This systematic review found that half the time clinicians fail to investigate questions they raised in the course of patient care, and this behavior has not changed over time despite the increasing availability of online clinical resources. The authors highlight the need for effective cognitive training and decision support for clinical decision-making. Barriers to seeking answers included insufficient time and doubt regarding the question's relevance.

Safety culture has many determinants, and studies in both inpatient and outpatient settings have shown that overall perception of safety culture varies between practice settings. This study used the AHRQ Medical Office Survey on Patient Safety Culture to evaluate perceived safety and quality of care in more than 300 primary care practices and found that smaller practices (those with fewer than 15 employees) generally had more positive perceptions of safety culture. The study did not find any relationship between safety culture and use of health information technology (IT), despite prior research showing that health IT implementation is associated with improved safety culture scores. The broader issue of patient safety in ambulatory care is discussed in a Patient Safety Primer.

This study reports on the initial experience with an Internet-based voluntary reporting system for medication errors in ambulatory care. The system was relatively easy to use, but some participants raised concerns about error reporting leading to negative consequences for the culture of safety.

Customizing drug interaction warnings within a computerized order entry system resulted in fewer clinicians overriding the warnings.

… of the American Medical Informatics Association : JAMIA … J Am Med Inform Assoc …