Medication reconciliation can reduce medication errors, but implementation practices can vary across institutions. In this study, researchers compared data for patients from six hospitals and different clinical departments and found that hospitals differed in the number and type of medication reconciliation interventions performed. Qualitative analysis suggests that patient mix, types of healthcare professionals involved, and when and where the medication reconciliation interviews took place, influence the number of interventions performed.

Identifying and reducing potentially preventable readmissions is a patient safety priority. This study found that 16% of readmissions at one teaching hospital in the Netherlands were medication-related; of those, 40% were considered potentially preventable. Preventable readmissions were attributed to prescribing errors, non-adherence, and handoff or transition errors.

Trigger tools facilitate detection of adverse events in medical records, which enables more efficient record review. This study identified adverse events following outpatient orthopedic surgeries using a trigger tool. There was an overall adverse event rate of 10%, suggesting significant improvements are needed in this ambulatory surgery setting.

This commentary, by leaders in the emergency medicine field, discusses the implications of the Institute of Medicine's recommendations regarding resident work hours for emergency medicine residency training. Some, but not all, of the IOM's recommendations were included in the recently released duty hour proposal from the Accreditation Council for Graduate Medical Education.

This commentary explores operational and sociotechnical aspects of applying lean thinking as a management approach to improve quality in health care.

Root cause analysis is commonly used to identify underlying system causes of adverse events. However, this study found that interrater agreement on the number and type of root causes was only moderate.

This study used simulation-based training of anesthetists to demonstrate a reduction in error rates in tested scenarios.