Leadership across all levels of a health system plays an important role in patient safety. In this study, researchers administered the Safety, Communication, Operational, Reliability, and Engagement (SCORE) survey to 31 Midwestern hospitals to evaluate how leadership behaviors influenced burnout, safety culture, and engagement. Findings indicate that local leadership behaviors are strongly associated with healthcare worker burnout, safety climate, teamwork climate, workload, and intentions to leave the job.

The COVID-19 pandemic increased symptoms of physician burnout, including emotional exhaustion, which can increase patient safety risks. This cross-sectional study examined emotional exhaustion among healthcare workers at two large health care systems in the United States before and during the COVID-19 pandemic. Respondents reported increases in emotional exhaustion in themselves and perceived exhaustion experienced by their colleagues. The researchers found that emotional exhaustion was often clustered in work settings, highlighting the importance of organizational climate and safety culture in mitigating the effects of COVID-19 on healthcare worker well-being.

… J Patient Saf. … Psychological safety (PS) is integral to … Safety WalkRounds and Positive Leadership WalkRounds ). … Adair KC,  Heath A, Frye MA, et al. The Psychological Safety … metric for the ability to speak up in healthcare settings. J Patient Saf. 2022;18(6):513-520. …

Teamwork is an essential component of patient safety.  This cross-sectional study of 50,000 healthcare workers in four large US health systems found that the teamwork climate worsened during the COVID-19 pandemic. Survey findings indicate that healthcare facilities with worsening teamwork climate had corresponding decreases in other measured domains, including safety climate and healthcare worker well-being. The researchers suggest that healthcare organizations should proactively increase team-based training to reduce patient harm.

… Jt Comm J Qual Patient Saf … Health system leadership practices can …

… J Perinatol … High levels of healthcare worker (HCW) burnout … and patient safety climate amid the COVID-19 pandemic.  J Perinatol . 2021;41(5):961-969. …

… Jt Comm J Qual Saf … Healthcare workers may experience distress … highlighting the importance of support programs . … Sexton JB, Adair KC, Profit J, et al. Perceptions of institutional …

This study administered the Safety, Communication, Organizational Reliability, Physician, and Employee burnout Engagement (SCORE) staff survey to general practice staff in the UK to assess safety culture over 9-12 month intervals with structured feedback, targeted interventions, and staff engagement after each survey round. This approach can be used with time and resource constraints to identify safety culture domains requiring immediate attention and engage with staff to develop solutions.   

… Jt Comm J Qual Patient Saf … Jt Comm J Qual Saf … This study used a brief survey to evaluate …

Prior research has found that perceptions about safety climate varies across neonatal intensive care units (NICUs). This large cross-sectional study examining the impact of caregiver perceptions of safety climate on clinical outcomes found that stronger safety climates were associated with lower risk of healthcare-associated infections, but climate did not affect mortality rates.

… J Patient Saf … J Patient Saf … Prior research has shown that health care …

Burnout is a highly prevalent patient safety issue. This survey study examined work–life balance and burnout. Researchers validated a novel survey measure for work–life balance by asking participants to report behaviors like skipping meals and working without breaks. Residents, fellows, and attending physicians reported the lowest work–life balance, and psychologists, nutritionists, and environmental services workers reported the highest work–life balance. Time of day and shift length also influenced work–life balance: day shift had better scores compared to night shift, and shorter shifts had better scores than longer shifts. The work–life balance score also clustered by the work setting: individuals with different roles within a given setting (such as the intensive care unit, the emergency department, or the clinical laboratory) had more similar work–life balance. Those with higher work–life balance reported better safety culture and less burnout. The authors suggest that burnout interventions target work settings rather than individuals, because work–life balance seems to function as a shared experience within health care settings.

Physician burnout is a highly prevalent patient safety concern. Researchers employed data from the American Medical Association to survey United States physicians about burnout and safety. Of 6586 respondents, 54% reported burnout symptoms, consistent with prior studies. More than 10% of respondents reported a major medical error in the prior 3 months, and these rates were even higher among physicians that had symptoms of burnout, even after adjustment for personal and practice factors. The majority of physicians graded their work unit safety as excellent or very good. The authors conclude interventions to improve safety must address both burnout and work unit safety. Because the survey response rate was less than 20%, it is unclear whether these findings reflect practicing US physicians more broadly. An Annual Perspective summarized the relationship between clinician burnout and patient safety.

… the relationship between burnout and patient safety. … Sexton JB, Adair KC, Leonard MW, et al. Providing feedback following Leadership …

… balance. In a previous PSNet interview , the lead author, J. Bryan Sexton, discussed resilience, burnout , and safety culture . …

Health care organizations measure safety climate by surveying providers and staff at all levels. Investigators assessed safety culture and teamwork in 44 neonatal intensive care units using two different survey tools—the Safety Attitudes Questionnaire and the Hospital Survey on Patient Safety Culture. They found significant variation in safety and teamwork climate scales of both tools, indicating that the instruments should not be used interchangeably.

The ambulatory care environment presents a range of challenges to patient safety. This review explores medical errors in ambulatory pediatric care and reviews strategies to improve safety in this setting, including structured communication tools and analysis of failures to develop safer systems.

Leadership WalkRounds, in which senior leadership visits directly with frontline staff on their clinical units with the goal of identifying and addressing safety concerns, has shown potential as a means of improving safety culture. However, initial enthusiasm for this approach has been tempered by a recent qualitative study and a randomized trial—both showed that walkrounds had little effect on safety culture. Conducted in 44 neonatal intensive care units, this cross-sectional study found that units who received feedback from walkrounds had lower rates of burnout and more positive perceptions of safety culture. The results of this investigation may help explain why walkrounds were not associated with improvements in other studies—when walkrounds are performed in a perfunctory fashion or when senior leadership does not systematically follow up on issues identified, frontline workers may become cynical and perceptions of safety culture may actually worsen.