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Quality & safety in the literature: July 2020
  1. Jennifer Meddings1,2,3,
  2. Ashwin Gupta1,2,
  3. Nathan Houchens1,2
  1. 1 Internal Medicine, University of Michigan Medical School, Ann Arbor, Michigan, USA
  2. 2 Medicine Service, Veterans Affairs Ann Arbor Healthcare System, Ann Arbor, Michigan, USA
  3. 3 Pediatrics and Communicable Diseases, University of Michigan Medical School, Ann Arbor, Michigan, USA
  1. Correspondence to Dr Jennifer Meddings, Internal Medicine, University of Michigan Medical School, Ann Arbor, Michigan, USA; meddings{at}

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Healthcare quality and safety span multiple topics across the spectrum of academic and clinical disciplines. Keeping abreast of the rapidly growing body of work can be challenging. In this series, we provide succinct summaries of selected relevant studies published in the last several months. Some articles will focus on a particular theme, while others will highlight unique publications from high-impact medical journals.

Key points

  • In a randomised clinical trial, use of 16 symptom-specific cognitive aids significantly reduced omitted critical management steps for surgical teams in simulation scenarios involving deteriorating postoperative patients. JAMA Surgery. 27 November 2019.

  • Retrospective analysis of electronic health records, combined with institutional telecommunication logs, showed incoming telephone call interruptions for paediatric intensive care unit nurses were significantly and temporally associated with medication administration errors. Errors also varied by shift, nurse experience in the unit, nurse-to-patient ratio and level of patient care required. JAMA Pediatrics. 20 December 2019.

  • To characterise the prevalence of financial relationships between industry funding (pharmaceutical or medical device) and non-profit organisations representing patient groups, a systematic review identified 26 cross-sectional studies published between 2003 and 2018. Industry funding was common. Among the few studies that assessed the associations between industry funding and organisational positions, industry-funded groups tended to have positions favourable to the industry sponsor. BMJ. 22 January 2020.


The rapidly increasing number of studies and commentaries on the COVID-19 (severe acute respiratory syndrome coronavirus 2) pandemic have yet to include papers primarily focused on healthcare quality or applying quality improvement methods. The months to come will likely see increasing numbers of studies explicitly applying quality improvement methods to aspects of the crisis, and we will of course highlight noteworthy examples. We will also review the quality and safety literature using the lens of this crisis to identify content with implications for care …

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  • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

  • Competing interests None declared.

  • Patient consent for publication Not required.

  • Provenance and peer review Commissioned; internally peer reviewed.