- Healthcare safety organization ECRI has named racial and ethnic disparities in healthcare delivery, particularly when it comes to screening and treatments for COVID-19, as the No. 1 patient safety concern for this year.
- Overall preparedness for pandemic response and supply chain and drug shortage concerns also made the top 10 list.
- Essentially, the COVID-19 pandemic made the ECRI list because it "threatens patients and staff directly and indirectly and has been a disruptive force in healthcare and in our daily lives," the organization said. "Beyond that, the pandemic has laid bare some of the most entrenched problems in healthcare."
ECRI's 2020 list of top patient safety concerns focused on missed and delayed diagnoses and maternal health. For 2019 it highlighted the appropriate use of test results in EHRs and antimicrobial stewardship.
But for 2021, racial and ethnic disparities — which had never been on ECRI's radar in past surveys — were considered the top concern. That suggests that the organization has been prompted by COVID-19 to take a more holistic view of the issues in the U.S. healthcare system, as opposed to focusing on a few narrow concerns.
Racial disparities in healthcare delivery had long been discussed among healthcare experts, but often as a backburner issue. The fact that COVID-19-related hospitalizations and deaths impacted people of color far more than White people put the issue front and center.
For example, 77% of the COVID-19 patients who died at hospitals operated by Ochsner Health, Louisiana's largest provider, were Black. Yet only about 30% of Ochsner's patients are Black.
ECRI noted in its report that Latinos made up nearly a third of all COVID-19-related deaths even though they represent just 18.5% of the U.S. population. It also noted that maternal mortality rates are more than three times higher among Black mothers than White mothers, and that Black men are 60% more likely to die of a stroke than White men.
And while a variety of providers and payers have announced initiatives intended to promote racial equity in healthcare delivery, the consensus is that the issue will take many years to proactively address.
"Clearly, racial disparities will not disappear overnight," ECRI CEO Marcus Schabacker said in a statement. "By profiling this issue, we are calling much-needed attention to this public health crisis."
Along with racial disparities and the issues with supply chain and drugs, other big healthcare safety concerns flagged by ECRI include workflow challenges for providing telehealth services (which have boomed due to COVID-19), improvised use of medical devices, and the risk of infection involving aerosol-generating procedures — yet another issue brought to the fore by the pandemic.