Although medical malpractice law is intended to deter negligence among health care providers and promote quality health care, it can result in defensive medicine. This commentary provides three recommendations to change the malpractice system: enhance awareness of medical error as a learning opportunity, build physician support systems, and reform the malpractice process to align with patient safety goals.

Medical education has evolved to teach learners about improving patient safety. This commentary explores how relationships between patients, families, and physicians could help reduce diagnostic error and discusses the importance of providing education about clinical decision-making.

Close collaboration between resident physicians and hospital leadership led to significant improvements in patient safety in areas ranging from patient flow to faculty supervision.

A past Institute of Medicine report highlighted the unique challenges in providing high-quality and safe patient care in emergency departments (EDs). In addition to overcrowding, fragmentation in care, and shortage of on-call specialists, there are noted barriers to adopting The Joint Commission's National Patient Safety Goals in the ED. This study surveyed ED providers from diverse practice settings to illustrate the disconnect between nationally stated safety goals and locally expressed safety concerns. Investigators discovered that overcrowding, lack of nursing staff, and unavailability of consultants were the most pressing safety problems identified. Rural providers were most concerned about consultant availability and lack of follow-up after ED care, whereas crowding was the greatest concern for suburban and urban providers. The authors advocate for greater measurement and reporting of these ED provider concerns in future safety benchmarking programs.

This retrospective cohort study, conducted over a 10-year period, linked hospital records and state death records to identify patients who died within 7 days of being discharged from the emergency department (ED). Approximately 30 unexpected deaths occurred per 100,000 ED discharges, and a potential error or misdiagnosis was detected in more than half of these cases. Although prior research found that both physician knowledge and system factors contributed to missed diagnoses in the ED, in this study, unexpected post-discharge deaths were more commonly associated with unusual illnesses or psychiatric or substance abuse comorbidities.