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Smith M, Vaughan Sarrazin M, Wang X, et al. J Am Geriatr Soc. 2022;70:1314-1324.
The COVID-19 pandemic disrupted healthcare delivery and contributed to delays in care. Based on a retrospective matched cohort of Medicare patients, this study explored the impact of the COVID-19 pandemic on patients who may be at risk for missed or delayed care. Researchers found that patients with four or more indicators for risk of missed or delayed care (e.g., chronic conditions, frailty, disability affecting use of telehealth) had higher mortality and lower rates of healthcare utilization, including primary care visits.
Mullur J, Chen Y-C, Wickner PG, et al. J Patient Saf. 2022;18:e431-e438.
COVID-19 restrictions and patient safety concerns have greatly expanded the use of telehealth and virtual visits. Through patient satisfaction surveys and patient complaints, this US hospital evaluated the quality and safety of virtual visits in March and April of 2020. Five patient complaints were submitted during this timeframe and overall patient satisfaction remained high. Safety and quality risks were identified (e.g., diagnostic error) and best practices were established.

Anjali Joseph, PhD, EDAC, is a Spartanburg Regional Healthcare System Endowed Chair in Architecture and Health Design. Molly M. Scanlon, PhD, FAIA, FACHA, is the Director at Phigenics, LLC. We spoke with them about how healthcare built environments have been temporarily modified during the COVID-19 pandemic and what learnings may be used moving forward.

This piece discusses areas where the healthcare built environment may contribute to the risk of COVID-19 transmission, mitigating strategies, and how the pandemic may impact the built environment moving forward.

Patrick NA, Johnson TS. Nurs Womens Health. 2021;25:212-220.
Improving maternal safety is a patient safety priority in the United States. This article reviews the unique impact of the COVID-19 pandemic on maternal and newborn populations, such as implications for maternity care, maternal-newborn separation, and universal testing. Based on experiences at a maternal-fetal medicine clinic in a tertiary care center in Wisconsin, the authors describe practice changes to maintain safety, minimize COVID-19 transmission, and optimize patient safety during the pandemic.
Brown NJ, Wilson B, Szabadi S, et al. Patient Saf Surg. 2021;15:19.
At the start of the COVID-19 pandemic, many elective surgical procedures were canceled or postponed due to limited resources (e.g., personal protective equipment, diagnostic tests, redeployment of healthcare personnel). This commentary discusses the implications of rationed non-urgent surgical care within the context of medical ethics: beneficence, non-maleficence, justice, and autonomy. The authors developed an algorithm to guide surgical teams through the decision-making process of delaying non-urgent surgical procedures, if necessary, in the future. 

In this PSNet Annual Perspective, we worked with co-authors Dr. Jacqueline C. Stocking, a quality improvement and critical care specialist, and Dr. Christian Sandrock, a patient safety professional and emerging infectious diseases specialist, to provide a look at news and research related to the impact of the COVID-19 pandemic on patient safety.

Silver Spring, MD: Division of Industry and Consumer Education, US Food and Drug Administration; February 9. 2021.

