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Objective: Given the increasing racial and ethnic diversity in the United States, hospitals face challenges in providing safe and high-quality care to minority patients. Cultural competency fostered through engagement in diversity programs can be used as a resourceful strategy to provide safe care and improve the patient safety culture. This article examined the association of cultural competency and employee's perceived attributes of safety culture., Methods: A longitudinal study design was used with 283 unique hospital observations from 2014 to 2016. The dependent variables were percent composite scores for 4 attributes of perceived safety culture: (1) management support for patient safety, (2) teamwork across units, (3) communication openness, and (4) nonpunitive response to an error. The independent variable was an engagement in diversity programs, considered in 3 categories: (1) high, (2) medium, and (3) low. Controls included hospital characteristics, market characteristics, and percent. Ordinal logistic regression was used for imputation, whereas multiple linear regression was used for analyses., Results: Results indicate that hospitals with high engagement have 4.64% higher perceptions of management support for safety, 3.17% higher perceptions of teamwork across units, and 3.97% higher perceptions of nonpunitive response, as compared with hospitals that have a low engagement in diversity programs (P < 0.05)., Conclusions: Culturally competent hospitals have better safety culture than their counterparts. Cultural competency is an important resource to build a safety culture so that safe care for patients from minority and diverse backgrounds can be delivered., Competing Interests: The authors disclose no conflict of interest., (Copyright © 2021 Wolters Kluwer Health, Inc. All rights reserved.)

The resilience of the healthcare industry, often considered recession-proof, is being tested by the COVID-19 induced reductions in physical mobility and restrictions on elective and non-emergent medical procedures. We assess early COVID-19 effects on the dynamics of decline and recovery in healthcare labor markets in the United States. Descriptive analyses with monthly cross-sectional data on unemployment rates, employment, labor market entry/exit, and weekly work hours among healthcare workers in each healthcare industry and occupation, using the Current Population Survey from July 2019-2020 were performed. We found that unemployment rates increased dramatically for all healthcare industries, with the strongest early impacts on dentists' offices (41.3%), outpatient centers (10.5%), physician offices (9.5%), and home health (7.8%). Lower paid workers such as technologists/technicians (10.5%) and healthcare aides (12.6%) were hit hardest and faced persistently high unemployment, while nurses (4%), physicians/surgeons (1.4%), and pharmacists (0.7%) were spared major disruptions. Unique economic vulnerabilities faced by low-income healthcare workers may need to be addressed to avoid serious disruptions from future events similar to COVID-19.

Objective: To examine the association between patient race/ethnicity, insurance status, and their interaction with patient safety indicators among hospitalized patients., Methods: Cross-sectional study was conducted. Data were extracted from the 2009 National Inpatient Sample. A total of 3,052,268 patient safety indicator-related discharges were identified. Dependent variables were 11 patient safety indicators (PSI) whereas independent variables included race/ethnicity and insurance status., Results: As compared with White patients, African American patients were more likely to experience pressure ulcer, post-operative hemorrhage or hematoma, and post-operative pulmonary embolism (PE) or deep vein thrombosis (DVE); Asian/Pacific Islander patients were more likely to experience pressure ulcer, post-operative PE or DVT, and two obstetric care PSIs; whereas Hispanic/Latino patients were more likely to experience post-operative physiometabolic derangement and accidental puncture/laceration. As compared with patients with private insurance, Medicaid patients were more likely to experience pressure ulcer, post-operative physiological metabolic derangement, post-operative PE or DVT, post-operative respiratory failure, post-operative wound dehiscence, and death among surgeries. However, both obstetric care PSIs showed that African Americans, Hispanics, and uninsured patients were less likely to incur them in comparison with their respective counterparts. Furthermore, strong interactive effects between African American and Medicaid on PSIs were detected., Conclusions: Although mixed findings in disparities in PSIs were observed in our study, Asian/Pacific Islander patients and Medicaid patients seem to be the most vulnerable. Further, interactive effects between African American and Medicaid indicate that poverty may be a key factor related to disparities in health care. Future research is merited to identify underlying factors that are related to PSIs among Asian/Pacific Islander patients. Strategies are needed to improve PSIs among Medicaid patients, especially during the current Medicaid program expansion due to the implementation of the Affordable Care Act.