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Al-Ghunaim TA, Johnson J, Biyani CS, et al. Am J Surg. 2022;224:228-238.
Burnout in healthcare providers has been linked to lower patient safety and increased adverse events. This systematic review examined studies focusing on the relationship between burnout and patient safety and professionalism in surgeons. Results indicate higher rates of burnout and emotional exhaustion were associated with an increased risk of involvement in medical error. Interventions to reduce burnout and improve surgeon well-being may result in improved patient safety.
Wallis CJD, Jerath A, Coburn N, et al. JAMA Surg. 2022;157:146-156.
Gender, racial, and ethnic disparities in healthcare can adversely impact patient safety and lead to poor outcomes. This retrospective study examined surgeon-patient sex discordance and perioperative outcomes among adult patients in Ontario, Canada, undergoing common elective or emergent surgical procedures from 2007 to 2019. Among 1.3 million patients, sex discordance between surgeon and patient was associated with a significant increased likelihood of adverse perioperative outcomes, including death. Subgroup analyses indicate that this relationship is driven by worse outcomes among female patients treated by male surgeons.
Brenner MJ, Boothman RC, Rushton CH, et al. Otolaryngol Clin North Am. 2021;55.
This three-part series offers an in-depth look into the core values of honesty, transparency, and trust. Part 1, Promoting Professionalism, introduces interventions to increase provider professionalism. Part 2, Communication and Transparency, describes the commitment to honesty and transparency across the continuum of the patient-provider relationship. Part 3, Health Professional Wellness, describes the impact of harm on providers and offers recommendations for restoring wellness and joy in work.

This piece discusses an expanded view of maternal and infant safety that includes the concept of whole-person care, which addresses the structural and social determinants of maternal health.

Alison Stuebe, MD, MSc, is a professor and Division Director for Maternal-Fetal Medicine in the Department of Obstetrics and Gynecology at the University of North Carolina (UNC) at Chapel Hill and the co-director of the Collaborative for Maternal and Infant Health. Kristin Tully, PhD, is a research assistant professor in the Department of Obstetrics and Gynecology at UNC Chapel Hill and a member of the Collaborative for Maternal and Infant Health.

D'Angelo JD, Lund S, Busch RA, et al. Surgery. 2021;170:440-445.
This study evaluated the type and effectiveness of resident and faculty coping strategies following an intraoperative error and the interaction with physician gender. Results show that while men and women surgeons experience adverse events at approximately the same rate, the coping methods utilized and effectiveness of the methods varied.
Wright MI, Polivka B, Abusalem S. AORN J. 2021;113:465-475.
Prior research identified variability in perioperative safety culture by provider type and experience. This study found that perioperative nurse engagement (e.g., energy, dedication, resilience) and perioperative nurse certification were significantly associated with self-reported safety culture in the operating room, but length of perioperative nurse experience was not.
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. 
Buhlmann M, Ewens B, Rashidi A. J Clin Nurs. 2020;30:1195-1205.
Adverse events can have significant impacts on the providers involved. This systematic review explored the experiences of critical incidents on nurses and midwives and their perceived support from the healthcare system. The article discusses the emotional, physical, and professional impacts; perceptions of personal, peer and workplace support; and how nurses and midwives move forward and cope with the impact of critical incidents.  
Arriaga AF, Szyld D, Pian-Smith MCM. Anesthesiol Clin. 2020;38:801-820.
Debriefing is an established strategy teams use to learn from critical events, reduce event occurrence, and improve failure response. This review examines how debriefing principles can be embedded for use of the practice in real time, rather than developed in simulated circumstances, to improve anesthesia safety.
Hewitt DB, Ellis RJ, Chung JW, et al. Ann Surg. 2021;274:396-402.
This cross-sectional survey of general surgery residents to assessed resident wellness and self-reported error and compared these results against National Surgical Quality Improvement Program (NSQIP) registry data to assess patient outcomes. Over a six-month period, 22.5% of residents self-reported a near-miss medical error and nearly 7% reported an error resulting in patient harm. Residents reporting harmful medical errors were more likely to report symptoms of burnout and poor psychiatric well-being, but researchers did not find any significant association between well-being and adverse postoperative patient outcomes reported in the NSQIP registry.
Hajibandeh S, Hajibandeh S, Satyadas T. The Surgeon. 2019;18:231-240.
Differences in weekend care for inpatients have been reported; however, the patient safety implications of the weekend effect are unclear. This meta-analysis pooled data from over 390,000 patients and found there was a higher risk of postoperative mortality among patients undergoing emergency general surgery on the weekends in the United States and Europe.
Potential deterioration of an aging surgeon's technical abilities is an emerging patient safety concern. This magazine article discusses how implementing policies and activities to assess the ability of surgeons to practice safely after a certain age can prevent risks.
Cooper WO, Spain DA, Guillamondegui O, et al. JAMA Surg. 2019;154.
Physicians who behave unprofessionally toward other health care workers compromise both safety culture and patient health. Hostile behavior among surgeons is particularly harmful because surgical care is both teamwork-dependent and has high stakes. Although many have reported anecdotally that disrespectful surgeon behavior has led to patient harm, it is challenging to study systematically. Investigators sought to determine whether patients whose surgeons had coworker reports of unprofessional behavior experienced more harm. Surgeons at two academic medical centers who had coworker reports of unprofessional behavior in the 3 years before a surgery were more likely to have patients experience both medical and surgical complications after the surgery. These findings highlight the importance of empowering team members to report unprofessional behavior so that it can be remediated. Two WebM&M commentaries describe different approaches to addressing unprofessional physician behavior.
During surgery for a forearm fracture, a woman experienced a drop in heart rate to below 50 beats per minute. As the consultant anesthesiologist had stepped out to care for another patient, the resident asked the technician to draw up atropine for the patient. When the technician returned with an unlabeled syringe without the medication vial, the resident was reluctant to administer the medication, but did so without a double check after the technician insisted it was atropine. Over the next few minutes, the patient's blood pressure spiked to 250/135 mm Hg.
Rosengart TK, Doherty G, Higgins R, et al. JAMA Surg. 2019;154:647-653.
Potential deterioration of older surgeons' technical performance is a patient safety concern. This guidance developed from a Society of Surgical Chairs panel discussion puts forth several steps to manage the transition of aging surgeons. Recommendations include mandatory cognitive and psychomotor testing for surgeons age 65 and older, respectful consideration of the financial and emotional concerns of aging surgeons, and lifelong mentoring around the transition from clinical to nonclinical roles. The authors anticipate that such initiatives will prompt thoughtful support for aging surgeons that ensures patient safety. In an accompanying editorial, an older physician supports mandatory testing and suggests individual-level steps to address aging as a surgeon, including healthy lifestyle and financial habits.
Royal College of Surgeons of England; RCS.
Physical demands and technical complexities can affect surgical safety. This resource is designed to capture frontline perceptions of surgeons in the United Kingdom regarding concerning behaviors exhibited by their peers during practice to facilitate awareness of problems, motivate improvement, and enable learning.
Nguyen S, Corrington A, Hebl MR, et al. JAMA Surg. 2019;154:555-557.
Prior research has shown that certain surgeon behaviors are associated with an increased risk of malpractice claims, but less is known about how certain patient factors such as sleep may impact patients' desire to pursue litigation and seek financial compensation. In this study, researchers randomized healthy adults to normal sleep and sleep-restriction. After 4 nights, participants read and rated eight medical error vignettes. Sleep restriction was associated with increased desire to punish the surgeons and provide greater financial compensation to the patients described in the vignettes.