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Orth J, Li Y, Simning A, et al. Gerontologist. 2021;61:1296-1306.
Nursing home patient safety culture is associated with healthcare quality and patient outcomes. This large cross-sectional study of nursing homes in the United States found that speaking-up behavior and communication openness were associated with a decreased risk of in-residence death among older adults with dementia. This association was strong in nursing homes located in states with higher nursing home nurse staffing requirements.  
Hoffman JR, Kanzaria HK. BMJ. 2014;349.
Lack of acceptance for human error and uncertainty have been known to contribute to overdiagnosis and overuse that may result in patient harm. This commentary explains why medical liability reform alone is not sufficient to address this issue. The authors suggest that both professionals and patients will need to adjust their expectations of failures in order to achieve behavior change.