Hospital leaders are essential partners to help establish and sustain a culture of safety. This longitudinal study of Australian hospitals found that hospital leadership and clinical leaders primarily relied on staff to ensure patient safety, rather than relying on systems and processes to prevent errors.

The patient safety movement catalyzed a well-known change in physician duty hours. A less known consequence of duty hour reform was an increase in clinical supervision for trainees. Although some studies have suggested that more clinical supervision leads to fewer adverse events, there were concerns that excessive trainee supervision impedes clinical learning. This systematic review examined how increased clinical supervision affects patient safety. Investigators found that complications from surgery and other invasive procedures were less likely when there was more supervision. Their data also indicated an overall mortality benefit associated with clinical supervision, but this result remains open to question because several of the included studies on mortality were of lower quality. At minimum, this meta-analysis argues for continued clinical supervision of surgeries and invasive procedures for optimal patient safety, as discussed in a previous PSNet perspective.

The investigators surveyed Australian health care managers to identify key competencies needed to be effective team members.

The authors suggest that people management qualities such as teamwork development, performance management, and training should be the primary emphasis during culture change initiatives within hospitals. They argue that better people management leads to, rather than results from, an improved organizational culture.