Minimum nurse staffing levels have been promoted by researchers and legislators to reduce adverse events and improve patient safety in both hospitals and nursing homes. While this review of reviews found higher nurse staffing was generally associated with positive outcomes, results varied between staffing groups (e.g., registered nurses compared to licensed vocational/practical nurses or nursing assistants). The authors identified several methodological challenges and described how study design modifications could yield a more robust examination of the causal relationship between staffing and outcomes.

Increased use of telehealth presents both benefits and potential threats to patient safety. In this study of 4,133 patients, researchers found that orders for colonoscopies or cardiac stress tests and dermatology referrals placed during telehealth visits were less likely to be completed within the designated timeframe compared to those ordered during in-person visits (43% vs. 58%). Not completing test or referrals within the recommended timeframe can increase the risk of delayed diagnoses and patient harm.

The increased risk of maternal morbidity and mortality among Black women in the United States is a patient safety and public health crisis. This literature review of 42 articles highlights the importance of cultural competence and disparities training for obstetric providers to reduce maternal mortality and morbidity among Black women. The authors also highlight the need for increased awareness regarding the increased risk of cardiovascular diseases among pregnant Black women.

Achieving zero preventable harm is an ongoing goal for healthcare organizations. This article describes one large, multistate community health system’s experience decreasing serious adverse events through implementation of high-reliability leadership, promoting human error prevention behaviors, and accelerating learning through a structured approach to cause analysis at both the individual and systems levels.

Computerized provider order entry (CPOE) systems can reduce medication errors by alerting prescribers to a variety of potential adverse events. However, too many alerts may result in alert fatigue. This scoping review identified 16 studies on interventions to reduce alert fatigue. Most interventions focused on drug-drug interactions. A decrease in the quantity and frequency of alerts was seen as a positive outcome, however only four of the studies reported any patient safety outcomes.

Overlapping surgeries, where one attending surgeon supervises two surgeries with noncritical portions occurring simultaneously, are generally considered as safe as non-overlapping surgeries. This review identified 11 studies into safety outcomes of overlapping orthopedic surgeries involving 34,494 overlapping surgeries. Consistent with prior research, although overlapping surgeries tended to have increased surgical times, short-term outcomes were no different than non-overlapping; one study showed increased risk for adverse events at one year. The authors suggest future research into overlapping robotic-assisted surgeries.

Involvement in patient safety incidents can erode patient trust in their own physicians and the healthcare system. This article summarizes the estimated frequency of lost trust after patient safety incidents, external factors contributing to mistrust, and approaches to restoring trust after incidents.

Remote or virtual patient care was an increasingly common strategy during the COVID-19 pandemic to keep patients safe and ensure adequate inpatient resources for patients unable to be cared for virtually. In this study, hospital physicians, pharmacists, and nurses described medication challenges associated with patients receiving virtual care (i.e., hospital-level care at home or hotel). Participants described challenges with lack of clarity on who is responsible for the patient's usual home medications, disruptions to typical workflow, and difficulties with transition from inpatient to virtual care.

Large-scale technology modifications can contribute to organizational disfunction. This commentary discusses five approaches to managing disruption associated with electronic health record modernization that establish cultural, functionality, staff, design, and monitoring conditions to reduce stress and the potential for patient harm during technology improvements.

Errors associated with high-risk medications (HRM) like insulin and anticoagulants carry a greater risk for harm. The purpose of this scoping review was to identify measures evaluating the safety of HRM during transitions of care. Measures were mapped to frameworks (e.g., Donabedian) and whether measures were reactive, proactive, or real-time. The authors describe ways technology can improve how the measures are implemented.

ChatGPT has emerged as a potentially useful tool for clinicians and the public in obtaining heath advice and diagnosis. In this study, six iterations of 22 pediatric emergency vignettes were entered into ChatGPT (total of 132 scenarios) to assess diagnostic accuracy, emergency call advice, and validity of advice given. ChatGPT correctly recommended contacting medical professionals in all cases but only advised calling emergency medical services (EMS) or 911 in 12 of the 22 scenarios. The correct diagnosis was made in 94% of cases, consistent with other research into ChatGPT. Considerably more research is required before ChatGPT could be recommended for diagnostic advice.

Overcrowding in the emergency department (ED) and boarding can place patients at increased risk for adverse events. This article outlines how ED overcrowding occurs and provides several approaches to mitigate risks and enhance patient safety in overcrowded EDs, such as checklists, huddles, and resource allocation.

Quality improvement and patient safety initiatives require incredible human and financial resources, they so must be selected carefully to achieve the greatest return on investment. This article describes important considerations for hospital leaders when selecting and implementing initiatives. Safety culture, policies and procedures, supporting staff, and patient engagement were notable themes. The included "patient safety governance model" provides a framework to develop patient safety policy.

Unmet health-related social needs (HRSNs; e.g., housing instability, food insecurity) and healthcare disparities can place patients at increased risk for patient safety incidents and poor outcomes. This article describes how existing Veterans Health Administration (VHA) initiatives to address HRSNs and disparities are being leveraged to address new Joint Commission standards to improve health care equity.

Surgical safety checklists have been credited with improving perioperative patient outcomes, but numerous studies have shown implementation to be variable across settings and surgical specialties. This study aimed to redesign and reimplement the surgical safety checklist in two academic hospitals. Item completion and fidelity improved after reimplementation and exploratory analysis suggests improved patient outcomes (e.g., serious complications).

Mitigating error and encouraging teamwork is essential in complex surgical environments. In this study, researchers found that surgical caps labeled with names and roles fostered a climate of safety and inclusion among perioperative clinicians.