Lack of access to ventilators during the COVID-19 crisis has necessitated care compromises to support multiple patients. This situation can reduce the effectiveness of monitoring patients on shared devices and introduce other challenges. This communication provides insights to enhance the safety of multiple-patient ventilator use.
Barranco R, Vallega Bernucci Du Tremoul L, Ventura F. Int J Environ Res Public Health. 2021;18:489.
Health systems have implemented various strategies to reduce the risk of nosocomial transmission of the COVID-19 virus. Based on ten studies, the authors estimate that the nosocomial transmission rate is 12-15%. The authors discuss the role of infection prevention and control procedures, and the potential implications of hospital-acquired COVID-19 on medical malpractice.  
Muhrer JC. Nurs Pract. 2021;46:44-49.
The COVID-19 pandemic has led to wide-ranging changes to health care delivery, some of which may negatively impact patient outcomes.The authors use a syndemic perspective to discuss existing challenges interfering with diagnosis (structural, socioeconomic, patient-related, and provider-related), how the COVID-19 pandemic has exacerbated those challenges, and strategies related to nurse practitioners and community health workers to improve diagnosis.  
Vimercati L, De Maria L, Quarato M, et al. Int J Infect Dis. 2021;102:532-537.
The pressures faced by hospitals and healthcare providers during the COVID-19 pandemic has raised concerns about nosocomial transmission of the virus. This single-setting study conducted in Italy including 5,750 healthcare workers compared the prevalence of COVID-19 infection among those in contact with COVID-19 patients and those working elsewhere in the hospital. The prevalence among exposed healthcare workers was 0.7% and 0.4% among all healthcare workers at this hospital. The authors conclude that correct use of personal protective equipment (PPE) and early identification of symptomatic healthcare workers can reduce nosocomial transmission.  
Tiao C-H, Tsai L-C, Chen L-C, et al. Qual Manag Health Care. 2021;30:61-68.
Hospitals have needed to adapt workflow processes to optimize infection control in response to the COVID-19 pandemic. This article describes the use of healthcare failure mode and effects analysis (HFMEA) 4-step model to implement preventive risk assessment and workflow management for high-risk medical procedures during the pandemic and prevention of nosocomial infections.   
Wessels R, McCorkle LM. J Healthc Risk Manag. 2021;40:30-37.
The COVID-19 pandemic has disrupted healthcare delivery. This study reviewed data from a large medical professional liability company to explore guidance sought by physicians and dentists during the initial months of the pandemic. Providers’ questions and concerns primarily involved operations (e.g., access to personal protective equipment, liability coverage), patient care (e.g., guidance for screening patients), scope of practice, and use of telemedicine.    
Britton CR, Hayman G, Stroud N. J Perioper Pract. 2021;31:44-50.
The COVID-19 pandemic has highlighted the crucial role that team and human factors play in healthcare delivery. This article describes the impact of a human factors education and training program focused on non-technical skills and teamwork (the ONSeT project) – on operating room teams during the pandemic. Results indicate that the project improved team functioning and team leader responsiveness.
LeRose J, Sandhu A, Polistico J, et al. Infect Control Hosp Epidemiol. 2021;42:997-1000.
The COVID-19 pandemic has resulted in changes to infection prevention and control practices in the hospital. In this study, the authors found that blood culture contamination and central line-associated blood stream infection (CLABSI) rates were significantly higher during the pandemic (January-May 2020) compared to pre-pandemic (January-May 2019).
Stall NM, Johnstone J, McGeer AJ, et al. J Am Med Dir Assoc. 2020;21:1365-1370.e7.
In response to the COVID-19 pandemic, nursing homes limited access to visitors and family caregivers in order to limit virus transmission. Based on existing nursing home visitor policies, the authors developed data-driven, expert-reviewed guidance for re-opening Canadian nursing homes to family caregivers and visitors.
Kasda EM, Robson C, Saunders J, et al. J Patient Saf Risk Manag. 2020;25:156-158.
This article describes one academic medical center’s use of the Donabedian framework to rapidly identify and mitigate COVID-19 related safety concerns.  This data-driven approach to systems learning is generalizable beyond the current pandemic and can be applied to other organizational changes.
Wake RM, Morgan M, Choi J, et al. Clin Med (Lond). 2020;20:e141-e145.
Health systems are undertaking various approaches to reduce nosocomial transmission of COVID-19. Using data from one NHS hospital, the authors found that 6.8% of patients developed hospital-acquired COVID-19 between March and May 2020. The authors describe the implementation of a triage system using clinical assessment, rapid targeted testing, and patient cohorting to reduce nosocomial transmission.
Pulia M, Wolf I, Schulz L, et al. West J Emerg Med. 2020;21:1283-1286.
Antimicrobial stewardship is one strategy to improve antibiotic use to reduce hospital-acquired infections. In this editorial, the authors discuss negative effects of COVID-19 on antimicrobial resistance and antibiotic stewardship in the emergency department (ED) and approaches for optimizing ED stewardship during the pandemic.  
Stark N, Kerrissey M, Grade M, et al. West J Emerg Med. 2020;21:1095-1101.
This article describes the development and implementation of a digital tool to centralize and standardize COVID-19-related resources for use in the emergency department (ED). Clinician feedback suggests confirms that the tool has affected their management of COVID-19 patients. The tool was found to be easily adaptable to accommodate rapidly evolving guidance and enable organizational capacity for improvisation and resiliency.