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Klatt TE, Sachs JF, Huang C-C, et al. Jt Comm J Qual Patient Saf. 2021;47:759-767.
This article describes the implementation of a peer support program for “second victims” in a US healthcare system. Following training, peer supporters assisted at-risk colleagues, raised awareness of second victim syndrome, and recruited others for training. The effectiveness of the training was assessed using the Second Victim Experience Support Tool. The most common event supported was inability to stop the progress of a medical condition, including COVID-19.
Preston-Suni K, Celedon MA, Cordasco KM. Jt Comm J Qual Patient Saf. 2021;47:673-676.
Presenteeism among healthcare workers – continuing to work while sick – has been attributed to various cultural and system factors, such as fear of failing colleagues or patients. This commentary discusses the patient safety and ethical considerations of presenteeism during the COVID-19 pandemic
Dhahri AA, Refson J. BMJ Leader. 2021;5:203-205.
Hierarchy and professional silos can disrupt collaboration. This commentary describes one hospital’s approach to shifting the surgical leadership role to facilitate communication and cross-organizational influence to affect quality and safety performance.
Geerts JM, Kinnair D, Taheri P, et al. JAMA Netw Open. 2021;4:e2120295.
The COVID-19 pandemic has disrupted many aspects of health care delivery and has placed unprecedented pressure on health care workers. This consensus statement, based on input from an international panel of individuals with expertise in health leadership, health care, and public health, outlines 10 imperatives to guide health and public leaders during the post emergency stage of the pandemic. Imperatives addressed in the framework include supporting staff well-being and psychological health, preparing for future emergencies, managing the backlog of delayed care, and the importance of sustaining learning, innovations and collaborations that arose during the pandemic.
Andel SA, Tedone AM, Shen W, et al. J Adv Nurs. 2021;78:121-130.
During the first weeks of the COVID-19 pandemic, 120 nurses were surveyed about nurse-to-patient staffing ratios, skill mix, and near misses in their hospitals. Personnel understaffing led to increased use of workarounds, and expertise understaffing led to increased cognitive failures, both of which shaped near misses. Hospital leaders should recognize both forms of understaffing when making staffing decisions, particularly during times of crisis.
Polancich S, Hall AG, Miltner RS, et al. J Healthc Qual. 2021;43:137-144.
The COVID-19 pandemic has disrupted many aspects of health care delivery, including how hospitals prevent common hospital-acquired conditions such as pressure injuries. Based on retrospective data, the authors of this study did not identify a longitudinal increase in hospital-acquired pressure injuries between March and July 2020. The authors discuss how prior organizational efforts to reduce hospital-acquired pressure injuries allowed their hospital to quickly adapt existing workflows and processes to respond to the COVID-19 pandemic.
Adelman JS, Gandhi TK. J Patient Saf. 2021;17:331-333.
The full impact of the COVID-19 pandemic on patient safety in the healthcare system is still unknown. New patient safety concerns have been introduced, and existing concerns have been exacerbated. The authors suggest several high reliability strategies to prevent and learn from patient safety hazards, including transparency, a culture of safety, and continuous analysis of errors.
Denning M, Goh ET, Tan B, et al. PLoS One. 2021;16:e0238666.
This cross-sectional study conducted from March to June 2020 measured anxiety, depression, and burnout in clinicians working in the United Kingdom, Poland, and Singapore. Approximately 70% of respondents reported feeling anxious, depressed and/or burnt out. Burnout was significantly inversely correlated with being tested for COVID-19 and perceiving high levels of safety. These findings highlight the importance of supporting staff well-being and proactive COVID-19 testing.
Haidari E, Main EK, Cui X, et al. J Perinatol. 2021;41:961-969.
High levels of healthcare worker (HCW) burnout may be associated with lower levels of patient safety and quality. In June 2020, three months into the COVID-19 pandemic, 288 maternity and neonatal HCWs were asked about their perspectives on well-being and patient safety. Two-thirds of respondents reported symptoms of burnout and only one-third reported adequate organizational support to meet these challenges. Organizations are encouraged to implement programs to reduce burnout and support HCW well-being.
Ginestra JC, Atkins JH, Mikkelsen ME, et al. NEJM Catalyst. 2020;2.
Health systems are rapidly adjusting and adapting processes to successfully respond to the COVID-19 pandemic. The University of Pennsylvania Health System developed the I-READI (integration, root cause analysis, evidence review, adaptation, dissemination, and implementation) conceptual framework to assist hospitals in preparing for and responding to patient safety challenges during times of crisis, such as the COVID-19 pandemic. The I-READI approach can streamline communication, enrich collaboration, and coordinate rapid change through the use of daily safety huddles, root cause analysis, and technology (e.g., ICU telemedicine and real-time ICU dashboards).

