The choice to pursue a career in healthcare comes with a weighty responsibility. Every day, you make decisions that directly impact your patients’ wellbeing, at the risk of medical errors. These incidents don’t just harm patients, they carry profound emotional weight for healthcare providers.
Around 1 in 10 patients experience harm while receiving hospital care, with many of these incidents being preventable, according to the World Health Organization (WHO). For physicians, each error represents not only a clinical failure but also a personal burden that can lead to guilt and anxiety.
By understanding common safety risks you can significantly enhance patient outcomes while protecting your own wellbeing. In this article, learn about the most common risks, and evidence-based approaches for avoiding them.
The biggest patient safety risks in healthcare centers
Patient safety risks vary depending on practice setting, but several categories consistently appear across healthcare systems.
Miscommunication or lack of coordination
Communication failures are a pervasive threat to patient safety, based on Sermo data. In an internal poll, members identified the issue as the biggest patient safety risk, with 59% of votes (note: respondents could choose more than one answer). Communication breakdowns can occur between physicians and patients, among healthcare team members or across different departments during care transitions.
A U.S.-based family medicine physician on Sermo encouraged communicating directly with patients in their native language, sharing their own experience: “Being able to communicate directly with the patient in their language makes a huge difference in the patient-physician relationship. Even basic phrases show care and foster a feeling of trust…The challenge with Spanish is the wide range of variations in words and accents from country to country,” they note. “My family is from the Dominican Republic but the Spanish my Mexican and South American patients speak is VERY different. Sometimes it takes asking the same question different ways to make sure I’m understanding the person correctly.”
Lack of coordination between providers during patient transfers or among members of a surgical team can also compromise patient safety. A recent study using electronic health record (EHR) data developed a model to predict post-surgical outcomes, including prolonged length of stay and 30- and 90-day mortality. The study found that patient transfer records were the most important factor for predicting prolonged length of stay, while coordination between surgeons and technicians was critical for predicting 30-day mortality. This suggests that thoughtful care coordination can improve identification of patients at risk for adverse outcomes.
Understaffing or staff turnover
Understaffing was a close second in the Sermo poll, with 47% of votes. Adequate staffing levels are fundamental to patient safety, but many healthcare facilities struggle with staffing shortages. For example, the U.S. is facing an overall projected shortage of 187,130 physicians in 2037.
Sometimes shortages can even lead to non-physicians working outside of their scope, according to a general practitioner from Nigeria on Sermo. “This reminds me so much of what happens in many rural parts of Nigeria,” they share. “In some communities, the Community Health Extension Worker becomes the only ‘medical authority’ patients ever see. They often make decisions far outside their training, sometimes with serious consequences.”
Medication errors or adverse events
Medication-related incidents encompass a broad spectrum of safety risks. They can occur at any point in the medication process: prescribing, transcribing, dispensing, administering or monitoring. Prescribing errors often stem from inadequate knowledge about drug interactions, inappropriate dosing for specific patient populations or failure to consider patient contraindications.
Polypharmacy, the use of multiple medications simultaneously, increases the complexity of medication management and the potential for adverse interactions. Elderly patients are particularly vulnerable, as they often take numerous medications and may have altered drug metabolism that affects how medications work in their bodies, research shows. 39% of participants in the Sermo poll chose medication errors or adverse events as the biggest patient safety risk.
Delayed or missed diagnoses
Diagnostic errors received 38% of votes in the poll. The errors can result from incomplete patient histories, inadequate physical examinations, misinterpretation of diagnostic tests or cognitive biases that lead physicians toward incorrect conclusions.
Time pressures can present diagnostic challenges. If you have limited time to spend with each patient, you may miss subtle clinical cues or fail to pursue additional diagnostic workup when initial tests are inconclusive.
Cognitive factors can also play a role. Anchoring bias—the tendency to rely too heavily on the first piece of information you encounter—can lead you to pursue a particular diagnostic pathway while overlooking alternative possibilities. Similarly, confirmation bias may cause you to focus on information that supports your initial impression while dismissing contradictory evidence.
System-level failures
Technology and organizational systems, while designed to support patient care, can create safety risks. This can include alert fatigue, i.e., when a physician receives an onslaught of safety alerts, becomes desensitized to the notifications, and then misses a critical alert.
Seemingly minor system failures can cascade into significant safety incidents. A delayed lab result might lead to a missed diagnosis, while a scheduling error could result in inadequate staffing for a high-acuity patient.
According to recent polling data from the Sermo physician community, communication and coordination issues, along with system-level failures, consistently rank among the top patient safety concerns across different practice settings. This aligns with decades of patient safety research showing that most medical errors result from system problems rather than individual failures. However, Sermo members view system-level failures as less of a threat compared to the aforementioned issues, with 24% of voters selecting the response.
Evidence-based strategies for improving patient safety
In the internal poll, Sermo members shared which outcomes have the biggest effect on improving patient safety. Improving communication came in the lead (64%), followed by reducing clinician workload (58%), reducing diagnostic errors and creating a stronger safety culture with team accountability (each 41%).
You can apply several strategies to help achieve some of these aims, including:
Enhanced communication systems
Structured communication tools can reduce your risk of losing information during patient handoffs and team interactions. The SBAR (Situation, Background, Assessment, Recommendation) framework provides a standardized format for clinical communication that ensures accurate transmission of information.
