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Townsend T, Cerdá M, Bohnert AS, et al. Health Aff (Millwood). 2021;40:1766-1775.
Misuse of prescription opioids represents a serious patient safety issue. Using commercial claims from 2014 - 2018, researchers examined the association between the 2016 CDC guidelines to reduce unsafe opioid prescribing and opioid dispensing for patients with four common chronic pain diagnoses. Findings indicate that the release of the 2016 guidelines was associated with reductions in the percentage of patients receiving opioids, average dose prescribed, percentage receiving high-dose prescriptions, number of days supplied, and the percentage of patients receiving concurrent opioid/benzodiazepine prescriptions. The authors observe that questions remain about how clinicians are tailoring opioid reductions using a patient-centered approach.
Marang-van de Mheen PJ, Vincent CA. BMJ Qual Saf. 2021;30:525-528.
Research has shown that patients admitted to the hospital on the weekend may experience worse outcomes compared to those admitted on weekdays (the ‘weekend effect’). This editorial highlights the challenges to empirically evaluate the underlying mechanisms contributing to the weekend effect. The authors propose viewing the weekend effect as a proxy for staffing levels and the influence of other factors influencing outcomes for patients admitted on weekends, such as patient acuity, clinician skill-mix and access to diagnostic tests or other ancillary services.
Placona AM, Rathert C. Med Care Res Rev. 2021:107755872110145.
This systematic review analyzed results of 32 studies comparing online patient reviews (OPRs) and measures of patient outcomes. While OPRs did have positive associations with patient experience, associations between OPRs and quality measures were mixed. Due to the weight that patients give OPRs, future research should focus on associations between OPRs and encounter setting, specialty, and specific quality measures.
Zhou Y, Walter FM, Singh H, et al. Cancers (Basel). 2021;13:156.
Delays in cancer diagnosis can lead to treatment delays and patient harm. This study linking primary care and cancer registry data found that more than one-quarter of bladder and kidney cancer patients presenting with fast-tract referral features did not achieve a timely diagnosis. These findings suggest inadequate adherence to guidelines intended to help identify patients with high risk of cancer based on the presence of alarm signs and symptoms.
Myers LC, Blumenthal KG, Phadke NA, et al. Jt Comm J Qual Patient Saf. 2021;47:54-59.
Learning from adverse events is a core component of patient safety improvement. These authors developed guidance for the use of peer review protected information (such as voluntary event reports and root causes analyses) in safety research. The guidance aims to ensure that data are handled safely and appropriately while supporting scientific discovery.  

116th Congress 2d session. December 10, 2020.

The strengthening of diagnostic error research and processes can strategically ensure lasting diagnostic improvement. The ‘‘Improving Diagnosis in Medicine Act of 2020’’ outlines characteristics of a proposed Federal program to enhance agency cooperation and coordination to improve diagnosis in health care by addressing systemic weaknesses, knowledge gaps, and training issues in the workforce.
Brown KW, Carlisle K, Raman SR, et al. Health Aff (Milwood). 2020;39:1737-1742.
Over the last decade, children have experienced a dramatic rise in hospitalizations and intensive care unit stays related to opioid use. Based on Medicaid claims in North Carolina, prescribers of opioids for children were most commonly physicians and dentists. More than 3% of children ages 1 to 17 years had at least one opioid prescription filled annually; 76.6 children per 100,000 experienced an opioid-related adverse event or other harm. Adolescents ages 15 to 17 years disproportionately experienced these harms compared to younger age groups. Black and urban children were less likely to fill opioid prescriptions or experience adverse events, but they were more likely to experience other opioid-related harm, such as abuse or dependence.   

Herd P, Moynihan D. Health Affairs Health Policy Brief. October 2, 2020.

The crossover of health equity concepts to patient safety has emerged as a consideration for improvement. This policy brief examines how administrative burdens can separate patients from the care they need and calls for increased attention to the problem.  

Smith KM, Hunte HE, Graber ML. Rockville MD: Agency for Healthcare Research and Quality; August 2020. AHRQ Publication No. 20-0040-2-EF.

Telehealth is becoming a standard care mechanism due to COVID-19 concerns. This special issue brief discusses telediagnosis, shares system and associate factors affecting its reliability, challenges in adopting this mode of practice, and areas of research needed to fully understand its impact.   
Krupat E, Dienstag JL, Padrino SL, et al. Acad Med. 2020;95.
Unprofessional behavior adversely impacts a culture of safety and can contribute to adverse events. This study compared medical school graduates who appeared before their schools’ review boards for professional-related reasons to matched controls to explore whether professionalism lapses predict problems in residents and clinical practice. Compared with controls, physicians who appeared before their schools’ review boards were more likely to undergo disciplinary review and require remediation or counseling during residency and were more likely to be sued or sanctioned during clinical practice.
Dzau VJ, Kirch D, Nasca TJ. N Engl J Med. 2020;383:513-515.
This commentary discusses the ongoing impact of COVID-19 on the physical, emotional, and mental health on the healthcare workforce and outlines five high-priority actions at the organizational- and national level to protect the health and wellbeing of the healthcare workforce during and after the pandemic.  
Thibaut BI, Dewa LH, Ramtale SC, et al. BMJ Open. 2019;9:e030230.
This exploratory systematic review aimed to describe the state of the research on patient safety in inpatient mental health settings. Authors included 364 papers, representing 31 countries and data from over 150,000 participants. The existing research base was categorized into ten broad safety categories – interpersonal violence, coercive interventions, safety culture, harm to self, safety of the physical environment, medication safety, unauthorized leave, clinical decision making, falls, and infection prevention/control; papers were of varying quality with the majority of papers assessed as “fair”. The authors note that several areas of patient safety in inpatient mental health are particularly understudied, such as suicide, as the review only yielded one study meeting inclusion criteria.
Rockville, MD: Agency for Healthcare Research and Quality. Special Emphasis Notice. August 2, 2018. Publication No. NOT-HS-18-015.
This announcement highlights Agency for Healthcare Research and Quality funding opportunities for health services research to assess local, state, and system-level policy to address the opioid crisis, evaluate interventions to minimize opioid misuse, and understand the rapid increase in opioid-related hospitalizations. This funding opportunity is now closed.