JAMA: 2008-01-30, Vol. 299, No. 4, Author in the Room™ Audio Interview

Interview with Stephen M. Shortell, PhD, MBA, MPH, author of Improving Patient Safety by Taking Systems Seriously. Summary Points: 1. To make real progress in patient safety will require redesigning the underlying system of care such that healthcare professionals and institutions providing a continuum of services from prevention to hospice can address multiple conditions and episodes over time. A "culture of systems" must be established. 2. Competing priorities, professional autonomy, solo and small physician practices, disciplinary silos, miss-aligned financial incentives, and inadequate feedback about performance all undermine efforts to create safe healthcare systems. 3. A number of strategic, cultural, technical, and structural barriers need to be addressed to assure safer care. This includes the need for patient safety organizations to gather information across the continuum of care and provide both rapid feedback to practitioners and analyze trends over time.