Patient and family engagement is essential to effective and safe diagnosis. OurDX is a previsit online engagement tool to help identify opportunities to improve diagnostic safety in patients and families living with chronic conditions. In this study, researchers implemented OurDX in specialty and primary care clinics at two academic healthcare organizations and examined the potential safety issues and whether patient/family contributions were integrated into the post-visit notes. Qualitative analysis of 450 OurDX reports found that participants contributed important information about the diagnostic process. Participants with diagnostic concerns were more likely to raise concerns about the diagnostic process (e.g., access barriers, problems with tests/referrals, communication breakdowns), which may represent diagnostic blind spots.

Patients and families are encouraged to play an active role in patient safety by, for example, reporting inaccurate or incomplete electronic health record notes after visits. In this study, patients and families at two US healthcare sites (pediatric subspecialty and adult primary care) were invited to complete a survey (OurDX) before their visit to identify their visit priority, recent medical history/symptoms, and potential diagnostic concerns. In total, 7.5% of patients and families reported a potential diagnostic concern, mainly not feeling heard by their provider.

Artificial Intelligence (AI) is used in an increasing range of health care situations to address a variety of care needs. This commentary examines the impact of AI on patient safety, in diagnosis, and on the limitations of AI that affect reliability.

Patients who access their electronic health record (EHR) through a patient portal have identified clinically relevant errors such as allergies, medications, or diagnostic errors. This study focused on patient-identified diagnostic safety blind spots in ambulatory care clinical notes. The largest category of blind spots was diagnostic misalignment. Many patients indicated they reported the errors to the clinicians, suggesting shared notes may increase patient and family engagement in safety.

… J Patient Saf … Striving for “ zero harm ” in healthcare has been advocated as a patient safety goal. In this article, the authors discuss … rather than performance goals. … Stockwell DC, Kayes DC, Thomas EJ. J Patient Saf . 2022;18(5):e877-e882. …

… J Healthc Qual … Medical errors in the neonatal intensive … patient safety . This children’s hospital implemented a robust process improvement program (RPI, which refers to … including healthcare-acquired infection. … Nether KG,  Thomas EJ, Khan A, et al. Implementing a robust process …

… J Perinatol … Patients in the neonatal intensive care unit … seven days of admission was 6.2%. … Shafer GJ, Singh H, Thomas EJ, et al. Frequency of diagnostic errors in the neonatal intensive care unit: a retrospective cohort study. J Perinatol. Epub 2022 Mar 4. …

Limited English-language health literacy (LEHL) and disadvantaged socioeconomic position (dSEP) have been shown to increase risk of adverse events and near misses. Using data from the 2017 Institute for Healthcare Improvement-National Patient Safety Foundation study, researchers found, while respondents with LEHL or dSEP experienced diagnostic errors at the same rate as their counterparts, they were more likely to report unique contributing factors and more long-term emotional, physical, and financial harm.

… take contextual factors into consideration. … Ranji SR, Thomas EJ. Research to improve diagnosis: time to study the …

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.

… … Bell SK, Bourgeois F, DesRoches CM, et al. Filling a gap in safety metrics: development of a patient-centred framework to identify and categorise …

… Hum Factors … A culture of safety is a key component to successful, sustainable patient safety … and drivers of safety culture. … Bisbey TM, Kilcullen MP, Thomas EJ, et al. Safety culture: an integration of existing …

… Acad Pediatr … This article reports findings from a survey of pediatric trainees at two large children’s … threats. Acad Pediatr. Epub 2020 Jul 17. doi: 10.1016/j.acap.2020.07.014 …

This editorial discusses priority areas for maintaining and promoting the well-being of the healthcare workforce during the COVID-19 pandemic. The authors discuss the importance of providing adequate personal protective equipment (PPE), supporting basic daily needs (e.g., provision of in-hospital food stores), ensuring frequent and visible communication, supporting mental and emotional well-being, addressing ethical concerns, promoting wellness, and showing gratitude for staff.

This article summarizes evidence-based recommendations for team-based patient care during the COVID-19 pandemic. These recommendations focus on team functioning, safety culture, and resilience. The authors discuss how individual-, team-, and organizational-level stressors, as well as work-life stressors, can affect team performance. 

… Qual Saf … Achieving “ zero harm ” has been advocated as a patient safety goal. This editorial proposes that the …

… BMJ Qual Saf … This article describes results of a cross-sectional recontact survey of Massachusetts residents … errors. Over half of respondents on the self-reporting a medical error 3-6 years ago survey stated at least one … involved in the error. … Prentice JC, Bell SK, Thomas EJ, et al. Association of open communication and the …

Using qualitative methods, this study sought to understand parent perceptions of patient safety in the NICU. The authors present a conceptual model of ‘parents as partners’ in NICU patient safety, emphasizing the importance of clinicians who are present, intentional, and respectful and highlighting factors influencing the parent-clinician partnership, such as communication and teamwork practices.

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.