Emerging Threats:
New Patient & Caregiver Issues

There are emerging threats that are keeping leaders up at night. A community of practice was developed in 2018 to provide a learning community leaders.

Dr. Gregory Botz and Chief William Adcox of MD Anderson Cancer Center comment on the following emerging threats:

• Brand Damage from Outside, Inside, and or Mixed Outside-Inside Threats including cyberterrorism.
• Workplace Violence including physical, verbal, sexual, or emotional harassment, bullying or harm to caregivers, staff, students, or patients.
• Active Shooter, Violent Intruder, and Deadly Force Incidents including events causing physical harm to staff, caregivers, students, or patients.
• Domestic Terrorism such as organized attacks using chemical, biologic, radiologic, nuclear, and explosive weapons. Also weaponization of transportation & vehicles (CBRNET)
• Violent Acts Against Leadership where administrative, clinical, or governance leaders are specifically targeted by insiders or outsiders.
• Intentional Harm of Patients by caregivers who commit harmful acts against patients with or without enablers who do not report such harm.
• Unintentional Patient Harm through errors of omission from systems failures identified by mortality reviews such as diagnostic errors.
• Failure to Rescue in pre-hospital, hospital, and post-hospital continuity of care.
• Hospital Optimization & Flow with overcrowding & boarding/transfer issues.
• Readiness for Epidemics including preparedness for testing and volume surges.
• Sexual Misconduct including sexual harassment, abuse of power, and or harm to caregivers, staff, students, or patients.
• Racial and or Sexual Discrimination against those we serve including patients and their families and or those who serve in the organization.
• Cybersecurity Patient Records Issues including breach, theft, and contamination of medical records leading to patient and caregiver harm.
• Cybersecurity Operation Issues including breach, theft, and contamination of operational records, invasion of data systems, and ransom crimes.
• Theft of Intellectual Property by insiders, outsiders, or nation-states.
• Sabotage of service, information systems, clinical care, and property.
• Nation State Influence through academic espionage, financial conflicts of interest, or other means.
• Drug Diversion by staff including caregivers and pharmacists who divert medications for themselves or others.
• Conflict of Interest of staff including physicians, researchers, and administrators including disclosed and undisclosed financial relationships.
• Conflict of Interest of Governance including undisclosed financial relationships and disclosed financial relationships.
• Academic Fraud including fabrication, falsification, plagiarism, or dishonest grant documentation including applications and reports.
• Defamation or Unfair Press by investigative reporting or false whistleblowers.
• Burn-out of caregivers, leadership, and staff.
• Critical Drug and Supply Shortages such as I.V. fluids, medications, and key supplies.
• Regulatory Compliance Issues including new risk for non-compliance.