In September 2024, the High Authority for Health (HAS) published its annual report on serious adverse events associated with care (EIGS) for the year 2023. This report, which is based on the declarations sent to the HAS, presents a summary of the incidents that occurred in healthcare establishments and highlights the main risks encountered in the healthcare system. The results show encouraging trends in terms of safety culture, while highlighting persistent challenges.
A significant increase in EIGS declarations
In 2023, the HAS recorded 4,083 reports of serious adverse events (SAEs)an impressive increase of 71% compared to the previous year. This figure does not necessarily reflect an increase in the number of serious incidents, but rather a better knowledge and use of the reporting system implemented by the HAS. According to the authors of the report, the increase in declarations is a sign of a progress of safety culture among healthcare professionals, more likely to report incidents with the aim of preventing them in the future.
A key point of the report highlights that almost one in two EIGS was deemed preventable. This means that these incidents could have been avoided if care had been in line with current best practices. This finding calls for continued efforts to strengthen patient safety and improve the quality of care.
Care and organisational errors top the list of reported errors
Data from 2023 shows that errors related to care or the organization of care remain the most frequent among the declared EIGS. They represent 28.5% events reported between 2017 and 2023. These errors include delays in care, errors in patient identification or even negligence in the management of medical procedures.
At the same time, the patient’s actions against himselfsuch as suicide attempts or self-harm, constitute 24.3% statements. This type of incident reveals the vulnerability of hospitalized patients and the importance of preventing psychological risks.
The report also highlights a notable development in 2023: errors related to interventional procedures (surgical or anesthetic) have been more often reported than medication errorsWhile medication errors have long dominated safety reporting, they now represent only 10.5% EIGS, against 12.5% for procedural errors. This trend reflects a growing need to make surgical procedures safer, with stricter protocols to avoid post-operative complications.
Risks associated with home hospitalization (HAD) under surveillance
The report pays particular attention to Adverse events occurring during home hospitalization (HAD)This method of care, which allows patients to remain at home while providing them with complex care, involves specific risks.
Between March 2017 and November 2022, 79 EIGS declarations in HAD were received by the HAS. Among these, Medication errors are the most commonrepresentative 43 of 79 reported cases. These errors are often linked to drug delivery device programming problemshighlighting the need to improve training for health professionals on the use of these devices.
Another critical point identified in the report is the lack of coordination between the different actors involved in the care pathway of patients in HAD, in particular between hospitals, home caregivers and community services. This failure in the coordination of care is often the cause of avoidable errors, as illustrated by an example taken from the report where a severe hyponatremia was not detected in time due to poor communication between teams.
Emergencies: errors still frequent despite recommendations
THE emergency services continue to represent a high-risk area for the occurrence of EIGS. Between January 2022 and March 2023, 195 EIGS were analyzed by the HAS. 63% of these incidents were judged avoidable or probably avoidablewhich underlines the importance of strengthening security measures in these critical environments.
The most common errors in emergency departments involve: care or the organization of carefollowed by errors related to clinic and diagnosis. The latter type of errors, such as delayed or erroneous diagnoses, constitute a major Source of concern, as they can lead to delays in treatment or inadequate care.
The report makes several recommendations to improve safety in emergency rooms, including: training of health professionals on diagnostic support tools, the suicide prevention and the better communication of medical information between teams throughout the patient’s care pathway.
Conclusion: towards continuous improvement of healthcare safety
The HAS 2023 annual report shows that, although notable progress has been made in reporting EIGS, Persistent challenges remain. The quality of the analyses remains improvable, and corrective actions must be strengthened to improve patient safety. Errors related to the organization of care, medication errors, as well as coordination failures between health professionals still represent major challenges to overcome.
In a context where healthcare safety is increasingly central, it appears essential to strengthen a safety culture based on rigorous and sustainable practices. Transparency of processes, ongoing training of professionals, as well as smooth and effective communication between healthcare teams, are essential levers for reducing incidents.
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