Perspectives on Safety | AHRQ Patient Safety Network

Issues | AHRQ Patient Safety Network





INTERVIEW

In Conversation With… Linda Aiken, PhD, RN

Nursing and Patient Safety, March 2018

Dr. Aiken is Claire M. Fagin Leadership Professor of Nursing, Professor of Sociology, and Director of the Center for Health Outcomes and Policy Research at University of Pennsylvania. She is generally considered the nation's foremost expert on health policy as it relates to the nursing workforce. We spoke with her about how nurse staffing and the work environment can affect patient safety and outcomes.

PERSPECTIVE

Missed Nursing Care: A Key Measure for Patient Safety

with commentary by Jane Ball, PhD, and Peter Griffiths, PhD, Nursing and Patient Safety, March 2018

This piece explores how missed nursing care may explain the association between low nurse staffing levels and increased mortality in hospital patients.

ANNUAL PERSPECTIVE

The Weekend Effect

with commentary by Sumant Ranji, MD, 2017

A considerable body of evidence demonstrates worsened clinical outcomes for patients admitted to the hospital on weekends compared to those admitted on weekdays. This Annual Perspective summarizes innovative studies published in 2017 that helped clarify the magnitude of this effect and identify possible mechanisms by which it occurs.

ANNUAL PERSPECTIVE

Patient Engagement in Safety

with commentary by Rachel J. Stern, MD, and Urmimala Sarkar, MD, 2017

Patient engagement in safety has evolved from obscurity to maturity over the past two decades. This Annual Perspective highlights emerging approaches to engaging patients and caregivers in safety efforts, including novel technological innovations, and summarizes the existing evidence on the efficacy of such approaches.

INTERVIEW

In Conversation With… Robert Hirschtick, MD

Clinical Documentation in the Modern Era, January 2018

Dr. Hirschtick is Associate Professor of Medicine at Northwestern Medicine, and the author of a number of prominent articles—many quite amusing—about the changes in medical practice wrought by information technology. We spoke with him about what it means to be a clinician in the modern era, particularly how digitization of health records has affected clinicians' notes.

PERSPECTIVE

EHR Copy and Paste and Patient Safety

with commentary by Shannon M. Dean, MD, Clinical Documentation in the Modern Era, January 2018

This piece explores concerns regarding the use of copy and paste in electronic health records and offers potential strategies to improve clinical documentation accuracy.

INTERVIEW

In Conversation With… Karl Bilimoria, MD, MS

Surgical Safety, December 2017

Dr. Bilimoria is the Director of the Surgical Outcomes and Quality Improvement Center of Northwestern University, which focuses on national, regional, and local quality improvement research and practical initiatives. He is also the Director of the Illinois Surgical Quality Improvement Collaborative and a Faculty Scholar at the American College of Surgeons. In the second part of a two-part interview (the earlier one concerned residency duty hours), we spoke with him about quality and safety in surgery.

PERSPECTIVE

The Evolution of Patient Safety in Surgery

with commentary by Robert M. Wachter, MD, Surgical Safety, December 2017

This piece explores progress of patient safety in the surgical field and where further improvement can be made, such as ongoing assessment of procedural skills along with video recording and review of surgical procedures.

INTERVIEW

In Conversation With… Wanda Pratt, PhD

Patient-facing Technologies: Opportunities and Challenges for Patient Safety, November 2017

Wanda Pratt is a professor in the Information School and an adjunct in Biomedical and Health Informatics in the School of Medicine at the University of Washington. We spoke with her about patient-facing technologies, including the opportunities and challenges for patient safety.

PERSPECTIVE

The Role of Patient-facing Technologies to Empower Patients and Improve Safety

with commentary by Ronen Rozenblum, MD, MPH, and David Bates, MD, MS, Patient-facing Technologies: Opportunities and Challenges for Patient Safety, November 2017

This piece explores how patient-facing technologies can enable patients to be more responsible for their care and improve the way clinicians practice.

