Perspectives on Safety
Narrow Results Clear All
- Communication Improvement 7
- Culture of Safety 5
- Education and Training 3
- Error Reporting and Analysis 11
- Human Factors Engineering 2
- Legal and Policy Approaches 14
- Logistical Approaches 1
- Policies and Operations 1
- Quality Improvement Strategies 12
- Teamwork 3
- Technologic Approaches 1
- Transparency and Accountability 2
- Diagnostic Errors 1
- Fatigue and Sleep Deprivation 1
- Medical Complications 4
- Medication Safety 2
- Nonsurgical Procedural Complications 2
- Psychological and Social Complications 4
- Second victims 1
- Surgical Complications 1
New Insights Into Apology and Disclosure Programs, April 2019
Dr. McDonald is President of the Center for Open and Honest Communication at the MedStar Institute for Quality and Safety, and Adjunct Professor of Law at Loyola University-Chicago School of Law and the Beazley Institute for Health Law and Policy. An internationally recognized patient safety expert, he served as a lead architect for the Communication and Optimal Resolution (CANDOR) toolkit, supported by AHRQ. We spoke with him about lessons learned over the years regarding event reporting and his insights about building and disseminating communication-and-resolution programs.
New Insights Into Apology and Disclosure Programs, April 2019
Dr. Schulz Moore is the Director of Learning and Teaching at the University of New South Wales Faculty of Law and an Associate with the University of New South Wales School of Public Health and Community Medicine. Her research in health law draws from her unique training in public health, law, and health social sciences. We spoke with her about disclosure and apology in health care as well as the intersection between health and legal systems in Australia, New Zealand, and the United States.
Health System Consolidation and Patient Safety, March 2019
Dr. Haas is an obstetrician–gynecologist and co-Principal Investigator for Ariadne Labs' work focused on health care system expansion. We spoke with her about the trend of health systems getting larger and more integrated, the risks to patient safety, and ways to mitigate these risks.
with commentary by Audrey Lyndon, RN, PhD, 2018
This perspective examines the troubling decline in maternal health outcomes in the United States and summarizes recent national initiatives to improve safety in maternity care.
Lean and Patient Safety, January 2015
Mr. Graban is an internationally recognized expert in Lean Healthcare. We spoke with him about applying Lean in hospitals to improve safety and decrease waste.
with commentary by Paul E. Plsek, MS, Lean and Patient Safety, January 2015
This book excerpt describes how integrating innovation and Lean concepts at Virginia Mason enhances clinical performance and the patient experience.
Global Patient Safety, December 2014
Dr. Kelley, PhD, is Director of Service Delivery and Safety for the World Health Organization (WHO). We spoke with him about his work with WHO and the global impact of the organization on patient safety.
with commentary by Shams B. Syed, MD, MPH, Global Patient Safety, December 2014
This piece describes the evolution of the World Health Organization's African Partnerships for Patient Safety program and its implications for global patient safety improvement.
Overuse as a Patient Safety Problem, September 2014
Ms. Gibson is Senior Advisor to The Hastings Center, an editor for JAMA Internal Medicine, and co-author of Wall of Silence and The Treatment Trap. We spoke with her about overuse of medical care and its effect on patient safety.
National Organizations in Safety, April 2014
Dr. Gandhi is President of the National Patient Safety Foundation and Associate Professor of Medicine at Harvard Medical School. We spoke with her about NPSF's evolving role in enhancing health care at a national level.
with commentary by Susan S. Huang, MD, MPH, Infection Prevention and Patient Safety, March 2014
This piece describes the history around efforts to address preventable health care–associated infections, including federal initiatives and further research avenues to consider.
Nurse Staffing and Patient Safety, September 2012
Prof. Needleman has performed some of the key studies on how the nursing workforce influences health outcomes, including seminal articles published in the New England Journal of Medicine in 2002 and 2011.
with commentary by Allen Kachalia, MD, JD, Disclosing Errors and Other Innovations in Risk Management, March 2012
This piece describes how evidence-based improvements to the medical liability system could influence both accountability and compensation for errors.
with commentary by Teryl K. Nuckols, MD, MSHS, Incident Reporting, September 2011
This piece discusses incident reporting systems as tools for improving patient safety.
with commentary by Barry M. Manuel, MD; Jack L. McCarthy; William Berry, MD, MPH; Kathy Dwyer, Risk Management and Patient Safety, December 2010
In 1990, a Harvard-based research team reported the incidence of medical errors in the state of New York, based on the hospital discharge analysis of 30,121 cases.
Measuring Patient Safety, November 2010
Patrick S. Romano, MD, MPH, is Professor of Medicine and Pediatrics at the University of California, Davis, School of Medicine.
with commentary by Amy K. Rosen, PhD, Measuring Patient Safety, November 2010
Emergency medicine has evolved from a location, with variably trained and experienced providers ("the ER"), to a discipline with a well-defined knowledge base and skill set that focus on the diagnosis and care of undifferentiated acute problems.
Checklists, October 2010
Peter J. Pronovost, MD, PhD, is a Professor of Anesthesia, Critical Care, and Health Policy at Johns Hopkins University and Director of the Johns Hopkins Quality and Safety Research Group. He may be best known for having led the Michigan Keystone project, which used checklists and other interventions to markedly reduce catheter-associated bloodstream infections in ICUs throughout the state. For this work and more, he received a MacArthur Foundation Fellowship, and Time Magazine named him as one of the 100 most influential people in the world. We asked him to speak with us about checklists and other thoughts about the science of improving patient safety.
Workarounds, August 2009
Patient Disclosure and Apology, January 2009
Thomas H. Gallagher, MD, is Associate Professor in the Department of Medicine and the Department of Medical History and Ethics at the University of Washington in Seattle. Dr. Gallagher's current research covers the disclosure of medical errors, examining patients' and doctors' attitudes about disclosure, how best to train providers to disclose and apologize for errors, and how to create a system that promotes appropriate disclosure. We asked him to speak with us about new developments in the field of patient disclosure and apologies.