Team-based communication training can help you develop skills in speaking up when you observe potential safety issues. This is particularly important in hierarchical healthcare environments where junior staff may hesitate to question senior physicians’ decisions, even when they have legitimate concerns.
Standardized protocols and checklists
You likely already have protocols in place that you use to foster patient safety. One Sermo member listed some of the steps they’ve taken in the operating room: “I put strings in my glasses to prevent them from falling during surgery, carefully handled needles and sharp blades, washed my hands for at least 5 minutes before entering the operating room, changed patients’ dressings with sterile gloves in the office to prevent falls, handled needles and surgical blades carefully, etc,” they recount.
Checklists and standardized protocols provide cognitive support during complex procedures and help ensure that you don’t overlook critical steps.
But, checklists can have their limitations, as one psychiatrist on Sermo notes. “Even when standardized tools indicate low suicide risk, clinical intuition remains essential,” they argue. “These tools can miss subtle cues or context-specific factors. Intuition—shaped by experience and relational insight—helps detect what checklists might overlook.”
Electronic health record optimization
While EHR systems can introduce new types of errors, they also offer powerful tools for improving patient safety when properly configured. Clinical decision support systems can alert you to potential drug interactions, allergies or guideline deviations at the point of care.
Interoperability between different healthcare systems allows for better care coordination when patients receive care from multiple providers. This is particularly important for patients with chronic conditions who may see specialists across different health systems.
Continuous monitoring and feedback
Regular monitoring of safety indicators allows healthcare organizations to identify trends and implement targeted interventions before incidents occur. This includes tracking traditional metrics like infection rates and medication errors, as well as indicators like patient complaints or staff concerns. Feedback systems that provide timely information to clinicians about their performance and patient outcomes can drive continuous improvement.
Leveraging technology to enhance patient safety
In the quest for patient safety, you can use technology to your advantage. Examples of devices that can support patient safety include:
- Smart infusion pumps: These devices incorporate drug libraries with predefined dosing limits and can alert you when programmed doses fall outside safe parameters. Research estimates that smart pumps can prevent 70 to 80% of infusion-related drug errors.
- Computerized Physician Order Entry (CPOE) systems: CPOE systems have transformed medication prescribing by eliminating handwriting interpretation errors and providing real-time alerts for drug interactions, allergies and dosing concerns. When combined with clinical decision support, CPOE systems can reduce medication errors by about half, research suggests.
- AI-powered diagnostic tools: AI tools may help reduce diagnostic errors. These systems can analyze medical images, laboratory results and clinical data to identify patterns that might be missed by human observers. In radiology, AI systems have shown ability to detect certain conditions, such as tumors or bone fractures, with accuracy that rivals human specialists.
- Predictive analytics: Predictive analytics can identify patients at high risk for complications before they become clinically apparent. For example, algorithms that analyze vital signs, laboratory values and other clinical data can predict patient deterioration hours before traditional monitoring would detect problems. This early warning capability allows for proactive interventions.
As you adopt new technologies, user training and ongoing support are important. Even the most sophisticated safety technology will fail if you or your patients don’t understand how to use it effectively.
Creating a culture of safety among physicians
Technology and protocols alone cannot ensure patient safety—you need to feel supported by an organizational culture that prioritizes learning over blame. A culture of safety exists when staff feels comfortable reporting errors and near-misses without fear of punishment or retribution. Training programs that teach communication skills and provide safe opportunities to practice speaking up can help.
Trust between leadership and frontline staff is fundamental. Healthcare leaders who consistently prioritize safety—even when it conflicts with productivity or financial pressures—demonstrate that it’s truly a core value rather than just a stated priority. Effective safety leadership involves regular rounds and conversations with frontline staff to understand their challenges and concerns.
Regular assessment of safety culture helps organizations understand their current state and track progress over time. Survey tools like the Agency for Healthcare Research and Quality (AHRQ)’s Hospital Survey on Patient Safety Culture (SOPS) provide standardized methods for measuring key dimensions of safety culture.
The ultimate measure of safety culture is not survey scores but rather the frequency and quality of safety reporting and patient outcomes. Organizations with strong safety cultures typically see higher rates of near-miss reporting (indicating that staff feel safe reporting concerns) combined with lower rates of actual patient harm.
Building resilience through collaborative learning
Patient safety can have dire implications, as one radiation oncologist on Sermo pointed out. “It is very important to ensure the safety of the patient in order to avoid complications such as infections, which can alter their quality of life in many aspects, such as economic, family, social and even risky for their own existence,” they assert.
Lapses in communication, diagnostic errors, system-level failures, and other factors can all compromise patient safety. The good news is that you have tools at your disposal to help prevent each issue. For example, standardized protocols and checklists, enhanced communication systems and technology like smart pumps and CPOE systems can be useful. An overall culture of safety in your workplace can make everyone on staff feel comfortable voicing potential safety threats, potentially avoiding issues before they arise.
Professional medical communities play a crucial role in this collaborative approach to patient safety. When physicians can discuss challenging cases, share experiences with safety initiatives and learn from each other’s mistakes in a supportive environment, the entire profession benefits. Sermo has more than one million members, who discuss patient safety concerns from numerous angles. Join the community to add your voice to the mix and glean advice from your peers.
