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A psychologically safe environment for healthcare teams is desirable for optimal team performance, team member well-being, and favorable patient safety outcomes. This piece explores facilitators of and barriers to psychological safety across healthcare settings. Future research directions examining psychological safety in healthcare are discussed.

Famolaro T, Hare R, Tapia A, Yount et al. Rockville, MD: Agency for Healthcare Research and Quality; December 2021. AHRQ Publication No. 22-0004.

Ambulatory surgery centers harbor unique characteristics that affect safety culture. This analysis from the Agency for Healthcare Research and Quality (AHRQ) shares results of 235 ambulatory surgery centers (ASCs) participating in the Surveys on Patient Safety Culture (SOPS) Ambulatory Surgery Center Survey. Most respondents (92%) rated their organization as committed to learning and continuous improvement.
Sotto KT, Burian BK, Brindle ME. J Am Coll Surg. 2021;233:794-809.e8.
The World Health Organization (WHO) Surgical Safety Checklist has been implemented in healthcare systems around the world. This systematic review and thematic analysis concluded that the surgical safety checklist positively impacts clinical outcomes (surgical outcomes and mortality), process measures, team dynamics, and communication, as well as safety culture. The authors note that the checklist was negatively associated with efficiency and workload; included studies often noted that checklist users felt the checklist slowed down processes within the operating room

Agency for Healthcare Quality and Research. Fed Register. August 31, 2021;86:48703-48705.

This announcement calls for public comment on the intention of the Agency for Healthcare Research and Quality to launch the Ambulatory Surgery Center Survey on Patient Safety Culture Database data collection process. The comment period is closed.
Weinger MB. BMJ Qual Saf. 2021;30:613-617.
Checklists are widely used strategies for error reduction and improved communication. This editorial discusses the limitations of checklists for perioperative safety (i.e., when used in isolation or implemented incorrectly) and suggests that safety initiatives taking a systems-oriented approach and organizational buy-in can lead to both perioperative and general safety improvements.

Preckel B, ed. Best Pract Res Clin Anaesthesiol. 2021;35(1):1-154.

The field of anesthesiology has realized impressive improvements in safety, yet challenges still exist in its practice. This special issue provides discussions on a variety of concerns that require continued effort, including use of early warning scores, differences associated with sex and gender, and use of incident reporting systems.
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.  

Azar FM, ed. Orthop Clin North Am. 2018;49(4):A1-A8,389-552.

Quality and value have intersecting influence on the safety of health care. Articles in this special issue explore key principles of safe orthopedic care for both adult and pediatric patients. Topics covered include leadership's role in implementing sustainable improvement, postsurgery patient education as a safety tactic, and the impact of surgical volume on safe, high-quality care.
Farag AA, Anthony MK. J Perianesth Nurs. 2015;30:492-503.
This survey study of nurses across four ambulatory surgical wards in Ohio found that nursing managers' leadership styles and some aspects of the safety climate (such as teamwork and organizational learning) were associated with how willing nurses are to report medication errors.
Mueller BU, Neuspiel DR, Fisher ERS, et al. Pediatrics. 2019;143.
This updated policy statement from the American Academy of Pediatrics reviews the epidemiology of medical errors in children, examines unique issues in safety for pediatric patients, and discusses specific approaches to improving safety in pediatrics. The article emphasizes the responsibility of pediatricians to be familiar with patient safety concepts and techniques, and the importance of establishing a culture of safety in both inpatient and outpatient settings. The article concludes with a series of specific recommendations for advancing the science of patient safety within the field of pediatrics.
Oakbrook Terrace, IL: Joint Commission Resources; 2010. ISBN: 9781599404073.
This report makes recommendations and provides strategies to ensure safe practice in surgical care.
Waring JJ, Bishop S. J Health Organ Manag. 2010;24:325-42.
Reporting systems, morbidity and mortality conferences, and case review all serve as mechanisms to learn about adverse events and identify opportunities for improvement. However, many of these forums rely on voluntary measures to bring issues to the forefront, leaving many “water cooler” conversations as a lost opportunity for organizational learning. This ethnographic study explores how informal knowledge sharing, the proverbial water cooler conversation, takes place in a staff lounge, a storeroom, and an operating room corridor. The authors found rich information sharing in this context, perhaps fueled by the trusting and mutually desired setting for the exchanges. They advocate for greater attention to capturing and fostering these communications as a potentially important source of hidden advancement in patient safety knowledge and a positive safety culture.