Algorithms are commonly used to guide clinical decision-making, but concerns have been raised regarding bias due to the use of race-based data. This qualitative analysis examined perspectives of 42 stakeholders (e.g., individuals, representatives from clinical professional societies or payers, etc.) regarding the use of race- and ethnicity-based algorithms in healthcare. Seven themes were identified, highlighting concerns regarding bias, algorithm transparency, lack of standardization regarding how race and social determinants are collected and defined, and the use of a social construct as a proxy in clinical decision-making.

Handoffs from one care team to another present significant risks to the patient if essential patient information is not shared or understood by all team members. Stakeholders at this children’s hospital developed a structured tool for handoff between surgery and pediatric or neonatal intensive care units. Transfer of information and select patient outcomes improved, handoff time was unchanged, and attendance by all team members increased.

… discharge counseling to discuss safe return to … s … chool/daycare, … a … ctivity restrictions, … f … ollow-up plans … e … xpected … comprehension of discharge instructions. … Uong A, Philips K, Hametz P, et al. SAFER care: improving caregiver …

Fatigue among health care workers can increase the risk of errors. This large cross-sectional study of attending and house staff physicians found that sleep-related impairment was associated with increased burnout, decreased professional fulfillment, and increased self-reported clinically significant medical error. Organizational policies should focus on reducing sleep-related impairment in order to reduce harm to patients and physicians.

This study examined variation in operative technical skills among patients undergoing colorectal and non-colorectal procedures and the association with patient outcomes. Higher technical skills were significantly associated with lower rates of complications, unplanned reoperations, and death or serious morbidity. The findings suggest that this skill variation accounts for more than 25% of the variation in patient outcomes.

Institutional betrayal occurs when a patient (or other individual) experiences a harm and the (health) systems compound that harm by failing to support or believe the patient. The authors of this commentary reflect on institutional betrayal during the COVID-19 pandemic and discuss examples of betrayal experienced by patients, family members, and medical providers.

… J Patient Saf … In this survey of clerkship directors in … of medical schools in the United States and Canada have a formal patient safety curriculum. Curricula tended to focus …

Delays in cancer diagnosis can lead to adverse patient outcomes. This systematic review examined whether smartphone-based apps can assist patients in assessing skin cancer risk and whether they should seek medical attention for suspicious lesions. The review included nine studies evaluating six different smartphone apps; reported sensitivity and specificity varied widely across studies. The authors note limitations of the included studies, such as failure to recruit a population representative of the general population. Findings are consistent with earlier studies reporting poor performance of smartphone apps for melanoma detection. Although these apps are intended to reduce delays in diagnosis, the authors conclude they can’t be relied upon for detection of all cases of skin cancer.

The authors present a case in which an unnecessary procedure was incorrectly performed on a patient who had opted to pursue hospice care. They highlight factors contributing to the error including those related to use of the electronic health record.

… infections . This AHRQ-funded study examined the effect of a collaborative to prevent adverse events in patients … in 56 intensive care units (ICUs) in 2 states over a 3-year period. The participating ICUs introduced a multifaceted intervention structured around the …

Catheter-associated urinary tract infections are considered preventable never events. This pre–post implementation project conducted in long-term care facilities employed a multimodal intervention, similar to the Keystone ICU project. This sociotechnical approach included checklists, care team education, leadership engagement, communication interventions, and patient and family engagement. The project was conducted over a 2-year period across 48 states. In adjusted analyses, this effort led to a significant decrease in catheter-associated urinary tract infections, despite no change in catheter utilization, suggesting that needed use of catheters became safer. A related editorial declares this project "a triumph" for AHRQ's Safety Program for Long-term Care.

… The American journal of the medical sciences … Am J Med Sci … Simulation has been adopted as a valuable teaching tool in health care. This commentary …

… Am J Infect Control … Am J Infect Control … This retrospective study demonstrated …