Early warning systems (EWS) use patient data from the electronic health record to alert clinicians to potential patient deterioration. Twelve months after a new EWS was implemented in one hospital, nurses were interviewed to gather their perspectives on the program experience, utility, and implementation. Six themes emerged: timeliness, lack of accuracy, workflow interruptions, actionability of alerts, underappreciation of core nursing skills, and opportunity cost.

Overnight coverage creates opportunities for increasing resident autonomy but can carry risks for patient safety.  This study found that the presence of overnight hospitalists was associated with fewer resident barriers to contacting supervising physicians overnight but that other barriers during overnight coverage – such as technological barriers and organizational culture – influence residents seeking help from supervising physicians.

… safety … BMJ Qual Saf … This educational intervention used a comic book format to convey patient safety concepts to … to the pre-test, suggesting this modality has promise as a patient safety education tool. …

… slightly at teaching hospitals after the 2011 changes. A past PSNet interview  discussed the effect of less …

This mixed-methods study combined survey data from resident physicians with a comparison of process maps from three academic medical centers to assess handoffs from intensive care units to medical wards. The vast majority of survey respondents could recall at least one adverse event related to suboptimal handoff communication between these settings, and review of the process maps revealed safety gaps in existing processes.

Engaging trainees in quality improvement efforts has been an important area of focus within graduate medical education, but less is known about how health system resources are aligned with these activities. Researchers used survey data to better understand the perceptions of internal medicine residency program directors regarding health system support for and alignment with graduate medical education quality improvement efforts.

Training resident physicians to use structured handoff tools reduces errors in the care of hospitalized patients. Researchers developed a handoff simulation incorporating the types of noise and distractions that are ubiquitous in hospitals. After training, distracted residents provided the same quality handoff as those able to communicate in a quiet place.

… increased appropriate test follow-up, and demonstrated a trend toward reduced hospital and emergency department visits after the care transition. A WebM&M commentary highlighted risks that breaches in …

Research suggests that standardization, dedicated space, and supervision improve resident handoffs, but less is known about how these best practices are implemented. Investigators surveyed residency program directors and found significant variation in the implementation of recommended handoff practices and educational strategies.

This survey study examined remote electronic health record use by attending physicians for resident supervision. Nearly all respondents reported accessing the electronic health record remotely. Of these, 92% reported discovering clinically relevant information that the residents had not conveyed to them. The authors conclude that this "backstage" supervision requires further study to identify best practices for safety and education.

… This prospective trial demonstrated that implementation of a standardized intensive care unit sign-out process among …

It is critical to educate trainees about patient safety. In this study, researchers described lessons learned from creating a leadership role that bridges quality and safety activities with graduate medical education in each of their institutions. Key responsibilities included clinical oversight, faculty development, and educational innovation. The authors advocate for further evaluation of this safety and education leadership role to determine its impact on medical education and patient outcomes.

Year-end handoffs in residency training settings are a known patient safety risk. This narrative review found that several practices can enhance the safety of year-end transitions, including standardizing written and verbal signout for high-risk patients and enhancing attending-level supervision.

This prospective cohort study across three sites with an internal medicine residency program found no relationship between resident discontinuity and adverse events. Safe handoffs have become even more essential in the era of resident duty hour restrictions.

… medical students to identify patient safety hazards in a hospital room. Students demonstrated a wide range of accuracy in identifying hazards, with fall …

… of failing colleagues or patients. Exploring findings from a previous study on presenteeism, this commentary spotlights …

… outcomes. However, this analysis of medical admissions to a teaching hospital found indications of an opposite association. Analyzing admissions over a 6-year period, investigators found that a higher total patient census and a greater number of daily …

Although this direct observation study found that medical team rounds usually include conversation about patient safety concerns, appropriate mitigating action was discussed for only 50% of issues. The authors highlight how rounds offer an opportunity to detect potential risks and educate teams about patient safety in real time.

… controversial. The New England Journal of Medicine hosted a roundtable discussion exploring the effects of duty hour … by Dr. Debra Weinstein, the discussion featured Dr. Vineet Arora, Dr. Eileen Reynolds, and surgical resident Dr. Brian …

… blending safety and quality improvement training into a medical school curriculum . …