Objectives The aim of the study was to determine whether race differences exist in voluntarily reported harmful patient safety events in a large 10 hospital healthcare system on a high reliability organization journey. Methods From July 1, 2015, to June 30, 2017, employees in a healthcare system based in Washington, District of Columbia, and Maryland voluntarily reported harmful patient safety events by type using a Patient Safety Event Management System. Inpatients, outpatients, and observation patients were identified as “black,” “white,” or “other” (N = 5038). Using retrospective analysis and χ2 goodness of fit, comparisons of race proportions were conducted to determine differences at the health system level, by hospital, by event type, and by severity. Results Significant race differences existed: (1) overall with higher proportions of whites and lower proportions of other in a Patient Safety Event Management System; (2) by type across races; (3) in six hospitals across races; and (4) by type and by hospital for blacks and whites. All differences were significant at P < 0.05. Conclusions Race differences in harmful events exist in voluntary reporting systems by type and by hospital setting. Healthcare organizations, particularly healthcare high reliability organizations, can use these findings to help identify areas of further study and investigation. Further study and investigation should include efforts to understand the root cause of the differences found in this study, including the role of reporting bias.

Objective: This study aims to capture perspectives of healthcare workers (HCWs) on COVID-19 and infection prevention and control (IPAC) measures implemented during the early phase of the COVID-19 pandemic. Design: A cross-sectional survey of HCWs was conducted. Participants: HCWs from the Hospital for Sick Children, Toronto, Canada. Intervention: A self-administered survey was distributed to HCWs. We analyzed factors influencing HCWs’ knowledge and self-reported use of personal protective equipment (PPE), concerns of contracting COVID-19 and acceptance of the recommended IPAC precautions for COVID-19. Results: A total of 175 HCWs (35 (20%) staff physicians, 24 (14%) residents or fellows, 72 (41%) nurses, 14 (8%) respiratory therapists, 14 (8%) administration staff and 14 (8%) other employees) completed the survey between March 6th and March 10th. Most of the respondents were from the emergency department (n=58; 33%) and the Intensive Care Unit (n=58; 33%). Eighty-six respondents (50%) identified the correct donning order. Only 60 (35%) identified the correct doffing order, but the majority (n=113, 70%) indicated the need to wash their hands immediately prior to removal of their mask and eye protection. Ninety-one (54%) respondents felt comfortable with recommendations for droplet/contact precautions for routine care of patients with COVID-19. HCWs’ occupation and concerns about contracting COVID-19 outside of work were associated with non-acceptance of the recommendation (p = 0.016 and p=0.036 respectively). Conclusion: As part of their pandemic response plans, healthcare institutions should have ongoing trainings for HCWs that focus on appropriate PPE doffing and discussions around modes of transmission of COVID-19.

Objectives: This study aimed to determine if race differences exist in voluntarily reported near-miss patient safety events in a large integrated, 10-hospital health care system on its journey to become a high reliability organization.

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