Pediatric Mental Health Crisis is ECRI Top Patient Safety Threat

The pediatric mental health crisis tops ECRI’s 2023 list of most pressing patient safety concerns.

According to a study in JAMA Pediatrics, rates of anxiety and depression in children aged 3-17 increased by 29% and 27%, respectively, in 2020 compared with 2016. The mean weekly number of emergency department visits for adolescent suspected suicide attempts was 39% higher in winter 2021 than in winter 2019, according to the Centers for Disease Control and Prevention.

ECRI’s experts identify several recommendations to address the crisis including performing universal mental health screenings during every office and hospital visit, making personal connections between pediatric mental health providers and patients/families (i.e., warm handoffs), and providing additional support to address social determinants of health.

The top 10 patient safety concerns for 2023 are:

1. The pediatric mental health crisis
2. Physical and verbal violence against healthcare staff
3. Clinician needs in times of uncertainty surrounding maternal-fetal medicine
4. Impact on clinicians expected to work outside their scope of practice and competencies
5. Delayed identification and treatment of sepsis
6. Consequences of poor care coordination for patients with complex medical conditions
7. Risks of not looking beyond the “five rights” to achieve medication safety
8. Medication errors resulting from inaccurate patient medication lists
9. Accidental administration of neuromuscular blocking agents
10. Preventable harm due to omitted care or treatment

Some issues on the safety concerns list are related to specific clinical practices and device malfunctions, but many are exacerbated by ongoing staffing shortages — including the pediatric mental health crisis, violence against healthcare staff, mismatches between assignments and competencies, poor care coordination and missed care opportunities.

ECRI and its affiliate, the Institute for Safe Medication Practices, analyzed a wide scope of data to identify the most pressing threats to patient safety, including scientific literature, patient safety events, concerns reported to or investigated by ECRI and ISMP, client research requests and queries and other internal and external data sources. The recommendations in this report are intended to help healthcare organizations create organizational resilience to navigate these threats and strive for total systems safety.