Anchoring bias is relying on initial diagnostic impression despite subsequent information to the contrary. In this study, radiologists were asked to read a mammogram and were told a random number which researchers claimed was the probability the mammogram was positive for breast cancer. Radiologists' estimation of breast cancer reflected the random number they were given prior to viewing the image; however, when they were not given a prior estimation, radiologists were highly accurate in diagnosing breast cancer.

A missed or delayed diagnosis of stroke increases the risk of permanent disability or death. This retrospective study compared rates of misdiagnosed stroke in patients presenting to general care or specialty care who were initially diagnosed with “benign dizziness”. Patients with dizziness who presented to general care were more likely to be misdiagnosed than those presenting to specialty care. Interventions to improve stroke diagnosis in emergency departments may also be successful in general care clinics.

Smart pumps are considered a valuable method to improve medication safety. This study used smart pump medication logs and reporting software to identify cancelled infusions and resolutions of infusions alerts to characterize near-miss infusion pump errors. The study identified a high number of lookalike-soundalike near-miss errors. Analyses indicate that incorrect medication and wrong dose selections account for approximately 22% of all cancelled infusions.

An international sample of chiropractic practitioners described actions taken by their practices in response to the COVID-19 pandemic. Practitioners discuss using innovative strategies such as telehealth to continue providing patient-centered care while complying with local regulations.

This study surveyed healthcare professionals in Israel and Portugal to identify key human factors that influence the use of personal protective equipment (PPE) when caring for patients with suspected or confirmed COVID-19. Respondents attributed difficulties in wearing PPE to discomfort, challenges in hearing and seeing, and doffing. Analyses also found an association between PPE discomfort and situational awareness, but this association reflected difficulties in communication (e.g., hearing and understanding speech).

Potentially inappropriate prescribing in older adults can lead to adverse health outcomes and worsened health-related quality of life. This meta-analysis estimated the prevalence of potentially inappropriate prescribing in older adults to be 3.3%, and estimated that potentially inappropriate prescribing explains 7.7 to 17.3% of adverse outcomes affecting older adults in primary care. Interventions to prevent potentially inappropriate prescribing should be prioritized as a key strategy to reduce medication-related harm along older adults in primary care settings.

This article describes innovative strategies pharmacists in China have explored to address the COVID-19 pandemic, such as establishing prescribing and workforce guidelines, utilizing remote inpatient order review and dispensing, and other telepharmacy approaches.  

This retrospective mixed-methods study explored patient safety within a pediatric telemedicine triage service by assessing the appropriateness and reasonableness of the diagnosis reached by the online physician. The researchers analyzed a random sample of telephone consultations and conducted qualitative interviews with physicians to obtain their perspectives about factors impacting their reaching diagnosis and deciding on reasonable and appropriate treatment. Analysis of telephone consultations found high levels of diagnosis appropriateness, decision reasonableness and accuracy. Physician interviews revealed six themes for appropriate diagnosis and decision-making: (1) use of intuition, (2) experience, (3) use of rules of thumb and protocols, (4) making shared decisions with parents, (5) considering non-medical factors, and (6) using additional tools such as video chat or digital photos when necessary.

Based on malpractice claims data in Spain, the authors propose eleven recommendations to mitigate preventable adverse events in dentistry. These recommendations include developing a culture of safety, improving the quality of clinical records, safe prescribing practices, using checklists in oral surgical procedures, and having an action plan for life-threatening emergencies in the dental clinic.

There is increasing interest in the use of artificial intelligence (AI) to improve breast cancer detection. This study developed and validated an AI algorithm using mammography readings from five institutions in South Korea, the United States, and the United Kingdom. The AI algorithm alone showed better diagnostic performance in breast cancer detection compared to radiologists without AI assistance (area under the curve [AUC] of 0.94 vs. 0.81, p<0.0001) or radiologists with AI assistance (0.88; p<0.0001). AI improved performance of radiologists and was better at detecting mass cancers, distortion, asymmetry, or node-negative cancers compared with radiologist alone.

Various tools for identifying potentially inappropriate medications (PIMs) have been developed. This 5-year prospective cohort study of 196 elderly patients receiving home-based medical services in Japan compared the use of two tools for identifying PIMs, the American Geriatrics Society’s Beers Criteria and the relatively new Screening Tool for Older Person’s Appropriate Prescriptions for Japanese (STOPP-J), to determine the impact of PIMs on hospitalization and mortality rates. PIMs categorized by STOPP-J were associated with hospitalization and mortality, whereas Beers Criteria PIMs were associated with hospitalization only after excluding proton pump inhibitors.

Patient safety events are common in dentistry, but it has been challenging for dental healthcare workers to establish a robust patient safety culture. This study used a cross-sectional survey to assess the safety attitudes among dentists and dental hygienists. Safety attitudes were high overall, but attitudes differed significantly by dentist characteristics. A 2016 Perspective on Safety in Dentistry offers more background on this topic. 

Understanding the contributors to adverse events helps to identify ways to prevent future events. This study used natural language processing (NLP) strategies and social network analysis (SNA) to explore the underlying behaviors contributing to adverse events, and suggested institutional-level approaches to reducing these events. 

Many older patients experience medication-related harm due to inappropriate prescribing. This meta-analysis found that potentially inappropriate medication prescribing in older patients worsened health-related quality of life and increased emergency department visits and hospitalizations. A WebM&M commentary discussed strategies for safer medication management for older patients.

Polypharmacy among older patients can increase the risk of adverse drug events. In this meta-analysis, researchers found that medication reviews performed by community pharmacists among older patients with polypharmacy reduced the risk of emergency department visits.

Patient engagement in safety is considered a best practice and a National Patient Safety Goal, but less is known about patients' perceptions regarding this topic. In this survey study involving 1445 patients in Sweden, researchers found that more than 80% of respondents felt comfortable directing questions to doctors and nurses. Patients who had filed a formal complaint reporting a safety concern were found to believe with greater certainty that the patient perspective can improve the safety of care.

This retrospective study found that clinicians who had access to a commercial clinical decision support tool made fewer diagnostic errors than clinicians who did not have access to the tool. The authors conclude that online clinical decision support from this platform improved diagnosis.

Pediatric patients are at high risk for medication errors. Researchers conducted a cross-sectional study on 166 infants younger than 3 months who were discharged from the hospital. They found a high frequency of medication errors by caregivers. In keeping with prior research, dose administration errors were the most common type of error.