlooked," said Dheerendra Kommala, ECRI's CMO. "Building resilient teams and fostering a workplace culture that encourages transparency and continuous learning are essential to reducing preventable harm."