INTERVIEW

In Conversation With… Jeffrey Starke, MD

Presenteeism: A Patient Safety Challenge, October 2017

Dr. Starke is Professor of Pediatrics–Infectious Disease at Baylor College of Medicine and previously served as Infection Control Officer at Texas Children's Hospital. We spoke with him about "presenteeism" (coming to work while ill) in health care and its impact on provider and patient safety.

PERSPECTIVE

Health Care Worker Presenteeism: A Challenge for Patient Safety

with commentary by Julia E. Szymczak, PhD, Presenteeism: A Patient Safety Challenge, October 2017

This piece explores the risks of presenteeism among health care workers and factors, such as cultural expectations, that contribute to its occurrence.

INTERVIEW

In Conversation With… Andrew Gettinger, MD

Health Information Technology and Safety, September 2017

Dr. Gettinger is the Chief Medical Information Officer and the Executive Director of the Office of Clinical Quality and Safety for the Office of the National Coordinator (ONC). He led the development of an electronic health record (EHR) system at Dartmouth and was the senior physician leader during their transition to a vendor-based EHR. We spoke with him about safety and health information technology.

PERSPECTIVE

Assessing the Safety of Electronic Health Records: What Have We Learned?

with commentary by Dean F. Sittig, PhD, and Hardeep Singh, MD, MPH, Health Information Technology and Safety, September 2017

This piece highlights four key lessons that the authors believe are useful for clinicians and health care organizations that seek to identify, prevent, and mitigate electronic health record–related safety issues.

INTERVIEW

In Conversation With… Karl Bilimoria, MD, MS

Resident Duty Hours Policy Changes, August 2017

Dr. Bilimoria is the Director of the Surgical Outcomes and Quality Improvement Center of Northwestern University. He is the principal investigator of the Flexibility in Duty Hour Requirements for Surgical Trainees (FIRST) trial and a Faculty Scholar at the American College of Surgeons. We spoke with him about the FIRST trial, which examined how less restrictive duty hours affected patient outcomes and resident satisfaction. Its results informed recent changes to duty hour policies.

PERSPECTIVE

ACGME's 2017 Revision of Common Program Requirements

with commentary by Kathy Malloy; Timothy P. Brigham, PhD; Thomas J. Nasca, MD, Resident Duty Hours Policy Changes, August 2017

This piece reviews how changes to the ACGME requirements emphasize patient safety and quality improvement, address physician well-being, strengthen expectations around team-based care, and create flexibility for work hours within the maximum 80-hour workweek.

INTERVIEW

In Conversation With… Michelle Mello, MPhil, JD, PhD

Legal Issues and Patient Safety, July 2017

Michelle Mello is Professor of Law at Stanford Law School and Professor of Health Research and Policy at Stanford University School of Medicine. She conducts empirical research into issues at the intersection of law, ethics, and health policy. We spoke with her about legal issues in patient safety.

PERSPECTIVE

Doctors With Multiple Malpractice Claims, Disciplinary Actions, and Complaints: What Do We Know?

with commentary by David Studdert, LLB, ScD, Legal Issues and Patient Safety, July 2017

This piece explores the risk of recurring medicolegal events among providers who have received unsolicited patient complaints, faced disciplinary actions by medical boards, or accumulated malpractice claims.

INTERVIEW

In Conversation With… Paul Aylin, MBChB

The Weekend Effect, June 2017

Professor Aylin is Professor of Epidemiology and Public Health at Imperial College London. We spoke with him about the weekend effect in health care—the observation that patients admitted to the hospital over the weekend often have worse outcomes than those admitted during the week.

PERSPECTIVE

The Weekend Effect in Cardiology: Is It Real? If So, Can It Be Fixed?

with commentary by Vanessa K. Martin, DO, MS; Nasim Mirnateghi, PhD; and Mahdi Khoshchehreh, MD, MS, The Weekend Effect, June 2017

This piece explores the weekend effect in cardiology and recommends allowing invasive management for patients with non ST-elevation myocardial infarction to improve outcomes in this group.