Perspectives on Safety
Our Perspectives on Safety section features expert viewpoints on current themes in patient safety, including interviews and written essays published monthly. Annual Perspectives highlight vital and emerging patient safety topics.
Narrow Results Clear All
Approach to Improving Safety
- Communication Improvement 4
- Culture of Safety 10
- Education and Training 11
- Error Reporting and Analysis 12
- Human Factors Engineering 1
- Legal and Policy Approaches 9
- Logistical Approaches 4
- Policies and Operations 2
- Quality Improvement Strategies 11
- Specialization of Care 1
- Teamwork 4
- Technologic Approaches 9
Safety Target
- Discontinuities, Gaps, and Hand-Off Problems 5
- Fatigue and Sleep Deprivation 1
- Identification Errors 1
- Medical Complications 3
- Medication Safety 5
- Nonsurgical Procedural Complications 2
- Psychological and Social Complications 6
- Surgical Complications 5
Clinical Area
Interview
In Conversation With… Susan Haas, MD, MSc
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.
Perspective
Building a Safety Program in a Vast Health Care Network
with commentary by Paul E. Phrampus, MD, Health System Consolidation and Patient Safety, March 2019
This piece outlines how large integrated health care systems can implement effective patient safety programs and spotlights the importance of leadership engagement and a just culture.
Interview
In Conversation With… Matthew Weinger, MD
Update on Simulation, August 2018
Dr. Weinger is Director of the Center for Research and Innovation in Systems Safety and Professor of Anesthesiology, Biomedical Informatics, and Medical Education at Vanderbilt University. He holds the Norman Ty Smith Chair in Patient Safety and Medical Simulation. We spoke with him about the current state of simulation training in health care, barriers to progress, and potential innovations.
Perspective
How Does Health Care Simulation Affect Patient Care?
with commentary by Joseph O. Lopreiato, MD, MPH, Update on Simulation, August 2018
This piece explores health care simulation including the four main methods used and the evidence base for its impact on learning and patient care.
Interview
In Conversation With… Harlan Krumholz, MD, SM
Post-Hospital Syndrome, April 2018
Dr. Krumholz is Professor of Medicine at the University of Yale School of Medicine and Director of the Yale-New Haven Hospital Center for Outcomes Research and Evaluation. We spoke with him about readmissions and post-hospital syndrome, a term he coined in an article in the New England Journal of Medicine to describe the risk of adverse health events in recently hospitalized patients.
Perspective
Patient Safety During Hospital Discharge
with commentary by Katherine Liang and Eric Alper, MD, Post-Hospital Syndrome, April 2018
This piece explores the risks patients face after hospital discharge and strategies to address them, such as patient education, Project RED, and the Care Transitions Intervention.
Perspective
Missed Nursing Care: A Key Measure for Patient Safety
with commentary by Jane Ball, PhD, and Peter Griffiths, PhD, Nursing and Patient Safety, March 2018
This piece explores how missed nursing care may explain the association between low nurse staffing levels and increased mortality in hospital patients.
Interview
In Conversation With… Karl Bilimoria, MD, MS
Surgical Safety, December 2017
Dr. Bilimoria is the Director of the Surgical Outcomes and Quality Improvement Center of Northwestern University, which focuses on national, regional, and local quality improvement research and practical initiatives. He is also the Director of the Illinois Surgical Quality Improvement Collaborative and a Faculty Scholar at the American College of Surgeons. In the second part of a two-part interview (the earlier one concerned residency duty hours), we spoke with him about quality and safety in surgery.
Perspective
The Evolution of Patient Safety in Surgery
with commentary by Robert M. Wachter, MD, Surgical Safety, December 2017
This piece explores progress of patient safety in the surgical field and where further improvement can be made, such as ongoing assessment of procedural skills along with video recording and review of surgical procedures.
