People with disabilities face barriers to safe, equitable care such as inaccessible equipment and facilities or provider bias. In this study, primary care and specialist physicians described challenges with caring for patients with disabilities. Many expressed explicit biases such as reluctance to care for people with disabilities, invest in accessible equipment, or obtain continuing education to provide appropriate care.

This commentary describes an incident involving diagnostic error and substandard care of a patient with disability. The author cautions against assumptions about individuals with disabilities that can compromise care. A PSNet commentary discussed the impact of diagnostic overshadowing on patient care.

Hospital-wide mortality rates are widely used as a marker of health care quality, but it remains unclear how to most accurately measure them. In this classic study, investigators provided standard hospital discharge data to four vendors who independently calculated hospital mortality rates. These methods produced varying rates of hospital mortality, and classification of hospitals as either higher or lower than average differed depending on the estimation method. These findings demonstrate that in-hospital mortality remains difficult to estimate and underscore the need for caution in considering it a marker of hospital care quality.

… study of physicians' attitudes toward professionalism. … Iezzoni LI, Rao SR, DesRoches CM, Vogeli C, Campbell EG. …

Patient safety initiatives will increasingly balance the tension between systems change and individual accountability, and medical professionalism is often at the center of this discussion. Although certain behaviors in medical school predict unprofessional behavior, efforts to teach these skills have been described, particularly in addressing disruptive behavior. This study surveyed physicians and found that nearly 70% believe that it is their professional responsibility to report an impaired or incompetent colleague. However, of those with knowledge of such a colleague, 33% failed to report them to a relevant authority. Barriers to reporting included a belief that it wasn’t their responsibility, nothing would happen from reporting them, and fear of retribution. A related editorial discusses medical professionalism in the context of this study’s findings and weighs different strategies to address the challenges. A past AHRQ WebM&M conversation and commentary also discuss professionalism and patient safety.

Confirming a phenomenon noted in prior research, this study revealed that perception of safety culture varied widely across clinical units at a single academic hospital. The study utilized the AHRQ Hospital Survey on Patient Safety Culture.

… … Jt Comm J Qual Patient Saf … This interview with Dr. Lisa Iezzoni highlights the unique safety and quality issues …

… yield in such interpretations of quality. … Weingart SN; Iezzoni LI; Davis RB; Palmer RH; Cahalane M; Hamel MB; …