Medication errors at hospital admission and discharge are a common cause of preventable harm, but robust medication reconciliation reduces such risks. Although medication reconciliation always involves the patient to some extent, it creates an opportunity to use health information technology (IT) to engage patients more meaningfully. Researchers piloted a tablet-based home medication review tool provided to patients at hospital admission. Patients found the tool easy to use and each identified 2.6 medication discrepancies on average. Most discrepancies were of significant severity and were not detected by clinicians during their medication reconciliation. However, the tool was not integrated into the electronic medical record, so clinicians had no streamlined way to incorporate patients' suggested medication changes. An Annual Perspective explored how health IT can be leveraged to enhance patient engagement in safety.

Patients are increasingly encouraged to take an active role in their own safety during hospital care. Some have criticized this strategy for shifting responsibility for patient safety. AHRQ, The Joint Commission, and other organizations have developed resources for patients to help prevent medical errors. This review identified 17 studies exploring the use of health information technology to increase patient engagement during inpatient care. Interventions ranged from efforts focused purely on engaging patients through entertainment to providing sophisticated personalized decision support. The authors conclude that the current literature leaves considerable gaps in knowledge regarding patient engagement in the hospital setting. A recent AHRQ WebM&M perspective discussed the opportunities and limitations of involving patients in safety.

Recent research has focused on identifying patient safety issues in the ambulatory setting. In this study, advanced practice nursing students recognized more than 800 patient safety issues during only 497 outpatient encounters.

Advanced practice nursing students reported witnessing a wide variety of errors in their training experiences, primarily related to communication between providers.

This study reports on an initiative to encourage student nurses to voluntarily report errors and near misses encountered during ambulatory care rotations.

Nursing students identified several categories of near misses relating to infection control practices in this study, using data from a Web-based voluntary reporting system.

This commentary describes how one institution devised, tested, and validated a self-reporting tool to assess clinicians' views about patient safety.