Patient safety in ambulatory care settings is receiving increased attention. Based on interviews and focus groups with patients, providers, and staff at ten patient-centered medical homes, this qualitative study explored perceived facilitators and barriers to improving safety in ambulatory care. Participants identified several safety issues, including communication failures and challenges with medication reconciliation, and noted the importance of health information systems and dedicated resources to advance patient safety. Patients also emphasized the importance of engagement in developing safety solutions. A recent PSNet perspective discusses patient safety challenges in ambulatory care, particularly during the COVID-19 pandemic.

… and treated as a whole person. … Lasser EC, Heughan JA, Lai AY, et al. Patient perceptions of safety in primary care: …

This study used qualitative methods to compare how patients versus front clinicians, administrators and staff conceptualize patient safety in primary care. Findings indicate that work function-based conceptualizations of patient safety (e.g., good communication and providing appropriate, timely care) better reflect the experiences of healthcare personnel and patients rather than domain-based conceptualizations (e.g., diagnosis, care transitions, and medications).

The aim of the Patient Centered Medical Home (PCMH) model is to reorganize primary care services to ensure team-based, coordinated, system-orientation, and accessible care is provided to patients. Using PCMH characteristic data, interviews and surveys with PCMH clinicians, administrators and staff, this study identified four key factors contributing to higher safety culture in PCMHs: (1) leadership in patient safety; (2) reciprocity in advice-seeking; (3) self-efficacy and job satisfaction, and; (4) quality improvement climate. The authors suggest that interventions to improve ambulatory patient safety should focus on leadership and clinician and staff advice-seeking relationships.