Simulation is becoming more common in healthcare education programs, but often focuses on in-hospital, skills-based training aimed at developing team human factors skills. This systematic review included 72 studies from 2004-2021 that included human factors skills with a variety of different designs, types of training interventions, and assessment tools and methods. The authors concluded that simulation-based training was effective in training teams in human factors skills; additional work is needed on the retention and transfer of those skills to practice.

The initial evidence supporting the impact of the World Health Organization's surgical safety checklist was a cohort study that found a significant reduction in mortality associated with the use of the checklist. More recently, the mandated adoption of surgical checklists in Canada failed to show any benefits on surgical outcomes. This retrospective point prevalence study evaluated checklist use in 426 hospitals across 28 European nations, involving more than 45,000 patients undergoing noncardiac inpatient surgery. Notably, there was striking variation in surgical checklist exposure, with checklists used for 0% to 99.6% of patients, depending on the nation. The use of surgical checklists was associated with lower hospital mortality, even after adjusting for risk factors. However, it is unclear from this study whether this improvement is due to the checklist or rather checklist usage is a process measure indicating higher overall perioperative quality. A prior AHRQ WebM&M perspective reviewed best practices for creating effective checklists.

The authors discuss the concept of automaticity, or the automation of a skilled behavior through repetition. They discuss its possible impact on patient safety and strategies to help health care managers minimize its negative effects.

The authors examine the organizational factors that lead to adverse events as identified in An Organization with a Memory and suggest issues for risk managers to consider when forming risk prevention strategies.