… emergency hospital admission. … Cecil E, Bottle A, Majeed A, et al. Factors associated with potentially missed …

Social distancing precautions due to the COVID-19 pandemic have led to increased use of telehealth. The authors of this systematic review conclude that there is insufficient evidence to determine whether remote prescribing in primary care changes antibiotic prescribing practices. Future research should further assess remote prescribing to ensure there are no negative impacts on antimicrobial stewardship.  

Health care safety is a global concern. This review examined the literature on improvement experience from developed countries and identified common themes. The authors recommend a patient-centered, systems-oriented approach built on leadership, teamwork, transparency, and communication as key elements for effectively implementing improvement efforts in developing countries.

Patients with cancer are at increased risk of medication errors in both the inpatient and outpatient settings. In this study, investigators solicited input from cancer care clinicians regarding their perception of causes and potential solutions for medication errors. Clinicians identified limited health literacy and inadequate information sharing among clinicians as barriers to providing safe care and they suggested increased patient engagement as one potential approach to improving safety.

Medication errors remain a significant source of patient harm. Although many studies have focused on the hospital setting, less is known about ambulatory medication safety. In this study, primary care physicians were asked to identify three significant problems and solutions regarding medication errors in the outpatient setting. Investigators used an innovative approach to rank the problems and solutions described by the 113 clinician respondents in the study. The top three problems identified included incomplete medication reconciliation during a transition in care, insufficient education provided to patients on their medications, and inadequate discharge summaries. Standardizing discharge summaries, decreasing unnecessary prescribing, and avoiding polypharmacy were the three highest ranked solutions. A previous PSNet perspective discussed safety in ambulatory care.

Compared with other patient safety issues, diagnostic errors have received little attention until recently. Missed or delayed diagnoses are a common reason for malpractice claims. This study sought to determine barriers and solutions to delays in diagnosis in primary care. Investigators sent a questionnaire to more than 500 clinicians and received 113 responses. Participants identified 33 discrete problems associated with delays in diagnosis and suggested 27 solutions. The main issues included inability to meet patients' care needs and inadequate communication between secondary and primary care. The top solutions included improving training of primary care doctors and enhancing communication among providers as well as between providers and patients, especially around test results. An Annual Perspective discussed diagnostic errors in more detail.

This systematic review explored many aspects surrounding patients' online access to electronic health records. Although patients seem to appreciate the access, health professionals have multiple concerns about privacy and increased workloads. No studies have reported any effects of patient online access on health outcomes.

This study found that unsolicited patient ratings of hospitals in the United Kingdom correlated reasonably well with standard measures of patient satisfaction with hospital care.

The AHRQ Patient Safety Indicators (PSIs) screen administrative data to identify cases of potential adverse events. This review analyzes studies of PSIs and other administrative data screening tools to identify how to refine the accuracy of these tools.

Despite large volumes of data generated in primary care settings, this literature review noted a paucity of data that is routinely used to measure adverse events.

Rapid adoption of digital health care technologies ("eHealth") to improve the quality and safety of care continues at an unprecedented pace. While many eHealth technologies require substantial investment, their adoption is often justified by beliefs that they support efficient and cost-effective care. Research focusing on different eHealth strategies, such as computerized provider order entry, electronic health records, e-prescribing, and clinical decision support systems, continues to grow. This study conducted a systematic review of 53 past systematic reviews assessing the impact of eHealth technologies. Investigators found that most clinical claims made about commonly used technologies were not substantiated by empirical evidence. Furthermore, their findings suggest poor grounds for arguing cost-effectiveness and raise additional concerns about the unintended risks introduced by new technologies. The authors advocate for continued vigilance in evaluating eHealth as a tool to improve patient care, including thoughtful incorporation of these evaluations into policy decisions and spending. A past AHRQ WebM&M interview discussed computerization in health care.