{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,4,11]],"date-time":"2026-04-11T06:46:20Z","timestamp":1775889980533,"version":"3.50.1"},"reference-count":54,"publisher":"Wiley","issue":"11","license":[{"start":{"date-parts":[[2024,3,15]],"date-time":"2024-03-15T00:00:00Z","timestamp":1710460800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"},{"start":{"date-parts":[[2024,3,15]],"date-time":"2024-03-15T00:00:00Z","timestamp":1710460800000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Journal of Advanced Nursing"],"published-print":{"date-parts":[[2025,11]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Aims<\/jats:title>\n                    <jats:p>Previous studies have shown the COVID\u201019 pandemic was associated with reductions in volume across a spectrum of non\u2010SARS\u2010CoV\u20102 hospitalizations. In the present study, we examine the impact of the pandemic on patient safety and quality of care.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Design<\/jats:title>\n                    <jats:p>This is a retrospective population\u2010based study of discharge abstracts.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>We applied a set of nationally validated indicators for measuring the quality of inpatient care to hospitalizations in Ontario, Canada between January 2010 and December 2022. We measured 90\u2010day mortality after selected types of higher risk admissions (such as cancer surgery and cardiovascular emergency) and the rate of patient harm events (such as delirium, pressure injuries and hospital\u2010acquired infections) occurring during the hospital stay.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      A total 13,876,377 hospitalization episodes were captured. Compared with the pre\u2010pandemic period, and independent of SARS\u2010CoV\u20102 infection, the pandemic period was associated with higher rates of mortality after bladder cancer resection (adjusted risk ratio [aRR] 1.20 (1.07\u20131.34)) and open repair for abdominal aortic aneurysm (aRR 1.45 (1.06\u20131.99)). The pandemic was also associated with higher rates of delirium (adjusted odds ratio [aOR] 1.04 (1.02\u20131.06)), venous thromboembolism (aOR 1.10 (1.06\u20131.13)), pressure injuries (aOR 1.28 (1.24\u20131.33)), aspiration pneumonitis (aOR 1.15 (1.12\u20131.18)), urinary tract infections (aOR 1.02 (1.01\u20131.04)),\n                      <jats:italic>Clostridiodes difficile<\/jats:italic>\n                      infection (aOR 1.05 (1.02\u20131.09)), pneumothorax (aOR 1.08 (1.03\u20131.13)), and use of restraints (aOR 1.12 (1.10\u20131.14)), but was associated with lower rates of viral gastroenteritis (aOR 0.22 (0.18\u20130.28)). During the pandemic, SARS\u2010CoV\u20102\u2010positive admissions were associated with a higher likelihood of various harm events.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>The COVID\u201019 pandemic was associated with higher rates of patient harm for a wide range of non\u2010SARS\u2010CoV\u20102 inpatient populations.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Impact<\/jats:title>\n                    <jats:p>Understanding which quality measures are improving or deteriorating can help health systems prioritize quality improvement initiatives.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Patient or Public Contribution<\/jats:title>\n                    <jats:p>No patient or public contribution.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1111\/jan.16136","type":"journal-article","created":{"date-parts":[[2024,3,16]],"date-time":"2024-03-16T02:37:53Z","timestamp":1710556673000},"page":"7556-7570","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["The impact of the COVID\u201019 pandemic on longitudinal trends of surgical mortality and inpatient quality of care in Ontario, Canada"],"prefix":"10.1111","volume":"81","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-9650-9105","authenticated-orcid":false,"given":"Steven","family":"Habbous","sequence":"first","affiliation":[{"name":"Ontario Health (Strategic Analytics)  Toronto Ontario Canada"},{"name":"Epidemiology &amp; Biostatistics Western University  London Ontario Canada"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Maggie","family":"Ford","sequence":"additional","affiliation":[{"name":"Ontario Health (Clinical Institutes and Quality Programs)  Toronto Ontario Canada"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Stacey","family":"Bar\u2010Ziv","sequence":"additional","affiliation":[{"name":"Ontario Health (Clinical Institutes and Quality Programs)  Toronto Ontario Canada"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Terri","family":"Donovan","sequence":"additional","affiliation":[{"name":"Ontario Health (Clinical Institutes and Quality Programs)  Toronto Ontario Canada"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Erik","family":"Hellsten","sequence":"additional","affiliation":[{"name":"Ontario Health (Strategic Analytics)  Toronto Ontario Canada"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2024,3,15]]},"reference":[{"key":"e_1_2_11_2_1","unstructured":"Agency for Healthcare Research and Quality. 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(2023).Hospital staffing and hospital harm trends throughout the pandemic.https:\/\/www.cihi.ca\/en\/hospital\u2010staffing\u2010and\u2010hospital\u2010harm\u2010trends\u2010throughout\u2010the\u2010pandemic"},{"key":"e_1_2_11_12_1","doi-asserted-by":"publisher","DOI":"10.1038\/s41467-022-33686-y"},{"key":"e_1_2_11_13_1","doi-asserted-by":"publisher","DOI":"10.1186\/s13104-018-3270-4"},{"key":"e_1_2_11_14_1","doi-asserted-by":"publisher","DOI":"10.1177\/07334648211067526"},{"key":"e_1_2_11_15_1","unstructured":"CIHI. 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