Skip to main content

All Content

Search Tips
Save
Selection
Format
Download
Published Date
Original Publication Date
Original Publication Date
PSNet Publication Date
Narrow Results By
Additional Filters
1 - 20 of 59
Koch A, Kozhumam A. Health Promot Pract. 2022;23:555-559.
Racial biases have been uncovered in pediatric emergency care; for example, Black children are less likely to receive pain medication for appendicitis. This article describes the use of the Racism as Root Cause (RRC) framework to identify and reduce adultification (when children are perceived or treated as being older than they are) of Black children in emergency departments. RRC calls for systemic, rather than individual, efforts.

Bryant A. UpToDate. June 28, 2022.

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
Olsen SL, Søreide E, Hansen BS. J Patient Saf. 2022;18:717-721.
Rapid response systems (RRS) are widely used to identify signs of rapid deterioration among hospitalized patients.  Using in situ simulation, researchers identified obstacles to effective RRS execution, including inconsistent education and documentation, lack of interpersonal trust, and low psychological safety.
Etherington C, Kitto S, Burns JK, et al. BMC Health Serv Res. 2021;21:1357.
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.  
Liese KL, Davis-Floyd R, Stewart K, et al. Anthropol Med. 2021;28:188-204.
This article draws on interviews and observations to explore medical iatrogenesis in obstetric care. The authors discuss how various factors – such as universal management plans, labor and delivery interventions, and informed consent – contribute to iatrogenic harm and worse perinatal outcomes for racial/ethnic minority patients.
Allison MK, Marshall SA, Stewart G, et al. J Emerg Med. 2021;61:396-405.
Transgender and gender nonbinary (trans/NB) people can face discriminatory behaviors when accessing health care services. Trans/NB patients were interviewed about their experiences accessing care in emergency departments. Four themes were uncovered: 1) system and structural issues; 2) interactions with clinicians/staff; 3) perceptions of clinician knowledge and education; and 4) impact on future health and healthcare access. Recommendations for improvement were provided at the system and clinician level.

Wands B. AANA J. 2021;89(2):168-174.

Healthcare professionals who experience emotional consequences after adverse events are often referred to as “second victims.” Targeted towards certified registered nurse anesthetists (CRNAs), this article discusses second victim experiences in anesthesiology and implications for anesthesia education and training.
Petrone G, Brown L, Binder W, et al. Disaster Med Public Health Prep. 2021;Epub Mar 26.
As COVID-19 infections surged worldwide, many states set up alternative care hospitals (ACH), or field hospitals. Prior to opening a Rhode Island ACH, four multi-disciplinary in situ simulation scenarios were run to perform system testing. This in situ simulation was successful in identifying patient safety concerns, resulting in equipment modification and protocol changes.
Brockett-Walker C, Lall M, Evans DD, et al. Adv Emerg Nurs J. 2021;43:89-101.
This review critiques a 2016 article (link below) which found unconscious, implicit bias can negatively impact patient care when emergency department providers are under increased cognitive stress. The authors propose strategies for educators and institutions to combat implicit bias including self-awareness, stress reduction, and respectful communication.
Lewandowska K, Weisbrot M, Cieloszyk A, et al. Int J Environ Res Public Health. 2020;17:8409.
Alarm fatigue, which can lead to desensitization and threaten patient safety, is particularly concerning in intensive care settings. This systematic review concluded that alarm fatigue may have serious consequences for both patients and nursing staff. Included studies reported that nurses considered alarms to be burdensome, too frequent, interfering with patient care, and resulted in distrust in the alarm system. These findings point to the need for a strategy for alarm management and measuring alarm fatigue.  
Avesar M, Erez A, Essakow J, et al. Diagnosis (Berl). 2021;8:358-367.
Disruptive and rude behavior can hinder teamwork and diminish patient safety. This randomized, simulation-based study including attendings, fellows, and residents explored whether rudeness during handoff affects the likelihood for challenging a diagnostic error. The authors found that rudeness may disproportionally hinder diagnostic performance among less experienced physicians.
Sharara-Chami R, Sabouneh R, Zeineddine R, et al. Simul Healthc. 2020;15:303-309.
Simulation training is used by hospitals to improve patient care. This article describes the use of a preparedness assessment and training intervention featuring in situ simulations followed by debriefing to prepare staff for challenges arising due to the COVID-19 pandemic. Observations and debriefings identified several latent safety threats related to infection control, leadership, and communication.
Meyer AND, Upadhyay DK, Collins CA, et al. Jt Comm J Qual Patient Saf. 2021;47:120-126.
Efforts to reduce diagnostic error should include educational strategies for improving diagnosis. This article describes the development of a learning health system around diagnostic safety at one large, integrated health care system. The program identified missed opportunities in diagnosis based on clinician reports, patient complaints, and risk management, and used trained facilitators to provide feedback to clinicians about these missed opportunities as learning opportunities. Both facilitators and recipients found the program to be useful and believed it would improve future diagnostic safety. 
Fasano HT, McCarter MSJ, Simonis JM, et al. Simul Healthc. 2021;6:85-91.
This study explored disparities in physician decision making among patients of varying socioeconomic status (SES) during simulated scenarios. While quantitative analyses did not identify a significant relationship between SES and image or medication ordering, patient-perceived empathy, or clinical performance, qualitative analyses identified three themes which may bias decision making – overt diagnostic focus, discharge planning, and risk and exposure.
Zhang LM, Ellis RJ, Ma M, et al. JAMA. 2020;323:2093-2095.
In this survey of 6,264 US general surgery residents, 70% reported experiencing at least one bullying behavior during surgical training and 18% reported frequent bullying. The most common types of bullying behavior were repeated reminders of mistakes, being shouted at, withholding of important information, persistent criticism, and hostility. Women and racial/ethnic minorities reported more frequent bullying. Residents reporting frequent bullying had higher rates of burnout, suicidal thoughts, and thoughts of leaving surgical training.
Hu Y-Y, Ellis RJ, Hewitt B, et al. New Engl J Med. 2019;381:1741-1752.
Physician burnout can negatively impact not only physician well-being, but patient safety as well. This national survey of general surgery residents found that about one-third of all respondents reported experiencing discrimination or abuse; 38.5% of residents reported weekly burnout systems and 4.5% reported suicidal thoughts within the past year. Residents reporting burnout or suicidal thoughts were more likely to have experienced discrimination, abuse or sexual harassment. Women reported more exposure to mistreatment, which may account for gender differences in rates of burnout and suicidal thoughts.  
Katz D, Blasius K, Isaak R, et al. BMJ Qual Saf. 2019;28:750-757.
Disruptive and unprofessional behavior in health care can compromise safety culture. Prior research has shown that male physicians and those working in procedural specialties may be more likely to demonstrate unprofessional behavior. Experiencing such incivility may have important implications on the clinical performance of those impacted. In this multicenter, prospective, randomized controlled trial, researchers subjected anesthesiology residents to a simulated operating room emergency in either a normal or a disrespectful environment; blinded evaluators rated their performance. They found that residents exposed to rude environments scored lower on every performance measure, although there was minimal difference in the self-assessment scores between the two groups. The authors suggest that improving the culture in operating room environments is crucial and advocate for focused education on communication in stressful situations during medical training. A past WebM&M commentary discussed an incident involving a communication failure in a pediatric intensive care unit.