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Stressful situations can degrade communication, teamwork and decision making. This commentary describes a program to minimize the potential impact of implicit biases in a crisis. Steps in the process include Pausing to Listen, working to Ally and Collaborate, and seeking to Empower patients and staff members.

Lack of organizational support can inhibit safety culture and increase risk of burnout among healthcare workers. Researchers surveyed internal medicine physicians to explore how institutional actions and policies influenced perceived organizational support (POS) during the COVID-19 pandemic. Higher POS was associated with opportunities to discuss ethnical issues related to COVID-19, adequate access to personal protective equipment, and leadership communication regarding healthcare worker concerns regarding COVID-19. High POS was also associated with lower odds of screening positive for burnout, mental health systems, and intention to leave the profession.

Social distancing policies implemented during the COVID-19 pandemic challenged healthcare system leaders and providers to balance infection prevention strategies and providing collaborative, team-based patient care. In this article, four primary care clinics made changes to the clinic design, operational protocols, and usage of spaces. Negative impacts of these changes, such as fewer opportunities for collaboration, communication, and coordination, were observed.

The COVID-19 pandemic dramatically increased the use of telehealth, including remote primary care triage and assessment. This qualitative study explored patients’ and clinicians’ experiences managing suspected COVID-19 during remote triage and assessment. Findings highlight the need to strengthen organizational resilience, develop and implement triage decision support tools, and address vulnerable and unsupported groups (e.g., the elderly, vulnerable and homebound patients).

The COVID-19 pandemic has impacted all aspects of healthcare delivery for both patients and health care workers. This study explored the how COVID-19-related policies and initiatives intended to improve patient safety impacted workflow, system adaptations, as well as organizational and individual resilience among community pharmacists.

This study explored administrator, physician, nurse, and caregiver perceptions of safety in pediatric inpatient care during the first months of the COVID-19 pandemic. Participants reported changes in workflows, discharge and transfer process, patient and family engagement, and hospital operations.

Families and caregivers play an important role in ensuring patient safety. At the start of the COVID-19 pandemic and, to a lesser extent, during surges, family and caregiver visitation was severely restricted. This commentary advocates reassessing risks and benefits of restricted visitation, both during the pandemic and beyond.

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.

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

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.

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.

This survey of 771 critical care nurses found that 40% had at least one symptom of depression and nearly half experienced some degree of anxiety. Nurses with poor physical or mental health reported making more medical errors than their healthier counterparts and nurses in supportive workplaces were more likely to have better physical and mental health. The authors suggest that improvements in an organization’s health and wellness support programs could result in fewer reported medical errors. Notably, this study was completed prior to the COVID-19 pandemic which has led to an even further decline in nurse wellness. 

Research has found that families and caregivers play a key role in identifying and preventing patient safety events.  Based on a national sample of hospitals, this study explored the impact of hospital visitation restrictions during the COVID-19 pandemic on patient experience and safety outcomes. Results indicate that hospitals with closed visitations experienced larger performance deficits across measures of medical staff responsiveness, fall rates, and sepsis rates.