In the United States, unannounced accreditation inspections are deployed extensively to evaluate hospital safety. This interrupted time-series analysis found that enhanced accreditation procedures in the United Kingdom did not improve rates of either pressure ulcers or falls. In a PSNet interview, the president of The Joint Commission discussed how accrediting bodies can help achieve high reliability.

Missed nursing care has been linked to safety problems, but ensuring reliable levels of nurse staffing remains challenging. This report provides the results of a 3-year investigation into whether tracking of vital signs by nursing staff could serve as a viable measure for safe patient coverage. The report identified correlations between low staffing, missed vital sign observation, length of stay, and likelihood of mortality. However, record review found no direct relationship between safety and staffing levels. A PSNet perspective examined the relationship between missed nursing care and patient safety.

Cognitive approaches to patient safety have mostly focused on individual decisions. This study instead examines group decision-making and its safety implications. The authors describe four pitfalls associated with group decisions: groupthink in which the strongly connected mentality of members hinders dissenting opinion; social loafing in which people expend less effort because of a perceived failure to obtain individual credit for efforts; group polarization in which individual moderate positions are subsumed by more extreme or effort intensive group decisions; and escalation of commitment in which a poor outcome following a significant investment results in further commitment of resources instead of exploring a new approach. These four concepts can serve as a theoretical framework for future empiric work to characterize and improve group decision-making as an aspect of safety culture.