… in patient outcomes. … Stulberg JJ, Huang R, Kreutzer L, et al. Association between surgeon technical skills and …

This article describes one academic health center’s protocol to initiate universal preoperative screening and testing for COVID-19 as they began to restore nonurgent, essential surgical care.

This cross-sectional survey of general surgery residents to assessed resident wellness and self-reported error and compared these results against National Surgical Quality Improvement Program (NSQIP) registry data to assess patient outcomes. Over a six-month period, 22.5% of residents self-reported a near-miss medical error and nearly 7% reported an error resulting in patient harm. Residents reporting harmful medical errors were more likely to report symptoms of burnout and poor psychiatric well-being, but researchers did not find any significant association between well-being and adverse postoperative patient outcomes reported in the NSQIP registry.

Reducing opioid prescribing in pain management is a key strategy to address the opioid crisis. This review highlights the unique role of the anesthesiologist in this approach. The authors emphasize preoperative identification of patients at risk for long-term opioid use and suggest organizational, clinical, and research strategies that can be led by anesthesiologists to reduce opioid use.

This systematic review of opioid stewardship practices following surgery identified eight intervention studies intended to reduce postsurgical opioid use. Organizational-level interventions such as changing orders in the electronic health record, demonstrated clear reductions in opioid prescribing. Clinician-facing interventions such as development and dissemination of local guidelines also led to reduced opioid prescribing. The authors emphasize the need for more high-quality evidence on opioid stewardship interventions.

… and changing policy . This review suggests that including a morphine milligram equivalent on opioid labels could reduce the potential for prescription-related harm. A PSNet perspective discussed opioid misuse as a patient safety problem. …

… Journal of the American College of Surgeons … J Am Coll Surg … This pre–post study applied an … cancer surgeries. The program was associated with a significant reduction in surgical site infections and an …

Standardization of care protocols has been shown to improve perioperative outcomes. This article presents the results of an evidence review to develop best practices for perioperative care around colorectal surgery. The authors acknowledge the need for local tailoring in implementing these recommendations.

… J Hosp Med … J Hosp Med … The weekend effect refers to worse patient … for staffing , illness severity, and delays in procedures. A recent PSNet interview discussed the weekend effect in …

… state that while these results are reassuring, there is a need for further study to determine the safety of …

… factors and solutions. Fear of malpractice was cited as a major reason for overtreatment. …

… JAMA Surgery … JAMA Surg … A large number of deaths in the United States have been … opioid misuse. Diversion of unused prescription opioids is a growing patient safety concern. This systematic review … pain management often go unused, are not stored in a locked location, and are rarely disposed of in compliance …

Standardization and manufacturing-focused interventions in health care may fail to consider the complexity of the surgical environment and the need to adapt in response to rapid changes during procedures. This commentary explores the application of factory approaches and complex adaptive systems in perioperative care improvement and provides two case examples to illustrate how applying such constructs resulted in effective surgical process redesign.

Analyzing data from a prior trial of flexible versus traditional duty hours, this study found that female residents perceived patient safety as worse than male residents. Changes in duty hours had mixed effects on these self-reported outcomes and seemed to exacerbate gender differences. The authors recommend further study to determine how to improve learning for trainees regardless of gender.

Surgical site infections are a persistent and costly challenge to patient safety. These guidelines provide recommendations to reduce this common hospital-acquired condition, including policies for surgeon attire, hand hygiene, and equipment sterilization.

Program infrastructure that incorporates the knowledge of staff at executive and unit levels can enable system improvements to be sustained over time. This commentary describes how an academic medical center integrated departmental needs with overarching organizational concerns to inform safety and quality improvement work. The authors highlight the need for flexibility and structure to ensure success.

… N. Engl. J. Med. … New Engl J Med … Resident physician duty hour policies have generated … rules that essentially followed the prior standard of a maximum 80-hour work week. Between these two groups, there …

… J. Am. Coll. Surg. … J Am Coll Surg … Safety culture is widely measured and … to fewer infections. Although this work does not establish a clear cause-and-effect relationship between safety culture …

This commentary explores elements of the hospital environment that can contribute to sleep deprivation and malnutrition in patients, including care complexity, hospital census, poor communication, and noise. The authors advocate for designing more patient-centered hospital systems to prevent this type of harm.

… Jt Comm J Qual Patient Saf … Jt Comm J Qual Patient Saf … Forming … describes the development of 14 clinical communities as a way to support institutional quality improvement goals in a large health care system. The authors report the benefits …