Reducing hospital errors: interventions that build safety culture.

Sara J. Singer; Timothy J. Vogus

Review

Reducing hospital errors: interventions that build safety culture.

February 6, 2013

Singer SJ, Vogus TJ. Annu Rev Public Health. 2013;34:373-96.

View more articles from the same authors.

This review details a framework to help health care organizations develop, implement, and enhance safety culture.

PubMed citation

Available at

Related Resources From the Same Author(s)

Creating highly reliable accountable care organizations.

September 27, 2017

National hospital ratings systems share few common scores and may generate confusion instead of clarity.

March 11, 2015

Safety in numbers: the development of Leapfrog's composite patient safety score for US hospitals.

October 16, 2013

Creating highly reliable health care: how reliability-enhancing work practices affect patient safety in hospitals.

November 2, 2016

The underappreciated role of habit in highly reliable healthcare.

September 23, 2015

Navigating care transitions: a process model of how doctors overcome organizational barriers and create awareness.

March 25, 2015

The impact of safety organizing, trusted leadership, and care pathways on reported medication errors in hospital nursing units.

October 10, 2007

The Safety Organizing Scale: development and validation of a behavioral measure of safety culture in hospital nursing units.

February 14, 2007

Pay practices and safety organizing: evidence from hospital nursing units.

December 13, 2023

The evolving literature on safety WalkRounds: emerging themes and practical messages.

October 1, 2014

The effectiveness of management-by-walking-around: a randomized field study.

April 23, 2014

Improving patient safety by taking systems seriously.

February 13, 2008

Safety organizing, emotional exhaustion, and turnover in hospital nursing units.

September 3, 2014

We're all in this together: how COVID-19 revealed the co-construction of mindful organising and organisational reliability.

February 9, 2022

Perceptions of hospital safety climate and incidence of readmission.

December 15, 2010

Exploring system features of primary care practices that promote better providers' clinical work satisfaction: a qualitative comparative analysis.

May 18, 2022

Adverse events and burnout: the moderating effects of workgroup identification and safety climate.

July 1, 2020

Understanding psychological safety in health care and education organizations: a comparative perspective.

March 16, 2016

Spreading a medication administration intervention organizationwide in six hospitals.

February 15, 2012

Front-line staff perspectives on opportunities for improving the safety and efficiency of hospital work systems.

June 18, 2008

Patient safety climate in US hospitals: variation by management level.

November 12, 2008

Leapfrog Hospital Safety Score, Magnet designation, and healthcare-associated infections in United States hospitals.

May 17, 2017

Unsafe by design: infusion task reallocation and safety perceptions in U.S. hospitals.

January 11, 2023

Relationship of safety climate and safety performance in hospitals.

April 1, 2009

Comparing safety climate in naval aviation and hospitals: implications for improving patient safety.

April 21, 2010

Effective surgical safety checklist implementation.

January 30, 2005

Operating room clinicians' attitudes and perceptions of a pediatric surgical safety checklist at 1 institution.

March 9, 2016

Hospital safety climate and safety outcomes: is there a relationship in the VA?

March 10, 2010

Patient safety climate in hospitals: act locally on variation across units.

June 30, 2010

Patient safety climate in 92 US hospitals: differences by work area and discipline.

February 4, 2009

Striving for high reliability in healthcare: a qualitative study of the implementation of a hospital safety programme.

June 22, 2022

Addressing ambulatory safety and malpractice: the Massachusetts PROMISES project.

December 14, 2016

Improving patient care through leadership engagement with frontline staff: a Department of Veterans Affairs case study.

July 31, 2013

Workforce perceptions of hospital safety culture: development and validation of the patient safety climate in healthcare organizations survey.

September 26, 2007

Low rate of completion of recommended tests and referrals in an academic primary care practice with resident trainees.

January 31, 2024

Completion of recommended tests and referrals in telehealth vs in-person visits.

December 6, 2023

Lessons learned in implementing a chronic opioid therapy management system.

December 21, 2022

Safety climate, safety climate strength, and length of stay in the NICU.

November 20, 2019

Implementation strategies in the context of medication reconciliation: a qualitative study.

July 14, 2021

Design and evaluation of simulation scenarios for a program introducing patient safety, teamwork, safety leadership, and simulation to healthcare leaders and managers.

August 31, 2011

Narrative feedback from OR personnel about the safety of their surgical practice before and after a surgical safety checklist intervention.

July 12, 2017

Relationship of hospital organizational culture to patient safety climate in the Veterans Health Administration.

