This direct observation study found frequent use of and satisfaction with a checklist of daily goals for patients in an intensive care unit. The intervention was associated with improved communication and fewer errors of omission. Although checklists are widely promoted for patient safety, a recent study suggests that they should be evaluated after implementation.

A positive safety culture has been linked to improved staff satisfaction as well as a lower incidence of errors. This study, conducted in 23 Canadian intensive care units (ICUs), sought to examine the relationship between safety culture and families' satisfaction with care. The authors found a strong positive correlation between safety culture and family satisfaction with care among a subset of patients who had prolonged and ultimately fatal ICU stays. This finding implies that families of patients who have lengthy hospitalizations are affected by the safety and organizational culture of the units where their loved ones are being cared for and that improving safety culture may also improve patient and family satisfaction with care.

This survey of Canadian intensive care units found that larger units and units directed by full-time intensivists had more positive safety culture scores.

While past literature has stressed the importance of optimal nurse staffing for improved patient outcomes, this study surveyed intensive care unit (ICU) directors to evaluate physician staffing practices. Investigators discovered overnight in-house physician coverage in only 60% of ICUs, work shifts that exceeded 20 hours more than 80% of the time, and a largely inexperienced group of overnight providers. All of these findings raise concern about workload, fatigue, and patient safety, particularly as they reflect a lack of compliance with guidelines from the Society of Critical Care Medicine in 2003. The survey results are not linked to patient outcomes, and this would represent an important and next step for future study.