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Medication Safety Officers Society 4494 Members Strong A society of healthcare professionals dedicated to improving medication safety in healthcare organizations |
Sustainability is not static maintenance; it is evolution. Health systems that can adapt, discard and relearn, retaining what matters and deliberately forgetting what no longer serves patients, can sustain high-value care and continually move beyond low-value practices.
When learning is not enough: why health systems must learn to forgetHealthcare prides itself on being a learning system. We collect data, consider the context, analyse outcomes and iterate improvement cycles. Yet, true sustainability—the ability to embed and maintain improvement over time—requires more than learning: it demands deliberate unlearning. Outdated order sets, decision rules and routines have the potential to shape care long after evidence has evolved.1 A paradox of improvement is that systems cannot sustain what is new until they have let go of what is old....
Patient safety huddles have been employed across healthcare settings to boost safety culture and improve patient outcomes. However, there is a dearth of literature pertaining to physicians’ levels of interest in participating in these huddles, as well as the impact of physician presence on patient care dynamics. Multidisciplinary huddles aimed at identifying and addressing patient safety issues related to the electronic health record (EHR), for example, were helpful for promoting discussion of EHR-related safety concerns.1 Furthermore, there is a robust literature demonstrating the patient safety benefits of perioperative time-outs in the surgical literature, as well as structured handoffs at the time of care transfer.2–5 Yet hospitalist physicians were not always routinely a key part of these huddles, even though representatives from the medical and surgical services were among the 40 roles that attended some huddles in these studies.
As people age, so do their kidneys.1 The average decline in renal function is approximately 1 mL/min/year after 30 years old.2 3 Over 40% of people >70 years meet the Kidney Disease Improving Global Outcomes definition of chronic kidney disease (CKD), reflecting the increased prevalence of this condition in older people.4 5 Renal function decline is further accelerated through conditions such as hypertension, atherosclerosis, diabetes and cardiovascular disease, which are common comorbidities in older people.6 Safe prescribing of medication for older people with reduced kidney function is an ongoing challenge. Reduced renal excretion of medications eliminated through the kidney exposes people to increased drug plasma levels and increases the risk of medication-related harm leading to adverse drug events, increased hospitalisations and increased mortality.1 7 The presence of polypharmacy, among other issues, in this age...