March 25, 2009

Factors associated with the use of cognitive aids in operating room crises: a cross-sectional study of US hospitals and ambulatory surgical centers.

May 9, 2018

Identifying organizational cultures that promote patient safety.

November 18, 2009

Evaluating a patient safety learning laboratory to create an interdisciplinary ecosystem for health care innovation.

July 13, 2022

Recruitment of hospitals for a safety climate study: facilitators and barriers.

April 30, 2008

Do patients who read visit notes on the patient portal have a higher rate of "loop closure" on diagnostic tests and referrals in primary care? A retrospective cohort study.

January 17, 2024

An overview of patient safety climate in the VA.

April 9, 2008

Surgical team member assessment of the safety of surgery practice in 38 South Carolina hospitals.

April 15, 2015

The surgical safety checklist and teamwork coaching tools: a study of inter-rater reliability.

July 30, 2014

Comparing safety climate between two populations of hospitals in the United States.

October 14, 2009

Scaling safety: the South Carolina Surgical Safety Checklist experience.

January 9, 2019

A case for safety leadership team training of hospital managers.

March 2, 2011

Is it time to move beyond errors in clinical reasoning and discuss accuracy?

August 27, 2014

Relationship between operating room teamwork, contextual factors, and safety checklist performance.

August 31, 2016

Team dynamics, clinical work satisfaction, and patient care coordination between primary care providers: a mixed methods study.

December 2, 2015

Implementation of the surgical safety checklist in South Carolina hospitals is associated with improvement in perceived perioperative safety.

May 11, 2016

An exploration of safety climate in nursing homes.

August 8, 2012

Primary care collaboration to improve diagnosis and screening for colorectal cancer.

May 3, 2017

Implementation and outcomes of a rapid response team.

October 3, 2007

Studying patient safety in health care organizations: accentuate the qualitative.

January 18, 2006

Perception of safety of surgical practice among operating room personnel from survey data is associated with all-cause 30-day postoperative death rate in South Carolina.

August 16, 2017

The Broselow tape as an effective medication dosing instrument: a review of the literature.

October 10, 2012

Expanded pharmacy technician roles: accepting verbal prescriptions and communicating prescription transfers.

February 1, 2017

Encouraging patients to ask questions: how to overcome "white-coat silence."

July 10, 2013

Saving without compromising: teaching trainees to safely provide high value care.

April 17, 2019

Evaluating ambulatory practice safety: the PROMISES Project administrators and practice staff surveys.

December 17, 2014

The culture of safety: results of an organization-wide survey in 15 California hospitals.

March 6, 2005

The association between transfer of emergency department boarders to inpatient hallways and mortality: a 4-year experience.

May 6, 2009

Mortality trends after a voluntary checklist-based surgical safety collaborative.

May 3, 2017

Quality and safety practices among academic obstetrics and gynecology departments.

August 30, 2023

Duty-hour limits and patient care and resident outcomes: can high-quality studies offer insight into complex relationships?

May 22, 2013

Systematic review: antimicrobial urinary catheters to prevent catheter-associated urinary tract infection in hospitalized patients.

January 31, 2006

Prioritizing threats to patient safety in rural primary care.

May 23, 2007

Use of electronic health records in US hospitals.

April 8, 2009

Medication errors: immunisation.

September 27, 2006

Medication incident recovery and prevention utilising an Australian community pharmacy incident reporting system: the QUMwatch study.

May 5, 2021

Targeting zero harm: a stretch goal that risks breaking the spring.

August 12, 2020

Toward understanding errors in inpatient psychiatry: a qualitative inquiry.

April 14, 2010

Difficult diagnosis in the ICU: making the right call but beware uncertainty and bias.

March 22, 2023

Medication errors: a prospective cohort study of hand-written and computerised physician order entry in the intensive care unit.

November 23, 2005

Randomized trial of reducing ambulatory malpractice and safety risk: results of the Massachusetts PROMISES Project.

July 19, 2017

Multiple-institution comparison of resident and faculty perceptions of burnout and depression during surgical training.

May 16, 2018

Processes for effective communication in primary care.

May 4, 2005

Family safety reporting in medically complex children: parent, staff, and leader perspectives.

July 6, 2022

Medication safety in the neonatal intensive care unit: big measures for our smallest patients.

March 8, 2017

The "July phenomenon": is trauma the exception?

October 14, 2009

The July effect: an analysis of never events in the nationwide inpatient sample.

