Burnout among healthcare workers is widespread and can threaten patient safety. This article summarizes the individual, organizational, and culture factors contributing to perioperative physician burnout, how burnout impacts surgical patient care, and strategies to mitigate perioperative physician burnout.

For incidents to be properly addressed, incident reports must be appropriately identified and categorized by safety managers. This study compared the categorization of incidents as involving health information technology (HIT) or not involving HIT by specialists trained in HIT and patient safety and safety managers trained in traditional methods of health safety. Safety managers only agreed with the HIT specialist classification 25% and 75% of the time on incidents involving or not involving HIT, respectively. Increased education for safety managers on the interaction of HIT and patient safety may result in better classification of HIT-related incidents.

Real-time use of artificial intelligence in the operating room allows surgeons to avoid or immediately address intraoperative adverse events. This review summarizes 13 articles published since 2010 that report on the use of artificial intelligence to predict intraoperative adverse events. Most studies used video and more than half were intended to detect bleeding.

Cognitive aids, such as checklists and decision aids, can reduce omissions in care and improve patient safety. This systematic review including 13 randomized trials found that cognitive aids in clinical emergencies reduced the incidence of missed care steps (from 43% to 11%) and medical errors, and improved teamwork, non-technical, and conflict resolution scores.

COVID-19 restrictions and patient safety concerns have greatly expanded the use of telehealth and virtual visits. Through patient satisfaction surveys and patient complaints, this US hospital evaluated the quality and safety of virtual visits in March and April of 2020. Five patient complaints were submitted during this timeframe and overall patient satisfaction remained high. Safety and quality risks were identified (e.g., diagnostic error) and best practices were established.

The COVID-19 pandemic has exacerbated existing challenges associated with diagnostic error. This study used natural language processing to identify and categorize diagnostic errors occurring during the pandemic. The study compared a review of all patient safety reports explicitly mentioning COVID-19, and using natural language processing, identified additional safety reports involving COVID-19 diagnostic errors and delays. This innovative approach may be useful for organizations wanting to identify emerging risks, including safety concerns related to COVID-19.

… medical interns to correctly diagnose dizziness. … Kotwal S, Fanai M, Fu W, et al. Real-world virtual patient simulation to …

Diagnostic over- and under-confidence in primary care can result in misdiagnosis, impacting millions of patients every year. This intervention study evaluated the effect of peer input on diagnostic confidence on cases with diagnostic uncertainty. In cases with high diagnostic uncertainly, peer input increased provider confidence.

… electronic safety reporting systems and daily huddles . … Desai S, Eappen S, Murray K, et al. Rapid-cycle improvement during the …

This study examined the prevalence and risk factors for COVID-19 infection among frontline healthcare personnel who work with COVID-19 patients. Serum specimens were collected from a convenience sample of 3,248 frontline personnel between April 3 and June 19, 2020.  Six percent (6%) tested positive for SARS-CoV-2 antibodies; a high proportion of these individuals did not suspect that they had been previously infected. This study highlights the role that asymptomatic COVID-19 infections play and authors suggest that enhanced screening and universal use of face coverings in hospitals are two strategies to reduce COVID-19 transmissions in healthcare settings.

… longer work hours. … Finn KM, Halvorsen AJ, Chaudhry S, et al. Does increased schedule flexibility lead to change? …

This article describes the development of a COVID-19 exposure disclosure checklist which reflects five core competencies for effective disclosure conversations with patients and families. The authors discuss disclosure with persons who have limited English proficiency, undocumented and immigrant patients, and patients with specific health needs.

… This paper describes one large academic medical center’s implementation of a Feedback to Reporter program in …

… cause  harm  to patients. … Morgan DJ, Dhruva SS, Coon ER, Wright SM, Korenstein D. 2019 Update on Medical Overuse: A Review …

Nearly 1 in 7 internal medicine residents reported being the victim of bullying during training. Of these, many described burnout as the most common consequence. Bullying is one example of disruptive and unprofessional behaviors that are known to affect patient safety.

Health care systems struggle to ensure patients with precancerous colon and lung lesions receive appropriate follow-up. This academic center hired navigators who effectively increased the proportion of patients who completed recommended diagnostic testing for colon polyps and lung nodules. A WebM&M commentary described how patients with lung nodules are at risk for both overtreatment and undertreatment.

This retrospective review of nearly 900 incident reports related to diagnostic imaging found that the most common type of safety problem was linked to the imaging procedure. Events associated with communicating abnormal results were less common but had a higher potential to harm patients. Most events had multiple contributing factors.