This paper describes the implementation of a "second victim" peer-support program in the surgery department at a tertiary care center. The program trained surgical attendings and trainees to provide peer-support for other surgeons involved in major adverse events. After one-year follow-up, 81% of affected surgeons elected to receive peer support. The majority (81%) felt the program had a positive impact on safety culture by providing a confidential, safe, and timely intervention for so-called "second victims". A 2011 Perspective on Safety with Dr. Albert Wu discussed ways that organizations can support "second victims."

… and quality. … Blanchfield BB, Demehin AA, Cummings CT, Ferris TG, Meyer GS. The Cost of Quality: An Academic Health …

In this study, better safety climates in emergency departments were associated with more intercepted near misses but not with fewer preventable adverse events.

This review discusses how setting ambitious goals can drive staff participation in quality and safety improvement efforts.

This survey found significant differences between American and British physicians regarding several aspects of patient safety, including appropriateness of error disclosure, tolerance for disruptive behavior, and prior experience with formal patient safety training.

This systematic review of health information technology (IT) studies found that most published studies reported positive effects on a variety of outcomes, ranging from patient safety to provider satisfaction and the effectiveness of care. This review extends and corroborates findings from a previous review published in 2006. Despite the benefits of health IT, both hospitals and clinics have been slow to implement comprehensive electronic health records, and the negative studies included in this review provide important insights into difficulties encountered while implementing health IT.

This study highlights the slow adoption of electronic health records in children's hospitals, with less than 3% having a comprehensive system in place. Hospital characteristics were not associated with implementation, and financing was the most important policy strategy identified to promote use.

Increasing the use of electronic health records (EHRs) is a major policy priority, as implementation has been slow both in the United States and in other countries. This survey of nearly 3000 US hospitals found that less than 2% had a fully functional EHR (defined as incorporating clinical documentation, laboratory and imaging results, computerized provider order entry, and clinician decision support). Survey respondents cited cost and maintenance considerations as major barriers to adopting EHRs, concerns that have been cited in prior research. Given that most outpatient practices also do not use electronic records, the authors recommend several policy initiatives to spur EHR implementation.

This study's findings raise concern about the current state of emergency care, most notably the presence of insufficient space, unsafe capacity, and untimely specialty consultations in emergency departments.

Implementation of information technology solutions for following up on test results improved reliability and provider satisfaction. However, clinics that only partially implemented such systems reported decreased efficiency and greater concern about patient safety issues.

Implementation of electronic health records (EHRs) is considered a high priority in order to improve patient safety and quality of care. However, EHR uptake has been slow in both hospital and ambulatory settings. This national survey of more than 2000 physicians found that only 17% were using any form of EHR, and only a small proportion of those were using systems with advanced capabilities such as clinician decision support. While users generally viewed EHRs as beneficial for patient care, implementation costs were identified as the major barrier to use of EHR, corroborating findings of prior research.

The authors describe the process used to implement a national epidemiological study of medical error in emergency departments.

This survey found strong physician support for the concepts of professionalism, but also found that many physicians do not translate their beliefs into practice. For example, although most physicians supported full disclosure of errors to patients, only a minority acknowledged actually having disclosed an error. Prior research has addressed the issue of detecting unprofessional behavior and teaching professionalism. A past AHRQ WebM&M commentary also discussed professionalism and the challenges it raises in training and in practice.

This article reviews the current status of patient safety efforts at academic medical centers (AMCs). Despite the leading role that many AMCs have assumed in safety and quality research, evidence indicates that patients cared for at AMCs are not safer than those hospitalized elsewhere. The authors discuss the unique aspects of AMCs that may hinder patient safety and quality improvement efforts, discuss methods for overcoming these barriers, and advocate for culture change within AMCs to promote patient safety programs. A prior study examined the culture of safety within an AMC and used findings to guide patient safety improvement efforts.

The authors report interviews on barriers to adoption of CPOE systems with 52 senior managers of 26 US hospitals. The authors identify physician and organizational resistance, capital funding constraints, and product/vendor immaturity as the chief barriers, and suggest organizational policy approaches to overcoming them.