Health care institutions are increasingly focused on providing high-value care and preventing overuse. In this study, researchers developed a validated High-Value Care Culture Survey and found that administering the survey at two large academic medical centers provided health care leaders with an opportunity to target their improvement efforts.

This before-and-after study examined the impact of a patient safety project which included simulation training, teamwork training, and patient safety educational conferences. The authors found a decrease in hospital-acquired complications, better nurse perceptions of safety culture, and an improved observed-to-expected mortality ratio. These promising preliminary results should spur larger studies of these organizational safety efforts.

Although physicians generally support disclosing adverse events, they often choose their words carefully when discussing errors with patients. Since few training programs include formal curricula in error disclosure, most residents and medical students learn these skills through direct observation of senior clinicians. This survey of trainees evaluated the effects of negative and positive role models on their attitudes and behaviors regarding error disclosure. Most trainees had observed a harmful medical error, and the majority reported exposure to positive role models. Poor role models were associated with negative trainee attitudes about disclosure and an increased likelihood of trying to evade responsibility for harmful errors. More than one-third of trainees reported nontransparent behavior in response to a harmful medical error they had made. Addressing the importance of role models in shaping clinicians' future behaviors will be important to advancing full disclosure efforts. An AHRQ WebM&M perspective by Dr. Albert Wu discusses the importance of disclosing adverse events.