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Weber L, Jewett C. Kaiser Health News. 2021-2022.

The infectious nature of COVID continues to impact the safety of hospitalized patients. This article series examines factors contributing to hospital-acquired COVID-19 infection that include weaknesses in oversight, patient legal protections, and documentation.
Etherington C, Kitto S, Burns JK, et al. BMC Health Serv Res. 2021;21(1):1357.
Gender bias has been implicated in negatively affecting patient safety. The authors conducted semi-structured interviews to explore how gender and other social identify factors impact experiences and teamwork in the operating room. Researchers found that women being routinely challenged or ignored or perceived negatively when assertive may hinder their pursuit of leadership positions or certain specialties. Implicit gender bias and stereotypes along with deeply entrenched structural barriers persist and complicate hierarchical relations between professions – all contributing to breakdowns in communication, increased patient safety risks, and poor team morale.  
Bacon CT, McCoy TP, Henshaw DS, et al. J Nurs Adm. 2021;51(11):e20-e26.
Organizational safety climate (OSC) has been associated with positive nurse outcomes. This study compared the association between organizational climate and job enjoyment in two surgical units, one that received crew resource management (CRM) training and the other that did not. The study used the Hospital Culture of Safety framework as a theoretical basis and found that job enjoyment and organizational safety climate scores were higher in the hospitals that received CRM training compared with those that did not.
Samuels A, Broome ME, McDonald TB, et al. J Patient Saf Risk Manage. 2021;26(6):251-260.
Healthcare systems have implemented communication-and-resolution programs (CRPs) (aka CANDOR) to encourage early disclosure of adverse events. This evaluation found that CRP training participants demonstrated improvements in self-reported empathy and communication skills.

Bryant A. UpToDate. September 13, 2021.

Implicit bias is progressively being discussed as a detractor to safe health care by fostering racial and ethnic inequities. This review examines the history of health inequities at the patient, provider, health care system, and cultural levels in obstetric and gynecologic care. It shares actions documented in the evidence base for application in health care to reduce the impact of implicit bias, with an eye toward maternal care
Marr R, Goyal A, Quinn M, et al. BMC Health Serv Res. 2021;21(1):1330.
Many hospitals are implementing programs to support clinicians involved in adverse events (‘second victims’). Researchers interviewed 12 representatives of second victim programs in the United States about the experiences of their programs. The article discusses representative feedback regarding the importance of identifying a need for second victim programs and services, perceived challenges to program success, structural changes after program implementation, and insights for success.   
Gampetro PJ, Segvich JP, Hughes AM, et al. J Pediatr Nurs. 2021;63:20-27.
Communicating and reporting patient safety incidents relies on a robust safety culture wherein health care providers feel supported, not blamed, for errors. Using pediatric registered nurses’ responses from the 2016 and 2018 Hospital Survey on Patient Culture, researchers explored (1) associations between the communication of RNs within their teams and the frequency that they reported safety events; (2) associations between RNs’ communication within their health care teams and their perceptions of safety within the hospital unit; and (3) whether RNs’ communication had improved from 2016 to 2018.
Saliba R, Karam-Sarkis D, Zahar J-R, et al. J Hosp Infect. 2022;119:54-63.
Patient isolation for infection prevention and control may result in unintended consequences. This systematic review examined adverse physical and psychosocial events associated with patient isolation. A meta-analysis of seven observational studies showed no adverse events related to clinical care or patient experience with isolation.
Dixon-Woods M, Aveling EL, Campbell A, et al. J Health Serv Res Policy. 2022;Epub Jan 3.
A key aspect of patient safety culture is the perception that all team members should speak up about safety concerns. In this study of 165 frontline and senior leader participants, deciding to report a safety event (referred to as a “voiceable concern”) is influenced by four factors: certainty that something is wrong and is an occasion for voice; system versus conduct concerns, forgivability, and normalization. Organizational culture and context effect whether an incident is considered a voiceable concern.
FitzGerald C, Hurst S. BMC Med Ethics. 2017;18(1):19.
Healthcare provider implicit bias can lead to inequitable care delivery and poor patient outcomes. This review identified 42 articles about healthcare professional implicit biases, including gender, race, ethnicity, and age. Biases were detected in provider attitudes, treatment decisions, and diagnosis.
Noor Arzahan IS, Ismail Z, Yasin SM. Safety Sci. 2022;147:105624.
A culture of safety is a key component to successful patient safety initiatives. This systematic review explored the relationship between safety culture and safety climate dimensions and safety performance measures. The most common dimensions used to assess this relationship were the involvement of leadership, safety resources, risk management and communication, safety rules and procedures, and involvement of healthcare workers.

Dean J, Subbe C, eds. Future Healthc J. 2021;8(3):e559-e618.

Full realization of the patient voice as a resource for safety is challenging. This special section provides global perspectives examining cultural, organizational, and system-focused opportunities to fully use patient knowledge in improvement initiatives.
Gandhi TK. Jt Comm J Qual Patient Saf. 2022;48(1):61-64.
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.
Winning AM, Merandi J, Rausch JR, et al. J Patient Saf. 2021;17(8):531-540.
Healthcare professionals involved in a medical error often experience psychological distress. This article describes the validation of a revised version of the Second Victim Experience and Support Tool (SVEST-R), which was expanded to include measures of resilience and desired forms of support.
De Angulo NR, Penwill N, Pathak PR, et al. Hosp Pediatr. 2021;Epub Dec 24.
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.