The role and value of theory in improvement work in healthcare has been seriously underrecognised. We join others in proposing that more informed use of theory can strengthen improvement programmes ...

Objective To contextualise the degree of harm that comes from unsafe medical care compared with individual health conditions using the global burden of disease (GBD), a metric to determine how much ...

This example provides a summary of a real case that occurred in a hospital and the failure to learn from the incident in spite of a root cause analysis. In a large acute hospital, a patient underwent ...

Background Patient complaints are associated with adverse events and malpractice claims but underused in patient safety improvement. Objective To systematically evaluate the use of patient complaint ...

Background Transfers of care, also known as handovers, remain a substantial patient safety risk. Although research on handovers has been done since the 1980s, the science is incomplete. Surprisingly ...

Ten years ago, the Institute of Medicine reported alarming data on the scope and impact of medical errors in the US and called for national efforts to address this problem. While efforts to improve ...

Department of Learning, Informatics, Management and Ethics (LIME), Medical Management Centre (MMC), Karolinska Institutet, Stockholm, Sweden Correspondence to Susanne Ullström, Department of Learning, ...

While there is an increasing emphasis on patient empowerment and shared decision making, evidence suggests that many patients do not wish to be involved in decisions about their own care. Previous ...

Correspondence to Dr Eduardo Salas, Department of Psychology, Rice University, Houston, TX 77005, USA; eduardo.salas{at}rice.edu Front-line medical teams are experiencing unprecedented stressors as a ...

Correspondence to Professor Martin Marshall, Department of Primary Care and Population Health, University College London, London E201AS, UK; martin.marshall{at}ucl.ac.uk It is temptingly easy to treat ...

Background: Breakdown in communication among members of the healthcare team threatens the effective delivery of health services, and raises the risk of errors and adverse events. Aim: To describe the ...

Background Surgical complications represent a significant cause of morbidity and mortality with the rate of major complications after inpatient surgery estimated at 3–17% in industrialised countries.