Healthcare leadership walkarounds (LWs) involve organizational leaders visiting hospital wards to hear directly from frontline staff about concerns and what is going well. This systematic review describes the impact of LWs on organizational and patient outcomes. Most studies (11 out of 12) measured organizational or clinical outcomes. Organizational outcomes included staff perception of safety culture, near miss reports, teamwork, and feeling heard. Only one study investigated the association between LWs and clinical outcomes; in that study, catheter-associated urinary tract infections decreased following implementation of LW.

Tiered huddle systems (THS) include staff at all levels of the organization- frontline healthcare workers, managers, directors, and executives- and have been shown to increase adverse event reporting and improve safety culture. This US health system implemented a three-level THS in hospital and ambulatory settings to increase event reporting. Based on an interrupted time series analysis, reporting increased for total safety events, including near misses.

The Normal Accident Theory suggests that failures are inevitable in complex environments, but proactive analysis of potential failures within systems can identify improvement strategies. This commentary discusses how one health care organization applied Normal Accident Theory concepts in its oncology service to improve process measures, staff perceptions of safety, and financial performance.

Use of a radiofrequency detection system to identify retained surgical instruments helped resolve discrepancies in the manual count.

This assessment of stressors and workload among radiation oncology providers highlighted the importance of interruptions, technical issues (e.g., software malfunctions), and teamwork failures as key contributing factors.