Background: Diagnostic errors are common, costly, and harmful. Cognitive biases and suboptimal clinical reasoning are contributing factors for diagnostic error. A diagnostic time-out (DTO) is a structured tool to optimize clinical reasoning, prioritize the differential diagnosis, and communicate diagnostic uncertainty in high-risk situations susceptible to diagnostic error. Purpose: To design and implement an interactive educational […]

Background: Several institutions have implemented a medical procedure service (MPS) to improve timeliness of bedside procedures and standardize performance and training of procedures by internal medicine (IM) residents (1-2). A critical barrier to starting an MPS has been a lack of experienced proceduralists (3). In 2011, our IM residency program created an MPS led by […]

Background: Diagnostic errors (DEs) represent ongoing threats to patient safety in the hospital. Little is known about the factors present on admission that can predict DE during the hospital encounter. Such knowledge is essential for prospective identification of hospitalized patients at risk for DE who can be targeted for early intervention. The purpose of this […]

Background: Diagnostic errors are common, costly, and harmful. Cognitive biases and suboptimal clinical reasoning are contributing factors for diagnostic error. A diagnostic time-out (DTO) is a structured tool to optimize clinical reasoning, prioritize the differential diagnosis, and communicate diagnostic uncertainty in high-risk situations susceptible to diagnostic error. Purpose: To design and implement an interactive educational […]

Background: Several institutions have implemented a medical procedure service (MPS) to improve timeliness of bedside procedures and standardize performance and training of procedures by internal medicine (IM) residents (1-2). A critical barrier to starting an MPS has been a lack of experienced proceduralists (3). In 2011, our IM residency program created an MPS led by […]

Background: Diagnostic errors (DEs) represent ongoing threats to patient safety in the hospital. Little is known about the factors present on admission that can predict DE during the hospital encounter. Such knowledge is essential for prospective identification of hospitalized patients at risk for DE who can be targeted for early intervention. The purpose of this […]

Background: The American Geriatric Society (AGS) creates a consensus report, the Beers Criteria, of medications that may potentially inappropriate for older persons. The 2019 Beers Criteria consists of medications across many classifications and indications that could have potentially harmful effects on older patients, including contributing delirium, falls, hypotension, and urinary retention. Providing the highest quality […]

Background: Healthcare in the U.S. is increasingly delivered by large health systems that include one or more hospitals and associated outpatient practices. It is unclear what role health systems play in driving or preventing overutilization of healthcare services in the U.S. We sought to learn what characteristics allow certain health systems to avoid low-value care […]

Background: Diagnostic and clinical reasoning errors are common and a source of harm to our patients. Improving clinical reasoning skills is challenging due to the absence of feedback. Care transitions have been recognized as an area of vulnerability for hospitalized patients, however, they also represent opportunities for error recognition and improvement as the oncoming clinician […]

Background: Current literature shows that many graduating health-professional students are not adequately trained to identify safety hazards [1]. With early integration of patient safety education in medical student education, we hope to reduce the occurrence of adverse events longitudinally throughout an individual’s medical career. Data demonstrates that patient safety simulations are an effective method to […]