Interviews with residency program directors, patient safety experts, and educational technology experts were used to identify priority areas for teaching and assessing competence in patient safety for residents and fellows.

Root cause analysis (RCA) is being increasingly applied in health care systems to improve the quality and safety of care. This study describes an educational assessment tool to evaluate competency in conducting an RCA.

A limited number of guidelines promote best practices for medication reconciliation. This study describes the implementation of a standardized reconciliation process on an academic family medicine inpatient service. Using a newly designed form, investigators developed a system of shared ownership among nurses, pharmacists, and physicians that led to reductions in medication discrepancies. Data from more than 100 patients also demonstrated a reduction in the severity of discrepancies, although actual adverse events were not measured following discharge. Similar to published case studies, these findings provide a model for implementing a reconciliation process beyond the use of an electronic system or pharmacist-only intervention.

The Joint Commission mandates that all hospitals implement a system for medication reconciliation, although many practitioners remain frustrated with local efforts. Current reports of best practices stem from the inpatient setting. This pilot study targeted patients from a single ambulatory clinic and administered a multifaceted intervention to reduce prescribing errors. Patients received mailed reminders to bring their medications into appointments and then actively participated in correcting mistakes within their medical record. The interventions led to significant reductions in prescribing errors and medication discrepancies. Similar to a past study, the authors advocate for greater patient involvement in ensuring accurate medication records.

This pilot study of a standardized assessment and educational program used trained actors to help medical students learn to communicate about and manage prescription errors.