Clinician well-being has important implications for patient safety and quality of healthcare delivery. In this study, researchers used a concept analysis to identify attributes of nurse well-being at the individual level (e.g., satisfaction, compassion) and organizational/community level (e.g., teamwork, pride in work). These findings can support the development of a standardized definition of nurse well-being to guide future research and policy considerations around well-being and burnout.
Goodair B, Reeves A. Lancet Public Health. 2022;7:e638-e646.
England’s National Health Service (NHS) allows patients to receive care from public or for-profit private organizations. In comparing treatable mortality rates at public and for-profit providers, researchers found an additional 557 treatable deaths at for-profit private organizations between 2014 and 2020. The authors recommend further research into potential causes.
Marang-van de Mheen PJ, Vincent CA. BMJ Qual Saf. 2021;30:525-528.
Research has shown that patients admitted to the hospital on the weekend may experience worse outcomes compared to those admitted on weekdays (the ‘weekend effect’). This editorial highlights the challenges to empirically evaluate the underlying mechanisms contributing to the weekend effect. The authors propose viewing the weekend effect as a proxy for staffing levels and the influence of other factors influencing outcomes for patients admitted on weekends, such as patient acuity, clinician skill-mix and access to diagnostic tests or other ancillary services.
Placona AM, Rathert C. Med Care Res Rev. 2021:107755872110145.
This systematic review analyzed results of 32 studies comparing online patient reviews (OPRs) and measures of patient outcomes. While OPRs did have positive associations with patient experience, associations between OPRs and quality measures were mixed. Due to the weight that patients give OPRs, future research should focus on associations between OPRs and encounter setting, specialty, and specific quality measures.
Brown KW, Carlisle K, Raman SR, et al. Health Aff (Milwood). 2020;39:1737-1742.
Over the last decade, children have experienced a dramatic rise in hospitalizations and intensive care unit stays related to opioid use. Based on Medicaid claims in North Carolina, prescribers of opioids for children were most commonly physicians and dentists. More than 3% of children ages 1 to 17 years had at least one opioid prescription filled annually; 76.6 children per 100,000 experienced an opioid-related adverse event or other harm. Adolescents ages 15 to 17 years disproportionately experienced these harms compared to younger age groups. Black and urban children were less likely to fill opioid prescriptions or experience adverse events, but they were more likely to experience other opioid-related harm, such as abuse or dependence.
Myers LC, Heard L, Mort E. Am J Crit Care. 2020;29:174-181.
This study reviewed medical malpractice claims data between 2007 and 2016 to describe the types of patient safety events involving critical care nurses. Decubitus ulcers were the most common diagnosis in claims involving ICU nurses and compared to nurses in emergency departments and operating rooms, ICU nurses were likely to have a malpractice claim alleging failure to monitor.
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.
Patients and families are critical partners in identifying and preventing patient safety events. A systematic review found willingness among patients and families engage in safety activities, but barriers such as limited patient/family knowledge, poor communication, and lack of systems-level efforts supporting patient and family engagement may hinder effective engagement.
Moore JS, Mello MM, Bismark M. Bioethics. 2019;33:948-957.
Patient engagement is now acknowledged as a cornerstone of patient safety, but the perspectives of patients who have experienced adverse events remain understudied. This interview study of 92 patients who had experienced iatrogenic injury identified several insights about the aftermath of adverse events. As with prior studies, researchers found that patients expressed a desire to be heard. Participants had positive perceptions of patient safety research and expressed a desire that others learn from the adverse event they experienced. The authors suggest that institutional review boards permit investigators to approach patients who have experienced adverse events to participate in studies, rather than prohibit such studies due to fear of causing further psychological harm. They also recommend that researchers discuss these adverse events with patients through a reciprocal lens, expressing support and sympathy rather than maintaining an emotionally distant stance. A previous PSNet interview with the lead author discussed disclosure and apology in health care.
The FDA recently raised awareness of the potential risks associated with the use of robotic-assisted surgical devices in mastectomies or cancer-related care. This commentary spotlights how payers, hospitals, and clinicians can prevent harm related to robotic surgical device use. Strategies to improve safety include enhanced credentialing, device-specific training, and informed consent. A WebM&M commentary discussed an incident of harm associated with robotic-assisted surgery.
Kozhimannil KB. Health Aff (Millwood). 2018;37:1901-1904.
Maternal harm is a sentinel event that is gaining increased attention in both policy and clinical environments. In this commentary, the author relates her family history of maternal morbidity and mortality and advocates for enhancements in collecting data on maternal health outcomes, access to care, understanding of racial disparities, accountability, and listening to patients and families who have been impacted by unsafe maternal care.
Shields MC, Stewart MT, Delaney KR. Health Aff (Millwood). 2018;37:1853-1861.
Despite concerns regarding the safety and quality of care for hospitalized psychiatric patients, research exploring this area of patient safety is lacking. This commentary suggests several policy-focused strategies to improve the safety and patient-centeredness of inpatient psychiatric care, including payment reforms, incentive alignment, and increased funding for research.
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