Perspectives on Safety
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.
INTERVIEW
In Conversation With… David Juurlink, MD, PhD
Opioids and Patient Safety, May 2017
Dr. Juurlink is professor of medicine, pediatrics, and health policy at the University of Toronto, where he is also director of the Division of Clinical Pharmacology and Toxicology. We spoke with him about the opioid epidemic and strategies to address this growing patient safety concern.
PERSPECTIVE
Opioid Overdose as a Patient Safety Problem
with commentary by Irene Berita Murimi, PhD, MA, and G. Caleb Alexander, MD, MS, Opioids and Patient Safety, May 2017
This piece explores the opioid epidemic in the United States, including factors that led to increased opioid prescribing, its adverse effects, and tactics to reduce opioid-related harm.
INTERVIEW
In Conversation With… Mark Chassin, MD, MPP, MPH
New Thinking About High Reliability, April 2017
Dr. Chassin is president and chief executive officer of The Joint Commission. He is also president of the Joint Commission Center for Transforming Healthcare, a center he began to promote high reliability and transformative practice. We spoke with him about new thinking in high reliability.
INTERVIEW
In Conversation With… Kathleen Sutcliffe, MN, PhD
New Thinking About High Reliability, April 2017
Professor Sutcliffe is a Bloomberg Distinguished Professor of Business and Medicine at Johns Hopkins University. She studies organizational adaptability, reliability, resilience, and safety in health care. We spoke with her about high reliability in health care organizations.
INTERVIEW
In Conversation With… Mary Dixon-Woods, DPhil
Approaching Safety Culture in New Ways, March 2017
Dr. Dixon-Woods is RAND Professor of Health Services Research at Cambridge University, Deputy Editor-in-Chief of BMJ Quality and Safety, and one of the world's leading experts on the sociology of health care. We spoke with her about new ways to approach safety culture.
PERSPECTIVE
Our Maturing Understanding of Safety Culture: How to Change It and How It Changes Safety
with commentary by Sara J. Singer, MBA, PhD, Approaching Safety Culture in New Ways, March 2017
This piece discusses the importance of strengthening safety culture in health care and offers insights for organizations seeking to achieve culture change.
ANNUAL PERSPECTIVE
Measuring and Responding to Deaths From Medical Errors
with commentary by Sumant Ranji, MD, 2016
The toll of medical errors is often expressed in terms of mortality attributable to patient safety problems. In 2016, there was considerable debate regarding the number of patients who die due to medical errors. This Annual Perspective explores the methodological approaches to estimating mortality attributable to preventable adverse events and discusses the benefits and limitations of existing approaches.
INTERVIEW
In Conversation With… Amy C. Edmondson, PhD, AM
Update on Teamwork, February 2017
Dr. Edmondson is the Novartis Professor of Leadership and Management at Harvard Business School. She is an expert on leadership, teams, and organizational learning. We spoke with her about the role of teamwork in health care and why it is becoming increasingly important.
PERSPECTIVE
New Insights About Team Training From a Decade of TeamSTEPPS
with commentary by David P. Baker, PhD; James B. Battles, PhD; Heidi B. King, MS, Update on Teamwork, February 2017
This piece outlines 10 insights about team training in health care learned from experience with the AHRQ-supported teamwork training program, TeamSTEPPS.
INTERVIEW
In Conversation With… Paul H. O'Neill, MPA
Workplace Safety, January 2017
Mr. O'Neill served as the United States Secretary of the Treasury under President George W. Bush and, prior to that, chairman and CEO of Alcoa. We spoke with him about workplace safety and its relationship to patient safety and organizational excellence.
PERSPECTIVE
Workplace Safety in Health Care
with commentary by Ross W. Simon and Elena G. Canacari, RN, Workplace Safety, January 2017
This piece explores how a team at Beth Israel Deaconess Medical Center combined tools and techniques used in manufacturing along with continuous improvement to develop a process to identify, prioritize, and mitigate hazards in health care settings.
ANNUAL PERSPECTIVE
Patient Safety and Opioid Medications
with commentary by Urmimala Sarkar, MD, and Kaveh Shojania, MD, 2016
Opioids are known to be high risk medications, and concerns about patient harm from prescription opioid misuse have been increasing in the United States. This Annual Perspective summarizes research published in 2016 that explored the extent of harm from their use, described problematic prescribing practices that likely contribute to adverse events, and demonstrated some promising practices to foster safer opioid use.
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