Interview
In Conversation With… Jeffrey Starke, MD
Presenteeism: A Patient Safety Challenge, October 2017
Dr. Starke is Professor of Pediatrics–Infectious Disease at Baylor College of Medicine and previously served as Infection Control Officer at Texas Children's Hospital. We spoke with him about "presenteeism" (coming to work while ill) in health care and its impact on provider and patient safety.
Perspective
Health Care Worker Presenteeism: A Challenge for Patient Safety
with commentary by Julia E. Szymczak, PhD, Presenteeism: A Patient Safety Challenge, October 2017
This piece explores the risks of presenteeism among health care workers and factors, such as cultural expectations, that contribute to its occurrence.
Interview
In Conversation With… Andrew Gettinger, MD
Health Information Technology and Safety, September 2017
Dr. Gettinger is the Chief Medical Information Officer and the Executive Director of the Office of Clinical Quality and Safety for the Office of the National Coordinator (ONC). He led the development of an electronic health record (EHR) system at Dartmouth and was the senior physician leader during their transition to a vendor-based EHR. We spoke with him about safety and health information technology.
Perspective
Assessing the Safety of Electronic Health Records: What Have We Learned?
with commentary by Dean F. Sittig, PhD, and Hardeep Singh, MD, MPH, Health Information Technology and Safety, September 2017
This piece highlights four key lessons that the authors believe are useful for clinicians and health care organizations that seek to identify, prevent, and mitigate electronic health record–related safety issues.
Perspective
ACGME's 2017 Revision of Common Program Requirements
with commentary by Kathy Malloy; Timothy P. Brigham, PhD; Thomas J. Nasca, MD, Resident Duty Hours Policy Changes, August 2017
This piece reviews how changes to the ACGME requirements emphasize patient safety and quality improvement, address physician well-being, strengthen expectations around team-based care, and create flexibility for work hours within the maximum 80-hour workweek.
Interview
In Conversation With… Michelle Mello, MPhil, JD, PhD
Legal Issues and Patient Safety, July 2017
Michelle Mello is Professor of Law at Stanford Law School and Professor of Health Research and Policy at Stanford University School of Medicine. She conducts empirical research into issues at the intersection of law, ethics, and health policy. We spoke with her about legal issues in patient safety.
Perspective
Doctors With Multiple Malpractice Claims, Disciplinary Actions, and Complaints: What Do We Know?
with commentary by David Studdert, LLB, ScD, Legal Issues and Patient Safety, July 2017
This piece explores the risk of recurring medicolegal events among providers who have received unsolicited patient complaints, faced disciplinary actions by medical boards, or accumulated malpractice claims.
Interview
In Conversation With… Paul Aylin, MBChB
The Weekend Effect, June 2017
Professor Aylin is Professor of Epidemiology and Public Health at Imperial College London. We spoke with him about the weekend effect in health care—the observation that patients admitted to the hospital over the weekend often have worse outcomes than those admitted during the week.
Perspective
The Weekend Effect in Cardiology: Is It Real? If So, Can It Be Fixed?
with commentary by Vanessa K. Martin, DO, MS; Nasim Mirnateghi, PhD; and Mahdi Khoshchehreh, MD, MS, The Weekend Effect, June 2017
This piece explores the weekend effect in cardiology and recommends allowing invasive management for patients with non ST-elevation myocardial infarction to improve outcomes in this group.
Interview
In Conversation With… David Juurlink, MD, PhD
Opioids and Patient Safety, May 2017
Dr. Juurlink is professor of medicine, pediatrics, and health policy at the University of Toronto, where he is also director of the Division of Clinical Pharmacology and Toxicology. We spoke with him about the opioid epidemic and strategies to address this growing patient safety concern.
Perspective
Opioid Overdose as a Patient Safety Problem
with commentary by Irene Berita Murimi, PhD, MA, and G. Caleb Alexander, MD, MS, Opioids and Patient Safety, May 2017
This piece explores the opioid epidemic in the United States, including factors that led to increased opioid prescribing, its adverse effects, and tactics to reduce opioid-related harm.