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Fighting a common enemy: a catalyst to close intractable safety gaps
  1. Hardeep Singh1,
  2. Dean F Sittig2,
  3. Tejal K Gandhi3
  1. 1Center for Innovations in Quality, Effectiveness and Safety, Michael E. DeBakey Veterans Affairs Medical Center and Baylor College of Medicine, Houston, Texas, USA
  2. 2School of Biomedical Informatics, University of Texas Health Science Center, Houston, Texas, USA
  3. 3Press Ganey Associates LLC, Boston, Massachusetts, USA
  1. Correspondence to Dr Hardeep Singh, Michael E. DeBakey Veterans Affairs Medical Center (MEDVAMC), Center for Innovations in Quality, Effectiveness and Safety (152), 2002 Holcombe Boulevard, Houston, TX 77030, USA; hardeeps{at}

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Since March 2020, the world has faced a singular threat: COVID-19. The shared commitment and responsibility uniting everyone within and outside of healthcare to bend the COVID-19 curve has been unparalleled. Prior to the pandemic, this type of shared commitment has been discouragingly lacking for other major healthcare concerns such as patient safety.1 Reasons for this include organisational leaders who are incentivised to focus on activities essential for reimbursement and quality measurement rather than those involving the promotion of safety culture and implementation of systems-based approaches to improve safety, compounded by lack of clear ownership and accountability to solve long-standing safety challenges.2 3

The COVID-19 pandemic is leading to several ongoing impacts on the healthcare delivery system,4 many of which have patient safety implications and will be quantified in future work. We are witnessing negative effects from delays in care from patients not seeking (or unable to seek) healthcare, patients with complex chronic conditions not having ongoing ambulatory care and new types of diagnostic errors.5 However, we are also witnessing some early short-term positive effects in selected safety areas where the COVID-19 pandemic has provided a new glimmer of hope. As of now, several changes have occurred in at least three safety-related domains: (1) adoption of key attributes of safety culture (transparency, communication and collaboration); (2) rapid implementation of safety practices to care for the previously often neglected healthcare workforce; and (3) use of state-of-the-art health information technology (IT) to improve the safety of patients and clinicians within the healthcare delivery system. Even though currently only temporary and not universal, the rapid adoption of these strategies demonstrates the potential of diverse stakeholders with competing interests to rally together against a common enemy, in this case a deadly virus.

Bringing about long-term changes and improvement of patient …

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