Marginalized patients are more likely to experience adverse events and it is important to encourage effective disclosure to reinforce and reestablish trust between patients and providers. This qualitative study involving clinicians and patient safety professionals explored challenges responding to and disclosing errors involving historically marginalized patients. Participants identified multilevel challenges, including fragmentation of care and patient mistrust as well a desire for disclosure training and culturally appropriate disclosure toolkits to support effective error disclosure.

Numerous organizations promote communication with patients and families after harm has occurred due to medical error. This commentary reflects on perceived barriers to patient disclosure and describes the patient and family perspectives and needs following harm. The authors promote the use of Communication and Resolution Programs (CRP) such as the learning community Pathway to Accountability, Compassion, and Transparency (PACT) to advance research, policy, and transparency regarding patient harm.

Communication with patients and caregivers is important after a diagnostic error. Using a simulated case involving delayed diagnosis of breast cancer, this study compared how crowdsourced laypeople and patient advocates rate physician disclosure communication skills. Findings suggest that patient advocates rate communication skills more stringently than laypeople, but laypeople can correctly identify physicians with high and low communication skills.

Patient engagement and encouraging speaking up can promote safety. This randomized study found that patients undergoing cancer treatment who were randomized to an active outreach program were significantly more likely to speak up and report healthcare concerns than patients in the control group.

This qualitative study explored the long-term impacts experienced by patients and family members involved in medical harm events. Participants described psychological, social/behavioral, and financial impacts and more than half reported ongoing physical impacts.

Effective communication between patients and providers – including after an adverse event – is essential for patient safety. This qualitative study identified unique challenges experienced by parents and providers when communicating about adverse birth outcomes – high expectations, powerful emotions, rapid change and progression, family involvement, multiple patients and providers involved, and litigious environment. The authors outline strategies recommended by parents and providers to address these challenges.

… Healthc (Amst). 2021;8 Suppl 1:100496. doi: 10.1016/j.hjdsi.2020.100496. …

… and the use of metrics to track CRP functioning.  … Gallagher TH, Boothman RC, Schweitzer L, et al. Making …

Use of professional interpreters can reduce language barriers contributing to safety risks, particularly in vulnerable  pediatric populations. This survey of pediatric emergency providers found that despite caring for patients enrolled in a study of professional interpreter modalities, many respondents reported lapses in professional interpretation and commonly reported less frequent and deferred communication due to the need for interpretation.

… prevent traditional legal actions. … Sage WM, Boothman RC, Gallagher TH. Another medical malpractice crisis?: Try …

… Jt Comm J Qual Patient Saf … This commentary discusses safety … late career practitioners: four key questions. Jt Comm J Qual Patient Saf. Epub 2020 Jul 24. doi: 10.1016/j.jcjq.2020.07.001 …

This article evaluates the implementation of the We Want to Know program, which encourages hospitalized patients to speak up about breakdowns in care. Over a three-year period at one large, community hospital, the program interviewed over 4,600 patients and identified 822 (17.6%) who experienced a breakdown in care. Of those, 66.5% identified harm associated with the incident and 61.9% had spoken to someone at the hospital about it. Stakeholders (e.g., nurses, nurse managers, physicians, hospital administrators and leadership) found the program reports provided timely, actionable information and allowed for real-time responses and resolutions. Concerns cited by stakeholders included overlap with exiting patient safety reporting efforts, high level of effort and resources required, ensuring adequate responses.

This study held focus groups with breast cancer providers to better understand attitudes and experiences regarding communicating with patients about diagnostic errors. Researchers presented three hypothetical vignettes for discussion. Participants identified challenges related specifically to breast cancer as well as challenges stemming from team-based care. To improve communication about these errors, participants recommended educating patients, being honest and empathetic, and focus on the positive and the patient’s future.

This commentary reviews general aspects of the disclosure movement, supportive evidence, and challenges associated with liability concerns. The authors discuss barriers unique to radiology that have hindered acceptance of the practice and highlight how communication-and-resolution programs can support radiologist participation in disclosure conversations.

Communication-and-resolution programs are designed to build healing relationships, offer appropriate compensation, and facilitate organizational learning after a harmful medical error. Although some success has been achieved, communication-and-resolution programs have yet to be widely implemented across the health system. This commentary discusses policy, safety outcome evidence, monetary, and program design weaknesses as prominent barriers to wide-scale implementation. The authors recommend aligning the programs to foundational concepts of safety and patient-centeredness to help drive progress.

Patients are frequently encouraged to engage with health care providers as partners in safety by speaking up and sharing their concerns. Although research has shown that patients and family members sometimes identify safety issues that might otherwise go unnoticed, they may not always be willing to speak up. In this cross-sectional study involving eight hospitals, researchers used postdischarge patient survey data to understand patients' comfort in voicing concerns related to their care. Almost 50% of the 10,212 patients who responded to the survey reported experiencing a problem during hospitalization, and 30% of those patients did not always feel comfortable sharing their concerns. An Annual Perspective summarized approaches to engaging patients and caregivers in safety efforts.

High reliability fields like aviation employ policies to require that professionals retire from risky work at a certain age. Researchers interviewed health care system leaders and other stakeholders to devise recommendations for managing physicians as they age. Respondents emphasized patient safety as a guiding principle in addressing aging physicians' performance.

Disclosure of medical errors to patients and families is recommended, but such conversations can have negative consequences for all involved if done incorrectly. This commentary describes a disclosure coaching initiative, including the toolkit and tactics used to help clinicians develop skills needed to ensure appropriate and effective communication during these stressful interactions.

… J Hosp Med … J Hosp Med … Patients can play a crucial role in identifying … Safety Primer and PSNet perspective . … Fisher K, Smith K, Gallagher T, Burns L, Morales C, Mazor K. We Want to Know: … Patients' Perspectives on Breakdowns in Care.  J Hosp Med . 2017;12(8):603-609. doi:10.12788/jhm.2783 …

Physician skills can degrade with age. Other high-risk industries assess older practitioners to confirm cognitive and technical competency, but medicine has been slow to adopt this safety strategy. Exploring how to approach assessments of the aging physician, this review suggests that health care institutions and professional organizations should develop processes and policies that support appropriate skill review within the context of physician well-being and patient safety.