… clinicians and leaders . … Linzer M, Neprash H, Brown R, et al. Where trust flourishes: perceptions of clinicians …

This systematic review analyzed results of 32 studies comparing online patient reviews (OPRs) and measures of patient outcomes. While OPRs did have positive associations with patient experience, associations between OPRs and quality measures were mixed. Due to the weight that patients give OPRs, future research should focus on associations between OPRs and encounter setting, specialty, and specific quality measures.

Clinician burnout is a pressing patient safety issue. This pre–post study found that improving clinicians' work conditions (e.g., chaos, communication, values alignment, and cohesion) led to a subsequent reduction in burnout and increased likelihood of remaining in their medical practices. The findings suggest that clinicians' satisfaction can be improved by addressing workplace conditions.

… The authors determined that reducing clinician burnout may not necessarily enhance patient safety and conclude that longer-term, standardized improvement interventions may be needed to augment health care quality. …

Providing patient-centered care calls for involving patients in all aspects of care. However, patient engagement in safety efforts remains challenging. Analyzing survey data from 21 Finnish patient safety experts, researchers determined that patient participation in maintaining their own safety varied across institutions and did not consistently meet national standards. They suggest that institutions should focus on creating a safety culture that promotes an equal partnership with patients to achieve high quality care.

A recent survey suggested that more than half of physicians in the United States have symptoms of burnout. This study examined multiple interventions aimed at improving work conditions for primary care physicians. Approximately 22% of intervention physicians showed improvements in burnout, compared to only 7% of those in the control group. Workflow interventions and targeted quality improvement projects led to fewer reported burnout and stress symptoms, while communication initiatives were associated with enhanced clinician satisfaction.

… safety , concerns persist that patient satisfaction may be more influenced by service quality rather than safety … service quality influenced overall patient satisfaction. … Rathert C, May DR, Williams ES. Beyond service quality: the mediating role of …

This survey identified communication problems as a major patient safety concern for hospitalized patients.

… their perceptions of the patient's role in safety . … Rathert C, Huddleston N, Pak Y. Acute care patients discuss …

Many factors inhibit clinicians from disclosing medical errors to patients, ranging from inadequate training in error disclosure, fear of precipitating a malpractice lawsuit, and sometimes explicit discouragement of disclosure. This article draws a sharp contrast between the traditional "deny and defend" approach to error disclosure, and the "disclose and apologize" model that has been successfully implemented at some institutions. Based on survey data, the authors argue that formal error disclosure training programs for staff not only teach important skills, but promote a values-based work environment. Health care leaders, in their view, should adopt "disclose and apologize" policies, and train employees to disclose and discuss errors as a key part of improving organizational safety culture.

The quality and safety of care in the ambulatory setting may require a different framework for assessment and improvement from that often applied in the hospital setting. The relationships between work environments and the care delivered in those environments similarly may differ between care settings. This AHRQ-funded study found that more than half of surveyed physicians reported time pressures during office visits and low control over their work, though only a quarter reported burnout. While adverse workflow and poor organizational culture were associated with adverse physician reactions (e.g., low satisfaction, stress, and burnout), there were no associations between these reactions and care quality or errors. This study builds on past analyses of these relationships from the same investigative team.

This cross-sectional field study discovered that continuous quality improvement behaviors exhibited by leaders not only impact teamwork but also moderate the relationship between teamwork and ethical climate.

This exploratory study examined the role of continuous quality improvement and psychological safety as predictors for workarounds, and found that the associations outlined could serve as a construct for future investigation.

… were correlated with suboptimal patient care. … Williams ES, Manwell LB, Konrad TR, Linzer M. The …

… and more comfortable discussing and reporting errors. … Rathert C, May DR. Health care work environments, employee satisfaction, …

In this AHRQ-funded study, investigators conducted focus groups with patients to explore health care quality and safety issues. The authors conclude that patients can provide important insight for systems improvement and error reduction.