April 15, 2015

Management of test results in family medicine offices.

July 29, 2009

Miscount incidents: a novel approach to exploring risk factors for unintentionally retained surgical items.

October 2, 2013

Disclosure of "nonharmful" medical errors and other events: duty to disclose.

March 29, 2012

The nature, severity and causes of medication incidents from an Australian community pharmacy incident reporting system: the QUMwatch study.

July 28, 2021

Medication prescribing errors involving the route of administration.

December 13, 2006

Perspective: beyond counting hours: the importance of supervision, professionalism, transitions of care, and workload in residency training.

July 18, 2012

Safety in the academic medical center: transforming challenges into ingredients for improvement.

September 13, 2006

Impact of teamwork and communication training interventions on safety culture and patient safety in emergency departments: a systematic review.

January 26, 2022

Electronic health records in ambulatory care- a national survey of physicians.

June 25, 2008

Using simulation to prepare nursing staff for the move to a new building.

April 26, 2017

The concept of shared mental models in healthcare collaboration.

December 11, 2013

Untenable expectations: nurses' work in the context of medication administration, error, and the organization.

February 1, 2023

Related Resources

Annual Perspective

Equity in Patient Safety

March 27, 2024

In situ simulation: a strategy to restore patient safety in intensive care units after the COVID-19 pandemic?

February 8, 2023

Exploring patient safety outcomes for people with learning disabilities in acute hospital settings: a scoping review.

June 30, 2021

Preventing violence in the health care setting.

June 9, 2021

COVID-19: patient safety and quality improvement skills to deploy during the surge.

June 24, 2020

Barriers and facilitators to healthcare workers' adherence with infection prevention and control (IPC) guidelines for respiratory infectious diseases: a rapid qualitative evidence synthesis.

May 13, 2020

Safer Hospital Care: Strategies for Continuous Innovation, Second Edition.

May 16, 2019

Quality and safety in orthopaedics: learning and teaching at the same time: AOA critical issues.

December 2, 2015

The relationship between patient safety culture and patient outcomes: a systematic review.

April 2, 2014

Graded autonomy in medical education—managing things that go bump in the night.

March 26, 2014

Team-training in healthcare: a narrative synthesis of the literature.

March 12, 2014

Speaking up for patient safety by hospital-based health care professionals: a literature review.

March 5, 2014

Eight critical factors in creating and implementing a successful simulation program.

January 15, 2014

Organizational culture and its implications for infection prevention and control in healthcare institutions.

January 8, 2014

Using crew resource management and a 'read-and-do checklist' to reduce failure-to-rescue events on a step-down unit.

November 6, 2013

Beyond crisis resource management: new frontiers in human factors training for acute care medicine.

October 30, 2013

The medical student as a patient: attitudes towards involvement in the quality and safety of health care.

October 30, 2013

High-reliability health care: getting there from here.

October 2, 2013

Residency schedule, burnout and patient care among first-year residents.

September 4, 2013

The effect of an organizational network for patient safety on safety event reporting.

August 28, 2013

Is evidence guiding practice? Reported versus observed adherence to contact precautions: a pilot study.

August 28, 2013

Why your TeamSTEPPS program may not be working.

August 21, 2013

Documenting quality improvement and patient safety efforts: the quality portfolio. A statement from the Academic Hospitalist Taskforce.

July 17, 2013

In situ simulation: identification of systems issues.

July 10, 2013

Resident Projects for Improvement.

June 19, 2013

Leadership and patient safety: a review of the literature.

May 29, 2013

Do team processes really have an effect on clinical performance? A systematic literature review.

May 29, 2013

Duty-hour limits and patient care and resident outcomes: can high-quality studies offer insight into complex relationships?

May 22, 2013

Effect of a systems intervention on the quality and safety of patient handoffs in an internal medicine residency program.

May 15, 2013

Safety leadership: a meta-analytic review of transformational and transactional leadership styles as antecedents of safety behaviours.

April 24, 2013

See More About The Topic

Hospitals

Health Care Executives and Administrators

Educators

General Internal Medicine

Hospital Medicine

Reducing hospital errors: interventions that build safety culture.

Connect With Us

Sign up for Email Updates

Agency for Healthcare Research and Quality

Reducing hospital errors: interventions that build safety culture.

Connect With Us

Sign up for Email Updates

Agency for Healthcare Research and Quality

Submit Your Innovations

Continue as a Guest

Continue Logged In

Submit Your Innovations

Continue as a Guest

Continue logged in

New Users to the PSNet site