Patient safety in ambulatory care settings is receiving increased attention. Based on interviews and focus groups with patients, providers, and staff at ten patient-centered medical homes, this qualitative study explored perceived facilitators and barriers to improving safety in ambulatory care. Participants identified several safety issues, including communication failures and challenges with medication reconciliation, and noted the importance of health information systems and dedicated resources to advance patient safety. Patients also emphasized the importance of engagement in developing safety solutions. A recent PSNet perspective discusses patient safety challenges in ambulatory care, particularly during the COVID-19 pandemic.

Patient-centered medical homes (PCMHs) are designed to be team-based, coordinated, accessible primary health care. This qualitative study explored patient perceptions about safety in PCMHs. Identified themes important to patient safety include communication with and between clinicians and trust in the care team, including being heard, respected, and treated as a whole person.

… J Patient Saf … The aim of the Patient Centered Medical Home … safety culture in medical homes: a coincidence analysis. J Patient Saf. Epub 2020 Aug 3. 10.1097/pts.0000000000000752 …

Efforts to address poor provider hand hygiene rates have escalated in the setting of increased attention to health care–associated infections. Along parallel lines, the importance of patient engagement was elevated by its introduction into the National Patient Safety Goals. This pilot study adopted a tool to engage patients in auditing provider hand hygiene rates in the ambulatory setting. Investigators found that patients were largely willing to monitor and report on providers' compliance with hand hygiene and did not feel it impacted their patient–provider relationship. Patient observations correlated well to independent direct observations of hand hygiene rates, suggesting that this type of engagement may be efficient and acceptable.

In response to multiple incidents of registration-associated patient misidentification (eg, assigning a new patient an existing patient's medical record number), an interdisciplinary team used plan-do-study-act methodology to investigate the root cause of such errors and formulate solutions. Several system problems were identified, ranging from inadequate training of registrars to the lack of a true master list of patients' medical record numbers. The authors describe the iterative process used to identify and address sources of error at several points within the patient registration process.