Simulation was initially applied to improve crisis management in anesthesia, and recently it has been used to assess and enhance both technical and teamwork skills. Summarizing the history of simulation training for safety improvement, this review describes the current gap in demonstrating a direct connection between the use of simulation and better patient outcomes.

Early efforts in patient safety have focused on error reduction in hospitalized patients, and the ambulatory setting is rapidly emerging with its own body of research. However, patients enrolled in hospice, nursing homes, and homecare settings are underrepresented in the safety literature. This study analyzed more than 160 studies to develop a taxonomy for adverse events in the homecare setting. Categories included adverse drug events and line-related problems as well as the expected focus on wounds and falls. Investigators reported that adverse event rates ranged from 3%–15%, with few intervention trials addressing these opportunities for improvement. The authors advocate for standardized definitions of common homecare–setting events that can foster necessary efforts to improve care for patients in this environment. A related editorial [see link below] discusses the opportunities to advance our understanding of patient safety in the homecare setting.

The authors developed a curriculum to teach structured sign-out skills to interns and found that participants were more comfortable with sign-out after going through the program.

The researchers surveyed more than 200 chief residents and found that few programs had comprehensive transfer processes in place or provided formal resident training on successful transfer communications and methodologies.