Becker's Clinical Quality & Infection Control

19 PATIENT SAFETY Racial bias in pulse oximeters may put Black patients at risk By Erica Carbajal P ulse oximeters were more often less reliable in Black patients than white patients, according to a study published in The New England Journal of Medicine Dec.17. Researchers compared pulse oximeter readings, an external oxygen measure, to arterial blood gas readings in a study of 10,001 patients. Re- sults indicated that 11.7 percent of Black patients had an arterial oxygen saturation measurement under 88 percent — an unsafe level — despite pulse oximeter readings showing a 92-96 percent level. The issue also occurred for 3.6 percent of white patients. "Reliance on pulse oximetry to triage patients and adjust supple- mental oxygen levels may place Black patients at increased risk for hypoxemia," the report said. "The variation in risk according to race necessitates the integration of pulse oximetry with other clinical and patient-reported data." n Death rate higher for patients who have procedure on surgeon's birthday, study finds By Mackenzie Bean O lder patients who have an oper- ation on their surgeon's birthday have a higher 30-day mortality rate, a study published Dec.10 in The BMJ found. Researchers at Los Angeles-based UCLA Health analyzed outcomes data for Medi- care patients who underwent 980,876 emergency procedures between 2011 and 2014. More than 47,000 surgeons were included in the analysis, and about 2,000 procedures occurred on surgeons' birthdays. The overall unadjusted 30-day mortality rate for patients who underwent oper- ations on their surgeon's birthday was 7 percent, compared to 5.6 percent for patients who had surgery on a different day. After adjusting for factors that may influence patient outcomes, patients in the former group still had a 23 percent higher risk of dying within 30 days. Researchers cited several potential reasons for this correlation, including that surgeons may feel more rushed to complete the procedure on time or that discussions about the surgeon's birthday plans may pose a distraction to the oper- ating room team. "Our study is the first to show the association between a surgeon's birthday and patient mortality, but further research is needed before we make a conclusion that birthdays indeed have a meaningful impact on surgeons' performance," lead author Yusuke Tsugawa, MD, PhD, an assistant professor of medicine at UCLA's David Geffen School of Medicine, said in a news release. "At this point, given that evidence is still limited, I don't think patients need to avoid a surgical pro- cedure on the surgeon's birthday." n Cardiologist claims Colorado system fired her 1 day after she told CEO concerns of understaffing By Molly Gamble A cardiologist claims that Broomfield, Colo.-based SCL Health fired her out of retaliation one day aer she emailed the system CEO with concerns about specialist understaffing, the Denver Post reported Dec. 21. Payal Kohli, MD, practiced at SCL Health's Good Samaritan Medical Center in La- fayette, Colo., from 2017 to 2019. She claims hospital and system leadership ordered cardiologists to cover the emergency room and ICU at the same times they were scheduled to see patients in their offices. She also alleges one physician who was qualified to perform procedures like placing pacemakers also had to cover multiple hospitals because the system did not have enough cardiologists. Dr. Kohli alleges that at least eight patients received substandard care in summer 2019, and a 29-year-old man died when no one was available to put in a pacemaker he needed. e physician claims she was passed over for promotions and stripped of her lead- ership roles aer she raised concerns about understaffing. She says she was fired one day aer emailing her concerns to Lydia Jumonville, president and CEO of SCL Health, according to the Denver Post. e eight-hospital system said it does not comment on pending litigation, but did share the following statement with the Denver Post: "Good Samaritan Medical Center and SCL Health take all complaints about patient care and safety very seriously, and we have a robust and confidential process in place to address patient care concerns, consistent with the process all hospitals follow per federal and Colorado state laws." n

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