Lucian Leape Institute Roundtable on Reforming Medical Education. Unmet Needs: Teaching Physicians to Provide Safe Patient Care. Boston: National Patient Safety Foundation; March 2010.

This white paper finds that US medical schools are not adequately facilitating student understanding of basic knowledge and the development of skills required for the provision of safe patient care. Key recommendations for reforming medical education in order to improve patient safety are discussed.

Various. Quality and Safety in Medicine. Academic Medicine. 2009;84(12):1641-1846.

Articles in this special Academic Medicine theme issue examine how medical schools and teaching hospitals are improving and measuring quality and safety. Articles include discussion of specific initiatives like hand hygiene measurement and electronic medical record implementation, as well as longitudinal analyses of established quality and safety programs such as the VA's National Quality Scholars Fellowship program.

Parry G, Horowitz L, Goldmann D. Patient safety attitudes of paediatric trainee physicians. Quality and Safety in Health Care. 2009;18(6):462-466.

This study in an academic pediatric hospital used Safety Attitude Questionnaires and a specific survey to assess physician trainee attitudes toward safety. The data showed that trainees appear comfortable with caring independently for patients, but less so caring interdependently. The authors note that recently developed patient safety culture instruments may enable additional understanding of what could be implemented to make improvements.

Federico F, Bonacum D. Strengthening the core: Middle managers play a vital role in improving safety. Healthcare Executive. 2010 Jan/Feb;25(1):68-70.

Because they are not in senior leadership positions or at the front lines of patient care, middle managers act as a crucial bridge between the two. This article describes the core skills that middle managers need to be successful in leading improvement efforts at the microsystem level, and what senior leaders must do to provide the necessary training and support structures within the organization.

Leape L, Berwick D, Clancy C, et al. Transforming healthcare: A safety imperative. Quality and Safety in Health Care. 2009;18:424-428.

Ten years after the Institute of Medicine report To Err Is Human that described the scope and impact of medical errors in the US, the Lucian Leape Institute reflects on progress toward improving patient safety. This article identifies five concepts that are fundamental to achieving meaningful improvement in health care system safety: transparency, care integration, patient/consumer engagement, restoration of joy and meaning in work, and medical education reform.

Carr S. Disclosure and Apology: What's Missing? Advancing Programs That Support Clinicians. Medically Induced Trauma Support Services; November 2009.

This report gives guidance to health care organizations for establishing programs that provide emotional support to clinicians and staff members following adverse events. The report was developed as a result of a day-long learning event at which physicians, nurses, risk managers, patient safety officers, health care executives, claims representatives, employee assistance program support staff, and others gathered to share experiences and better practices.

Bismark MM. The power of apology. New Zealand Medical Journal. 2009 Oct;122(1304):96-106.

An apology to the patient following an adverse event can bring comfort to the patient, forgiveness to the health practitioner, and help restore trust in their relationship. Yet, for many practitioners saying "I'm sorry" remains a difficult thing to do. This article explores the key elements of a full apology and when they should be used, and how to support practitioners in making an apology to patients who have been harmed.

Peto RR, Tenerowicz LM, Benjamin EM, Morsi DS, Burger PK. One system's journey in creating a disclosure and apology program. Joint Commission Journal on Quality and Patient Safety. 2009 Oct;35(10):487-496.

In 2006 Baystate Health in Massachusetts began implementing a formal disclosure and apology program to support prompt and skillful disclosure of adverse events. The hospital trained coaches and established and expanded emotional support services for patients, families, and clinicians. This article describes their experience to date, including key challenges and lessons learned.

Adler L, Denham CR, McKeever M, Purunton R, Guilloteau F, Moorhead D, Resar R. Global Trigger Tool: Implementation basics. Journal of Patient Safety. 2008 Dec;4(4):245-249.

This article has been written to assist front-line community hospitals that are contemplating using the IHI Global Trigger Tool methodology to measure overall harm (adverse events). The experience of Florida Hospital is described, from initial leadership agreement, to team training, and finally to lessons learned in setting up an ongoing system of harm measurement using the IHI Global Trigger Tool.

Nance J
Bozeman, Montana: Second River Healthcare Press; 2008

An internationally recognized medical/patient safety and aviation safety expert, John Nance has been a leader in applying aviation safety concepts such as crew resource management in health care settings for numerous years. In this book, he describes the new and different (and sometimes radical) methods for supporting front-line hospital staff in providing safe, high-quality care for patients.