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Teaching clinical reasoning to medical students is a key strategy for reducing diagnostic errors. This paper describes a new longitudinal clinical reasoning curriculum taught in a US medical school’s first and second year of medical training. Students reported high self-efficacy after completing the curriculum; however, a competency audit revealed room for improvement in including system-related aspects of care.

Biases in decision support technologies precipitate racial inequities. This commentary discusses how algorithms in machine learning contribute to inaccuracies in the care of persons of color and the displaced. Legal actions to mitigate racial biases in decision making programs and implementation steps toward improvement are discussed.

Dashboards provide a way to display patient safety data (e.g., medication safety) in real time. This narrative review and SWOT (strengths, weaknesses, opportunities, threats) of existing patient safety dashboards can form the basis for developing future dashboards.

In 2016, the Centers for Disease Control (CDC) issued an opioid prescribing guideline intended to reverse the increasing death rate from opioid overdoses. This study describes the development, implementation, and effect of a safe prescribing strategy (TOWER) in an HIV-focused primary care setting. Providers using TOWER were more adherent to the CDC guidelines, with no worsening patient-reported outcome measures.

Clinical reasoning is an essential component of diagnostic safety. This paper describes the development of a new curriculum to improve clinical reasoning skills and processes in medical students. The curriculum uses several educational strategies (e.g., classroom teaching, simulation training, patient encounters) during pre-clerkship and clerkship to improve clinical reasoning skills across several domains (theory, patient assessment, diagnosis, and shared decision-making).

A 2011 systematic review identified nine tools to assess patient safety competence in nurses. This review identified multiple instruments released since that review; the most frequently used was the Health Professional Education in Patient Safety Survey (H-PEPSS). The authors suggest future research should consider including ethics in patient safety and responsiveness to change over time.

Computerized provider order entry has become standard practice for most medication ordering. This article reports on the safety and efficiency of ordering mixed-drug infusions before and after implementation of electronic prescribing. After implementation, rates of prescription errors, time to process discharge orders, and time between prescription and administration all decreased.

Speech recognition software is a potential strategy to reduce documentation burden and burnout. This study compared the accuracy handwritten nursing notes versus online and offline speech recognition software. Findings indicate that the speech recognition software was accurate but created more errors than handwritten notes.

Medication prescribing errors are common, particularly during medical training. This retrospective review of prescriptions from ten general practitioners in training in the United Kingdom identified a high rate of prescribing errors (8.9% of prescriptions reviewed) and suboptimal prescribing (35%).

Patient portals allow patients and their caregivers to read clinical notes, view test results, and communicate with their provider, with the goal of improving patient safety. This scoping review found limited evidence of improved patient safety with the use of patient portals. Additionally, the authors found multiple naming conventions, such as patient portal, personal health record, and personal medical record.

Patient exposure to allergens healthcare settings, such as latex or certain medications, can lead to adverse outcomes. Based on data from an incident reporting system, researchers in this study developed a system for classifying allergy-related safety events. Classification categories include: (1) incomplete or inaccurate EHR documentation, (2) human factors, such as overridden allergy alerts, (3) alert limitation or malfunction, (4) data exchange and interoperability failures, and (5) issues with EHR system default options. This classification system can be used to support improvements at the individual, team, and systems levels. 

Potentially inappropriate prescribing in older adults can increase the risk of adverse drug events (ADEs). This systematic review assessed increased healthcare costs associated with ADEs related to potentially inappropriate medications (PIMs) among older adults. Higher costs were due to increases in hospitalizations, health care expenses, and emergency department visits. Costs were higher among patients with more than one PIM, patients older than 75 years of age, patients with dementia, and patients with other drug interactions.

In 2019, a consensus group identified twelve competencies to improve diagnostic education. This article details next steps for incorporating competencies into interprofessional health education: 1) Developing a shared, common language for diagnosis, 2) developing the necessary content, 3) developing assessment tools, 4) promoting faculty development, and 5) spreading awareness of the need to improve education in regard to diagnosis.

Residents and trainees frequently report experiencing bullying and disrespectful behaviors in the workplace. This study explored the relationship between resident psychological safety, perceived organizational support, and humiliation. Results indicate resident perception of increased organizational support (e.g., help is available when they have a problem) reduces the negative impact of humiliation on their psychological safety.