Vital Sounds 2026, Quarter 2
Vital Sounds 2026, Quarter 2
ECRI SPECIAL REPORT: Top 10 Patient Safety Concerns for 2026
May 7, 2026
ECRI SPECIAL REPORT: Top 10 Patient Safety Concerns for 2026
May 7, 2026
By Connie Christian, MBA, CPHRM
Facility Risk Management and Patient Safety Advisor
The annual report issued by ECRI and the Institute for Safe Medication Practices outlines the 10 most critical patient safety challenges anticipated to impact the healthcare industry in 2026.
From the report:
“The numbers tell the story. Preventable adverse events in US hospitals drain $17.1 billion annually.[1] Another $4.6 billion in annual US costs come from clinician burnout.[2] In addition, up to 12.6% of all health spending in high-income countries, including the United States, is on managing the consequences of unsafe care.[3] Combined, these costs represent a financial hemorrhage that no organization can afford.”[4]
The List for 2026
1. Navigating the AI Diagnostic Dilemma
In order for AI to be used effectively in diagnosis, clinicians must view it as a tool designed to supplement and support clinical expertise—not replace it. This requires a balanced approach to adoption, thoughtfully considering both the benefits and risks of AI to the diagnostic process. Clinicians who want to best utilize an AI system for diagnosis must be trained on the system’s proper use and must understand its capabilities and limitations.
2. Reduced Access to Rural Healthcare Increases Health Risks and Disparities
More than 80% of US counties lack proper access to healthcare services, including pharmacies, primary care providers, hospitals, trauma centers, and low-cost health centers. These healthcare deserts disproportionately affect rural communities as financial strains lead to widespread facility closures and diminished services across care settings. Although local tax revenues and government grants exist, there is no guarantee that these funds will continue, cover higher costs, or offset losses on services to uninsured or Medicaid patients.
3. Increasing Rates of Preventable Acute Diseases in Communities and Healthcare Settings
The resurgence of acute preventable diseases strains healthcare systems and drives unnecessary morbidity and mortality. Sustaining immunization programs, strengthening surveillance, and countering misinformation are essential. Health equity must also remain a central focus. Without equitable access to vaccines, clean water, and timely care—especially as vaccine hesitancy and misinformation continue to drive down immunization rates—the most vulnerable populations will face the greatest risk of illness and death, widening disparities and threatening to reverse decades of progress in global public health.
4. Effects of Federal Funding Cuts on Healthcare Operations and Patient Safety
Healthcare organizations are currently facing a period of tremendous financial strain. Many healthcare facilities depend on federal reimbursement programs such as Medicare, Medicaid, and grant funding to sustain essential services. In spite of financial challenges, an unwavering commitment to safety, risk management, and quality must remain the foundation of trusted healthcare.
5. Lack of Recognition and Reporting of Harm Events
Patient harm is one of the top causes of morbidity and mortality worldwide, according to the World Health Organization, which conservatively ranks it as No.14. However, because healthcare systems capture only half of the harm events that occur and act on even fewer—it is incredibly difficult to respond to, learn from, or mitigate the risk of adverse events. When organizations accurately identify and report events, risks can be addressed effectively. Moreover, patients involved in harm events can be cared for appropriately, and organizations can implement policies and procedures to decrease the likelihood of future harm occurrence.
6. Structural and Systemic Barriers Inhibit Equitable Pain Management for Women
Inequities regarding women’s healthcare are critical patient safety issues. Not only do women face unique health risks related to pregnancy, childbirth, and other reproductive conditions, they also face challenges to receiving adequate pain management due to structural and systemic barriers such as implicit bias and inconsistent guidelines. Implement comprehensive and standardized pain assessment tools that are validated across gender, age, and cultural groups. Encourage providers to adapt perspective-taking interventions during assessments by asking open-ended questions, avoiding judgment statements, and eliminating medical jargon.
7. Persistent Workforce Shortages Continue to Burden Staff and Restrict Access to Care
8. The Impact on System Improvement When a Culture of Blame Hinders Learning
Healthcare workers continue to cite fear of being shamed or disciplined for reporting errors or unsafe practices as a key barrier to reporting; thus, organizations miss opportunities to identify and rectify systemic issues. This puts patients at risk and creates a toxic work environment that makes continuous improvement impossible. Leadership is encouraged to embrace a broad view of just culture as a workplace accountability mindset, not limited to safety but inclusive of all human errors, such as service and privacy errors.
9. Emergency Department Boarding Contributes to Worse Patient Outcomes
Emergency department (ED) boarding leads to delayed/missed care, longer hospitalizations, increased readmissions, increased violence against healthcare workers, increased medication errors and adverse events, decreased infection control, decreased compliance with standards of care, higher morbidity and mortality, increased provider burnout, and decreased patient satisfaction. Establish clear processes and workflows for managing high-capacity situations. Use organizational data to measure and monitor ED throughput and boarding. Track metrics such as the number of boarded patients, boarding duration, ED patient satisfaction scores, and the number of patients who leave without being seen.
10. Persistent Gaps in Manufacturer Packaging and Labeling Design Continue to Undermine Medication Safety Efforts
Safety gaps in the design of manufacturer medication packaging and labeling (e.g., look-alike products, strengths, concentrations) have been identified as contributing factors in up to 29% of events reported to the ISMP National Medication Errors Reporting Program (ISMP MERP). Errors, particularly those that involve high-alert medications (i.e., drugs that have an increased risk of causing significant harm if used incorrectly), have contributed to significant patient morbidity and mortality. Healthcare organization leaders should ensure that high-leverage strategies—such as barcode scanning in the pharmacy and barcode medication administration—are deployed and utilized to help identify incorrect medication product selections.
More Information
Download ECRI’s Top 10 Patient Safety Concerns 2026.
The full Top 10 report offers action recommendations, resources, and references.
References
[1] Van Den Bos J, Rustagi K, Gray T, Halford M, Ziemkiewicz E, Shreve J. The $17.1 billion problem: the annual cost of measurable medical errors. Health Aff (Millwood). 2011;30(4):596-603.
[2] Han S, Shanafelt TD, Sinsky CA, et al. Estimating the attributable cost of physician burnout in the United States. Ann Intern Med. 2019;170(11):784-790.
[3] World Health Organization. Global Patient Safety Report 2024. WHO; 2024. Accessed November 24, 2025
[4] ECRI.org Top 10 Patient Safety Concerns 2026