What are the Top 10 Technology Hazards in 2014? (Part 1 of 2)

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MTR-thumb2The ECRI Institute released its 2014 list of health care’s top 10 technology hazards last month, and the contents of the list should prove beneficial to most organizations, reports Cheryl Clark for HealthLeaders Media.

So, in a manner that would do Casey Kasem proud, let’s count down these top 10 technology hazards, starting with the last five in today’s post and continuing with the second five in tomorrow’s post.

Coming in at No. 10 on the ECRI list: “retained devices and unretrieved fragments.”

As Clark notes, this particular hazard hasn’t made an appearance on the list for the past three years. What brought it back?

Several factors actually: “A 2012 Pennsylvania patient-safety reporting system found 452 retained surgical items in 2011, one third of which caused patient harm; a recent analysis of 9,744 malpractice settlements and judgments between 1990 and 2010 found nearly half involved a retention of a surgical item; and a recent Sentinel Event alert from the Joint Commission noted 772 such incidents reported to the Sentinel Event Database from 2005 to 2012, including 16 resulting in patient death.”

At No. 9 on the list is “robotic surgery complications due to insufficient training.”

This is a new entry on the list, Clark writes, probably because of the increased use of such robotic-surgical systems as Intuitive Surgical’s da Vinci Surgical System.

According to ECRI, the “initial training by the device supplier ‘is intended to help users become familiar with the system and the supplier suggests ways surgeons can get specific training. However, the supplier’s program does not teach trainees how to perform specific surgical procedures. Thus it is up to the hospital to verify that surgical staff have the necessary procedure-specific skills.'”

Clocking in at No. 8, “risks to pediatric patients from ‘adult’ technologies.”

In its second appearance on the ECRI list, the Institute expresses its concern that “many hospital systems are not configured for children.” ECRI points out that EHR systems “may not facilitate the recording and review of important pediatric-specific data, such as vaccinations, or may not allow both height and weight to be viewed on the same screen, which in turn can contribute to vital information being overlooked.”

At No. 7, we have “neglecting change management for network devices and systems.”

This item is also making its grand debut on the ECRI list, mainly because hospitals don’t seem to fully grasp the consequences that “updates, upgrades, or modifications made to one device or system have on other connected devices or systems.” This warning extends from EHR software updates to Windows 7 upgrades.

“When making changes to interfaced systems, closely monitor the systems after the change is made to ensure their safe and effective performance,” ECRI advises.

Next on the list, No. 6, is “inadequate reprocessing of endoscopes and surgical instruments.”

This has been named as a technology hazard by ECRI for five years now, Clark writes, noting that “problems with disinfection of endoscopes have resulted in transmission of hundreds of infectious disease-causing organisms. But this year, ECRI has added improper sterilization of other surgical devices, such as an arthroscopy shoulder cannula and a broncoscopy scope.”

ECRI warns that a hospital’s reputation, patient-satisfaction scores, and financial health and well-being can all be threatened by the inadequate processing of instruments.

Have you or your organization experienced the consequences of any of these hazards? How did you confront these threats and improve processes so that the hazard was minimized? What advice would you give to your colleagues who are reading this?

-by Pete Fernbaugh

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