title: Patient safety: Part II. Opportunities for improvement in patient safety.
abstract: The quality movement in medicine has prompted a shift from a "name, shame, blame" approach to medical errors to one in which each error is regarded as an opportunity to prevent future patient harm. This new culture of patient safety requires the involvement of all members of the health care team and learned skill sets related to quality improvement. A root cause analysis identifies the sources of medical errors, allowing system changes that reduce the risk. In large organizations, sentinel events and signals prompt chart reviews and reduce the reliance on voluntary reporting. Failure mode analysis prompts the development of safety nets in the case of a system failure. The second part of this two-part series on patient safety examines how the culture of patient safety is taught, how medical errors and threats to patient safety can be identified, and how engineering tools can be used to improve patient care. It also examines efforts to measure clinical effectiveness and outcomes in the practice of medicine.
  
  
  OBJECTIVE
  After completing this learning activity, participants should be able to improve patient safety through an understanding of both the beneficial and adverse consequences of quality reporting, apply safety engineering tools to the practice of dermatology, and be able to establish a quality improvement plan for a dermatologic practice.
authors.affiliation: Departments of Dermatology and Pathology, Geisinger Medical Center, 100 N Academy Ave, Danville, PA 17822-1406, USA. dmelston@geisinger.edu
authors.forename: Dirk M
authors.initials: DM
authors.lastname: Elston
authors.forename: Erik
authors.initials: E
authors.lastname: Stratman
authors.forename: Hillary
authors.initials: H
authors.lastname: Johnson-Jahangir
authors.forename: Alice
authors.initials: A
authors.lastname: Watson
authors.forename: Susan
authors.initials: S
authors.lastname: Swiggum
authors.forename: C William
authors.initials: CW
authors.lastname: Hanke
mesh_terms: D002170:Canada; D002983:Clinical Competence; D003880:Dermatology / Q000592:standards* / Q000639:trends; D004502:Education, Medical, Continuing / Q000592:standards; D005260:Female; D006801:Humans; D008297:Male; D019300:Medical Errors / Q000517:prevention & control*; D009819:Office Visits; D015279:Organizational Culture; D017410:Practice Guidelines as Topic; D010818:Practice Patterns, Physicians' / Q000592:standards / Q000639:trends; D011785:Quality Assurance, Health Care; D012308:Risk Management / Q000592:standards / Q000639:trends; D017751:Safety Management / Q000592:standards* / Q000639:trends; D012955:Societies, Medical; D014481:United States