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de Loizaga SR, Clarke-Myers K, R Khoury P, et al. J Patient Exp. 2022;9:237437352211026.
Parents have reported the importance of being involved in discussions with clinicians following adverse events involving their children. This study asked parents and physicians about their perspectives on inclusion of parents in morbidity and mortality (M&M) reviews. Similar to earlier studies, parents wished to be involved, while physicians were concerned that parent involvement would draw attention away from the overall purpose (e.g., quality improvement) of M&M conferences.
Kostick-Quenet KM, Cohen IG, Gerke S, et al. J Law Med Ethics. 2022;50:92-100.
Biases in decision support technologies precipitate racial inequities. This commentary discusses how algorithms in machine learning contribute to inaccuracies in the care of persons of color and the displaced. Legal actions to mitigate racial biases in decision making programs and implementation steps toward improvement are discussed.
Barnard C, Chung JW, Flaherty V, et al. Jt Comm J Qual Patient Saf. 2022;Epub Apr 28.
Organizations such as The Joint Commission and the Leapfrog Group require participating healthcare organizations to evaluate their patient safety culture, but surveys can represent a time burden on staff. An Illinois health system aimed to lessen this burden on staff by creating a shorter, revised survey. The final survey consisted of five questions with comparable measurement properties of the original 17-question survey; however, the authors caution the shorter survey will yield less detail than the longer version.

Ferrere A, Rider C, Renerte B et al. Sloan Manag Rev. Summer 2022;39-43.

A baseline expectation in a safe organization is that employees feel comfortable and supported when sharing concerns. This article summarizes key results of a large workplace survey to identify cultural elements supporting the psychological safety required to encourage speaking up when ethical or other issues are identified in operations.
Bamberger E, Bamberger P. BMJ Qual Saf. 2022;Epub Apr 15.
Disruptive behaviors are discouragingly present in health care. This commentary discusses evidence examining the impact of unprofessional behaviors on safety and clinical care. The authors suggest areas of exploration needed to design reduction efforts such as teamwork, the Safety I mindset and targeting of the root influences of impropriety.
Guzek R, Goodbody CM, Jia L, et al. J Pediatr Orthop. 2022;Epub May 9.
Research has demonstrated inequitable treatment of racially minoritized patients resulting in poorer health outcomes. This study aimed to determine if implicit racial bias impacts pediatric orthopedic surgeons’ clinical decision making. While pediatric orthopedic surgeons showed stronger pro-white implicit bias compared to the US general population (29% vs. 19%), the bias did not appear to affect decision making in clinical vignettes.

Armstrong Center for Patient Safety and Quality. September 29, 2022.

The Resilience in Stressful Events (RISE) program provides peer assistance for healthcare workers who experience psychological effects after involvement in stressful adverse care events. This virtual session presents RISE implementation education and orientation for staff to respond when peer support is needed.
Galiatsatos P, O'Conor KJ, Wilson C, et al. Health Secur. 2022;Epub Apr 26.
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.
Appelbaum NP, Santen SA, Perera RA, et al. J Patient Saf. 2022;18:370-375.
Residents and trainees frequently report experiencing bullying and disrespectful behaviors in the workplace. This study explored the relationship between resident psychological safety, perceived organizational support, and humiliation. Results indicate resident perception of increased organizational support (e.g., help is available when they have a problem) reduces the negative impact of humiliation on their psychological safety.
Prudenzi A, D. Graham C, Flaxman PE, et al. Psychol Health Med. 2022;27:1130-1143.
Previous research has found that mindfulness interventions can reduce stress and burnout among physicians. This survey of 98 healthcare workers within the UK National Health Service (NHS) explored the relationship between poor wellbeing, burnout and perceived safe practice and identified a positive relationship between mindfulness processes and perceived safe practices.

Andreou A. Scientific AmericanMay 26, 2022.

Negative comments and attitudes indicate a lack of professionalism that can affect patient care. This article shares concerns about surgeon biases toward patients who are overweight and calls for clinicians to recognize the problem and address it.

The U.S. Surgeon General’s Advisory on Building a Thriving Health Workforce. Washington DC: Office of the Surgeon General; May 2022.

Health care staff and clinician wellbeing is known to affect safety and quality. This advisory suggests national priorities to target improvement efforts. Areas of focus include workforce shortages, system inequities and burnout.
Dyrbye LN, West CP, Sinsky CA, et al. JAMA Netw Open. 2022;5:e2213080.
Burnout is characterized as emotional exhaustion, depersonalization, and decreased sense of accomplishment at work which results in overwhelming negative emotions. Earlier studies have focused on the association of burnout with the electronic medical record and the COVID-19 pandemic, among others. This study focused on the association of physician burnout and mistreatment by patients, families and visitors. Survey respondents reported experiencing mistreatment (e.g., racially or ethnically offensive remarks) and discrimination (e.g., patients or families refusing to allow the physician to provide treatment based on their gender, race, or ethnicity) in the past year. Experiencing mistreatment or discrimination was associated with burnout.
McQueen JM, Gibson KR, Manson M, et al. BMJ Open. 2022;12:e060158.
Patients and families are important partners in improving patient safety. This qualitative study explored the experiences of patients and family members involved in adverse event reviews. The authors identified four themes (communication, trauma, learning and litigation) outline eight key recommendations to address these themes by involving patients and families in adverse event reviews.
Shiner B, Gottlieb DJ, Levis M, et al. BMJ Qual Saf. 2022;31:434-440.
Previous research has emphasized suicide prevention in inpatient mental health settings, but less is known about suicide in outpatient settings. Using longitudinal data from 2013 to 2017, this study found no relationship between overall quality of outpatient mental healthcare and suicide rates among patients treated by the Veterans Health Administration healthcare system.
Sonis J, Pathman DE, Read S, et al. J Healthc Manag. 2022;67:192-205.
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.

Sausser L. Kaiser Health News. May 24, 2022.

Lack of education contributes to misunderstandings and unhelpful preconceptions. This article discusses biases affecting the care of patients who are overweight. It introduces an educational effort to raise awareness of potential diagnostic and treatment actions affected by clinician bias to decrease safety for this patient population.

ISMP Medication Safety Alert! Acute care edition. May 19, 2022;27(10):1-5.

Challenging authority can be difficult but necessary in risky situations. This article examines a serial euthanasia overdose case and how the individuals interfacing with the physician involved sensed the medications ordered were inappropriate, yet said nothing. The piece discusses organizational and individual steps to encourage raising concerns in an appropriate and effective manner.
Rockville, MD: Agency for Healthcare Research and Quality; 2019.
The AHRQ Surveys on Patient Safety Culture™ (SOPS®) Hospital Survey and accompanying toolkit were developed to collect opinions of hospital staff on the safety culture at their organizations. An accompanying database serves as a central repository for hospitals to report their results. Participating hospitals will be able to measure patient safety culture in their institutions and compare results with other sites. Data will be collected for the latest submission period from June 1–July 22, 2022.
Joseph K, Newman B, Manias E, et al. Patient Educ Couns. 2022;Epub Apr 26.
Lack of patient engagement in care can place them at increased risk for safety events. This qualitative study explored ethnic minority stakeholder perspectives about patient engagement in cancer care. Focus groups consisting of participants from consumer and health organizations involved in cancer care in Australia identified three themes supporting successful engagement – consideration of sociocultural beliefs about cancer, adaptation of existing techniques tailored to stakeholders (e.g., culturally specific content), and accounting for factors such as cultural competence during implementation.