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Journal Article > Review
Speaking up behaviours (safety voices) of healthcare workers: a metasynthesis of qualitative research studies.
Morrow KJ, Gustavson AM, Jones J. Int J Nurs Stud. 2016;64:42-51.
A key aspect of positive safety culture is the perception that all team members should speak up about safety concerns. This review of studies identified hierarchy and role expectations as barriers to nurses speaking up and found that nurse managers play a central role in determining the extent to which speaking up is valued. These results suggest that speaking up about safety remains aspirational for nurses and other health care workers.
Institute for Healthcare Improvement Web site. March 20, 2006.
This article reviews the importance of medication reconciliation, discusses the difficulties of building the process into patient care, and shares stories from hospitals that have successfully implemented programs.
Journal Article > Study
Lost in translation: challenges and opportunities in physician-to-physician communication during patient handoffs.
Solet DJ, Norvell JM, Rutan GH, Frankel RM. Acad Med. 2005;80:1094-1099.
One of Joint Commission on Accreditation of Healthcare Organizations' (JCAHO) National Patient Safety Goals for 2006 involves implementation of a standardized approach to handoff communications. This study provides a literature review of patient handoffs and discusses the variability of existing systems in one internal medicine training program. The authors define handoffs as "any transfer of role and responsibility from one person to another." They discuss a broad number of barriers to effective handoffs, such as physical setting, social setting, language and communication barriers, and time and convenience. Their recommendations call for development of standard educational practices and incorporation of handoff tools into existing information technology systems.
Cases & Commentaries
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Sidney T. Bogardus, Jr., MD; April 2003
Delirious and coagulopathic patient with subdural hematomas falls out of bedtwice!