Patients are delaying or forgoing necessary care due to concerns about COVID-19 transmission. This study analyzed inpatient discharges between January 2019 and March 2020 at one tertiary healthcare system to explore the trends in hospitalizations for acute cardiovascular conditions (e.g., chest pain, heart failure, stroke) before and during the COVID-19 pandemic. Results showed that during the early months of the pandemic, there was a marked decline in hospitalizations for acute cardiovascular conditions and patients who were admitted had shorter lengths of stay, which may signal that acute care was deferred or abbreviated during the pandemic.

Detecting adverse events in the health care setting remains an ongoing challenge. Engaging patients and their family members may help to escalate safety issues not identified by other means. In this mixed-methods study, investigators analyzed the types of issues patients and their care partners reported in real time through a web-based electronic application implemented on three hospital units. After implementation of the tool, event reporting by patients to the Patient Family Relations Department declined, suggesting that patients preferred to report concerns anonymously through the application. The authors conclude that additional research is needed to understand how these types of applications could be integrated into patient safety programs. A past PSNet perspective highlighted how patient-facing technologies can empower patients.

Using AHRQ Patient Safety Indicators to compare two surgical techniques for abdominal aortic aneurysm repair, this chart review study found that endovascular repair was safer, emphasizing the utility of these measures for characterizing surgical safety despite controversy about their accuracy.

Vascular surgery is considered a higher risk surgical specialty, as many patients undergoing vascular procedures are elderly and have other comorbid illnesses, putting them at elevated risk of postoperative complications. This study used Patient Safety Indicators (PSIs) to analyze more than 1.4 million patients who underwent vascular surgery from 2005–2009 and found that more than 5% experienced a postoperative adverse event. Procedural complexity and comorbidities were associated with increased risk of a PSI, corroborating prior studies that have found a link between illness severity and risk of complications in medical patients. The PSIs are best used to screen administrative data for potential adverse events, as in this study. In surgical patients, the National Surgical Quality Improvement Program measures have been shown to be superior for accurate detection of postoperative adverse events.

The 2003 residency duty hour regulations were not associated with a change in the 30-day hospital readmission rate for Medicare patients hospitalized with common medical or surgical conditions.

This large study found that surgical procedures performed at night in an academic tertiary care hospital were not associated with increased complication risks, despite prior literature that has raised concern over the safety of care delivered at night.

This study found that a teamwork training program increased compliance with time outs, briefings, and debriefings in multiple surgical settings. Based on noted interactions between NOTECHS scores and individual sites, the authors advocate for greater attention to elements of safety culture such as organizational commitment.

The safety impact of the ACGME trainee work hour restrictions remains controversial due to contrasting findings that have suggested benefit, harm, and no significant impact. This observational study analyzed all Medicare patients admitted to acute care facilities with a predefined set of primary diagnoses to estimate the 30-day mortality among high-severity medical admissions and the failure to rescue in postoperative surgical admissions. Investigators found no significant harm or benefit to patients with higher-severity illness compared with those with lower risk among both the medical and surgical patients. A past AHRQ WebM&M perspective discussed the impact of fatigue and extended shifts among trainees on the incidence of medical errors.

The Patient Safety in Surgery study documented remarkable improvements in postoperative outcomes at Veterans Affairs hospitals following implementation of a quality improvement program. This study demonstrated similar improvement in clinical outcomes, including surgical site infection rates, following implementation of the program in private sector hospitals.

Surgical procedures performed with trainee physicians' involvement had a slightly higher incidence of complications, but a slightly lower risk of mortality.