Toccafondi G, Di Marzo F, Sartelli M, et al. Int J Qual Health Care. 2021;33(Supp 1):51-55. 

 

The impact of the COVID-19 pandemic on infection prevention efforts and healthcare-associated infections is unclear. This article discusses how the COVID-19 pandemic has led to adaptations to infection prevention and control and surveillance (IPCS) practices and a human factors and ergonomics perspective in surgery. Leveraging lessons learned from the pandemic, the authors use a human factors perspective to propose an enhanced infection prevention and control approach to prevent surgical site infections. 
Kozasa EH, Lacerda SS, Polissici MA, et al. Front Psych. 2020;11:570786.
Situational awareness during critical incidents is a key component of teamwork. This study found that a mutual care training can increase situational awareness for healthcare workers and consequently improve mental health and well-being before and during the COVID-19 pandemic.

McGaffigan P, Gerwig K, Kingston MB. Healthcare Executive. 2020 Nov;35(6):48-50.

Health care workforce satisfaction is the responsibility of leadership and it is reliant on the organizational safety culture. This article highlights the importance of worker conditions as a component of safety and summarizes recommendations for keeping workers safe and thriving.

Begun JW, Jiang HJ. NEJM Catalyst. October 9, 2020. 

Complexity science provides a foundation to manage and learn from crisis. This report using case studies to highlight how complexity constructs can address health care system stressors due to the COVID pandemic. The authors also describe how to apply that experience to learn from crisis situations to better respond as future challenges emerge. 
Dubé MM, Kaba A, Cronin T, et al. Adv Simul (Lond). 2020;5:22.
This article describes the planning and implementation of a multi-site, multidisciplinary simulation program to provide critical just-in-time COVID-19 education in one Canadian province. The authors discuss the unique features and advantages of a centralized simulation response and key themes of the simulation program.

ISMP Medication Safety Alert! Acute care edition. August 27, 2020;25(17).

The culture of blame is exacerbated by stress, production pressure, and a negative work environment. This article discusses how medication errors that take place during the care of patients with COVID-19 are not being reported by nurses due to lack of time and psychological safety. Recommendations to avoid this situation include heightening prevention efforts by employing tactics such as deployment of huddles and use of pre-mixed medication solutions.  
Denning M, Goh ET, Scott A, et al. Int J Environ Res Public Health. 2020;17:7034.
This study used the Safety Attitudes Questionnaire to evaluate the impact of COVID-19 on safety culture at a large UK teaching hospital compared to baseline scores collected in 2017. Overall, respondents reported more positive perceptions of safety; training and support for redeployment were associated with higher perceptions of safety. However, the analysis identified a significant decrease in error reporting after the onset of the COVID-19 pandemic.
Yong E. The Atlantic. 2020;September.
This article takes a holistic view of the multiple preventable failures of the U.S. in managing the COVID-19 pandemic, raising several patient safety issues from the metasystems perspective. The piece highlights systemic problems such as lack of transparency, investment in public health and learning from experience.
Borshoff DC, Sadleir P. Curr Opin Anaesthesiol. 2020;33:554-560.
The COVID-19 pandemic has resulted in the delivery of anesthesia outside of operating rooms, such as in emergency departments, intensive care units, and makeshift field hospitals. This review examines challenges in maintaining patient safety while providing anesthesia services in nontraditional operating room environments.