For the 4th year in a row, alarm-related issues top ECRI Institute's list of the top 10 health technology hazards for hospitals, but with a slight twist. There's also a new entry on the list for 2015: recall and safety alert management, reflecting a concern that facilities aren't keeping pace with the growing number of medical devices being recalled.

The emphasis on alarms has shifted this year to a focus on alarm configuration policies, including determining which alarms should be enabled, which alarm limits to use and the importance of establishing a default alarm priority level. Alarm fatigue, says ECRI, shouldn't be the only factor considered.

The new entry, "overwhelmed recall and safety-alert management programs," is No.10 on the list, with the institute citing FDA reports that the number of recalled medical devices grew from 604 in 2003 to 1,190 in 2012. Managing recalls and alerts, i.e. "receiving them, distributing them, responding to them, and documenting the process," says ECRI, "is more than an administrative task; it is a critical patient safety function."

Here are the top 10:

1. Alarm hazards: Inadequate alarm configuration policies and practices
2. Data integrity: Incorrect or missing data in electronic health records and other health IT systems
3. Mix-up of IV lines leading to misadministration of drugs and solutions
4. Inadequate reprocessing of endoscopes and surgical instruments
5. Ventilator disconnections not caught because of mis-set or missed alarms
6. Patient-handling device use errors and device failures
7. "Dose creep" : Unnoticed variations in diagnostic radiation exposures
8. Robotic surgery: Complications due to insufficient training
9. Cybersecurity: Insufficient protections for medical devices and systems
10. Overwhelmed recall and safety alert management programs

The 33-page report, "Top 10 Health Technology Hazards for 2015" which can be downloaded for free, provides details and overviews of each hazard, followed by recommended action steps.

Jim Burger