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1 - 13 of 13

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.
Oliveira J. e Silva L, Vidor MV, Zarpellon de Araújo V, et al. Mayo Clin Proc. 2020;95:1842-1844.
This article discusses the threat that the “flexibilization” of science has played during the COVID-19 pandemic, defined as the loosening of methodological standards leading to low-quality studies, and resulting in unreliable data and anecdotal evidence.
Choudhury A, Asan O. JMIR Med Inform. 2020;8:e18599.
This systematic review explored how artificial intelligence (AI) based on machine learning algorithms and natural language processing is used to address and report patient safety outcomes. The review suggests that AI-enabled decision support systems can improve error detection, patient stratification, and drug management, but that additional evidence is needed to understand how well AI can predict safety outcomes.  
Fraczkowski D, Matson J, Lopez KD. J Am Med Inform Assoc. 2020;27:1149-1165.
The authors reviewed studies using qualitative and quantitative methods to describe nursing workarounds related to the electronic health record (EHR) in direct care activities. Workarounds generally fit into three categories – omission of process steps, steps performed out of sequence, and unauthorized process steps. Probable causes for workarounds were identified, including organizational- (e.g., knowledge deficits, non-formulary orders), environmental-, patient- (e.g., barcode/ID not accessible), task- (e.g., insufficient time), and usability-related factors (e.g., multiple screens to complete an action). Despite nurses being the largest workforce using EHRs, there is limited research focused on the needs of nurses in EHR design.
Freeling M, Rainbow JG, Chamberlain D. Int J Nurs Stud. 2020;109:103659.
This literature analysis assessed the evidence on the impact presenteeism in the nursing workforce and found that presenteeism is associated with risk to nurse well-being and patient safety, but that additional research exploring the relationship between presenteeism, job satisfaction, and quality of care is needed.
Singh H, Sittig DF. Ann Intern Med. 2020;172:S92-S100.
This article describes the Safety-related EHR Research (SAFER) Reporting Framework, which facilitates reporting patient safety-focused EHR interventions through a sociotechnical lens. It discusses the benefits of a sociotechnical approach to reporting and components to operationalizing the SAFER framework, including necessary hardware and software, clinical content, a human-computer interface, workflow and communication, rules and regulations, and measurement and monitoring. SAFER is not intended to replace current research reporting guidelines, but complement their use.
Wiig S, Hibbert PD, Braithwaite J. Int J Qual Health Care. 2020;32.
The authors discuss how involving families in the investigations of fatal adverse events can improve the investigations by broadening perspectives and providing new information, but can also present challenges due to emotions, trust, and potential conflicts in perspectives between providers and families.

Auerbach AD, Bates DW, Rao JK, et al, eds. Ann Intern Med. 2020;172(11_Supp):S69-S144.

Research and error reporting are important strategies to uncover problems in health system performance. This special issue highlights vendor transparency and context as important areas of focus to ensure electronic health records (EHR) research and reporting help improve system reliability. The articles cover topics such as a framework for research reporting, design of randomized controlled trials for technology studies, and designing research on patient portal enhancement.
Lampert A, Haefeli WE, Seidling HM. J Patient Saf. 2020;16.
Through focus groups with patients, family caregivers and nurses, this study explored experiences with medication administration and perceived needs for assistance. Patients and caregivers were generally unaware of errors and primarily attributed administration problems to dosage form (eg, lack of confidence in using syringes). Participants identified lack of training or education about proper administration as contributing to administration errors.
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.  

Rockville, MD: Agency for Healthcare Research and Quality; May 14, 2020.

The unprecedented nature of the COVID-19 pandemic requires unique evaluation strategies to examine system responses to the pandemic and its effects on quality and patient safety. AHRQ will award $5 million in fiscal year 2020 to support novel, high-impact studies that evaluate the responsiveness of health care delivery systems, health care professionals, and the overall U.S. health care system in response to the COVID-19 pandemic. AHRQ expects to fund critical research focused on topics such as the effects on quality, safety, and value of the health system response to COVID-19; the role of primary care practices and professionals during the COVID-19 epidemic; understanding how the response to COVID-19 affected socially vulnerable populations and people with multiple chronic conditions; and the integration of digital health in the response to COVID-19, including innovations and challenges encountered in the expansion of telehealth. The process for submitting applications is now closed.
O’Donovan R, McAuliffe E. BMC Health Serv Res. 2020;20:101.
Organizational cultures that encourage psychological safety has been shown to increase safe healthcare practices. This systematic review evaluated fourteen studies targeting psychological safety, speaking up and voice behavior within healthcare settings; studies primarily used educational interventions including simulation (5 studies), video presentations (2 studies), case studies (3 studies) or workshops (1 study). While some interventions showed improvement in psychological safety, this was not consistently demonstrated across studies. The authors note that the ability to demonstrate improvements were limited by lack of objective outcome measures and the inability of educational interventions alone to result in behavior change. 
Cheraghi-Sohi S, Panagioti M, Daker-White G, et al. Int J Equity Health. 2020;19.
To better understand patient safety issues of marginalized groups, this scoping review assessed 67 articles primarily focusing on four patient groups: ethnic minorities, frail elderly, care home residents and those with low socioeconomic status. A variety of patient safety issues were identified, and half of the included studies looked at either medication safety, adverse outcomes, and near misses. This review highlights the need for additional research to understand the intersection between marginalization and the multi-dimensional nature of patient safety issues.