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Cases & Commentaries
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- Web M&M
George R. Thompson III, MD, and Abraham Verghese, MD; August 2006
A man with paraplegia was admitted to the hospital, but the admitting physician, night float resident, and daytime team all "deferred" examination of the genital area. The patient was later discovered to have life-threatening necrotizing fasciitis of this area.
Journal Article > Review
Does clinical supervision of health professionals improve patient safety? A systematic review and meta-analysis.
Snowdon DA, Hau R, Leggat SG, Taylor NF. Int J Qual Health Care. 2016;28:447-455.
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.