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Cases & Commentaries
- Web M&M
Daniel Mason, MD; September 2004
A medical student discovers that a hospital's radiology records are accessible via Internet, without any security, and struggles with whether and to whom to report the obvious HIPAA violation.
Journal Article > Study
Safe medication prescribing: training and experience of medical students and housestaff at a large teaching hospital.
Garbutt JM, Highstein G, Jeffe DB, Dunagan WC, Fraser VJ. Acad Med. 2005;80:594-599.
This study reports the findings of a survey administered to medical trainees about the safety of their prescribing behaviors. Results suggested an inconsistent use of safe prescribing practices, such as checking for drug allergies, assuring normal renal function, and addressing potential drug interactions. The authors conclude by advocating for greater efforts toward safer prescribing strategies with emphasis on trainee education.
Journal Article > Study
Speaking up about traditional and professionalism-related patient safety threats: a national survey of interns and residents.
Martinez W, Lehmann LS, Thomas EJ, et al. BMJ Qual Saf. 2017;26:869-880.
Health care provider comfort with raising patient safety concerns is a critical aspect of safety culture. This survey of resident physicians at six academic medical centers demonstrated that trainees remain reluctant to speak up. Nearly half reported observing a patient safety threat. The majority spoke up about patient safety concerns, but a significant proportion did not. Although unprofessional behavior was more frequently observed, fewer trainees raised concerns about lack of professionalism than about patient safety. Even when respondents perceived the unprofessional behavior as having high potential for adverse patient consequences, they were not as likely to speak up about this compared to a traditional patient safety threat such as inadequate hand hygiene. The authors recommend specifically measuring tolerance for unprofessional behaviors as a part of safety culture assessment.
Journal Article > Commentary
Using a modified A3 lean framework to identify ways to increase students' reporting of mistreatment behaviors.
Ross PT, Abdoler E, Flygt L, Mangrulkar RS, Santen SA. Acad Med. 2018;93:606-611.
This project report describes how an academic health system utilized a modified Lean framework to uncover weaknesses in reporting processes for student mistreatment. The authors found that reporting was hindered by lack of student awareness regarding reporting mechanisms and perceptions that no action would result from reporting mistreatment. The authors outline recommendations to address these challenges.