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Notwithstanding the rising magnitude of system factors in patient safety improvement, “human factors” such as idiosyncratic deals (i-deals) which also contribute to the adjustment of system deficiencies should not be neglected. The purpose of this paper is to investigate the role of value-based HR practices in catalyzing i-deals, which then influence clinical error control. The research further examines the moderating role of corporate social responsibility (CSR) on the effect of value-based HR practices on i-deals.

The data were collected from middle-level clinicians from hospitals in the Vietnam context.

The research results confirmed the effect chain from value-based HR practices through i-deals to clinical error control with CSR as a moderator.

The HRM literature is expanded through enlisting i-deals and clinical error control as the outcomes of HR practices.

The purpose of this review is to enable readers of the journal to gain a quick over-view of articles published in this issue.

A review of articles published within this issue of CGIJ with added commentary.

Clinical governance continues to be an important issue in contemporary healthcare and the concept is being applied to many different facets of healthcare provision.

The originality value is that CGIJ is the only Emerald journal containing this type of review section.

Key findings from recent and relevant studies on patient safety and clinical handoffs are summarized and analyzed. After briefly reviewing process management and accounting control theory, the aim of this paper is to discuss how these latter two disciplines can be combined to further improve patient safety in handoffs.

A literature review on studies of patient safety, clinical processes and clinical handoffs was conducted in leading medical, quality, and information systems journals.

This paper issues a call for research using a trans‐disciplinary methodology to shed new light on information quality issues in clinical handoff processes, which in turn should improve patient safety.

The literature review employed systematic, heuristic, iterative and practical criteria for identifying and selecting papers, trading off completeness for multi‐disciplinarity. No prior empirical patient safety studies combined process management and accounting control theory.

The above‐noted trans‐disciplinary analytic approach may help medical professionals develop more effective handoff processes, checklists, standard operating procedures (SOPs), clinical pathways, and supporting software, and audit and continuously monitor their implementation.

This paper responds to recent calls for trans‐disciplinary research on healthcare quality improvement. The literature review is valuable for understanding clinical handoff problems and solutions from multiple perspectives. The proposed combination of two theories – accounting control theory and business process management – is novel and useful for describing, improving and monitoring handoff processes in the broader context of clinical processes, using a common terminology for information quality traits.

The purpose of this paper is to provide international data on the occurrence (and rates) of clinical errors, identified by type and consequence in the Lombardy region, and to assess empirically the association between hospital accreditation‐type measures and clinical error rates by merging hospital discharge records and medical malpractice claim data in the Lombardy region (Italy).

Data were drawn from the regional database collecting claims and demands for reimbursement declared by patients hospitalized in regional healthcare structures and regional archives collecting hospital discharge records. To model the variability of clinical errors rates, binomial negative regression models were applied. For improved interpretation of the results, a regression tree methodology was used.

The results demonstrated that the rate of readmission for the same major diagnostic category and the rate of discharges against medical advice significantly affect the incidence of errors causing patient death, whereas the rate of unscheduled surgical readmission in the operating room significantly affects the rate of surgical error.

The findings confirm that claims data is problematic in nature because of the limited number of claims generally emerging from administrative sources. The article proposes using proper regression models for count data, taking into account over‐dispersion and excess zeroes and classification tree methods for a better interpretation of empirical evidence.

Health structures where quality outcomes have a significant impact on clinical error rates should be monitored in depth, investigating the medical charts of involved patients to identify quality problems and problematic areas.

As a risk management strategy, the combined use of claims data and clinical administrative data is proposed to shed light on the more problematic, error‐prone areas, allowing regional stakeholders to receive relevant, highly cost‐effective and timely information and an in‐depth understanding of the problematic areas in the assessment of risk.

This study aims to fathom the role of nursing governance as a mechanism to activate the chain effect from corporate social responsibility (CSR) through psychological contract to knowledge sharing, which in turn reduces clinical errors in hospitals in the Vietnam context. Clinical errors not merely result from human factors but also from mechanisms which influence human factors.

The clues for the research model were established through structural equation modeling-based analysis of cross-sectional data from 233 nurses of Vietnam-based hospitals.

Research findings unveiled the positive correlation between nursing governance and ethical CSR as well as the negative correlations between nursing governance and legal CSR or economic CSR. Ethical CSR was found to have positive effect on psychological contract, whereas legal or economic CSR was found to have negative effect on psychological contract. The chain effects from psychological contract through knowledge sharing to clinical error control were also attested in this inquiry.

Research results have contributed to literature in some ways, for example, expanding health-care quality and patient safety literature through the chain of antecedents (nursing governance, CSR, psychological contract and knowledge sharing) to clinical error control, underscoring the role of psychological contract in cultivating knowledge sharing and adding organizational outcomes such as knowledge sharing and clinical error control to the nursing governance literature.

Medical errors in obstetric departments are commonly reported and may involve both mother and neonate. The complexity of obstetric care, the interactions between various disciplines, and the inherent limitations of human performance make it critically important for these departments to provide patient-safe and friendly working environments that are open to learning and participative safety. Obstetric care involves stressful work, and health care professionals are prone to develop burnout, this being associated with unsafe practices and lower probability for reporting safety concerns. This study aims to test the mediating role of burnout in the relationship of patient-safe and friendly working environment with unsafe performance. The full population of professionals working in an obstetrics department in Malta was invited to participate in a cross-sectional study, with 73.6% (n = 184) of its members responding. The research tool was adapted from the Sexton et al.’s Safety Attitudes Questionnaire – Labor and Delivery version and surveyed participants on their working environment, burnout, and perceived unsafe performance. Analysis was done using Structural Equation Modeling. Results supported the relationship between the lack of a perceived patient-safe and friendly working environment and unsafe performance that is mediated by burnout. Creating a working environment that ensures patient safety practices, that allows communication, and is open to learning may protect employees from burnout. In so doing, they are more likely to perceive that they are practicing safely. This study contributes to patient safety literature by relating working environment, burnout, and perceived unsafe practice with the intention of raising awareness of health managers’ roles in ensuring optimal clinical working environment for health care employees.

Recent reports by the Institute of Medicine (IOM) signal a substantial yet unrealized deficit in patient safety innovation and improvement. With the aim of reducing this dilemma, we provide an introductory account of clinical error resulting from poorly designed systems by reviewing the relevant health care, management, psychology, and organizational accident sciences literature. First, we discuss the concept of health care error and describe two approaches to analyze error proliferation and causation. Next, by applying transdisciplinary evidence and knowledge to health care, we detail the attributes fundamental to constructing safer health care systems as embedded components within the complex adaptive environment. Then, the Health Care Error Proliferation Model explains the sequence of events typically leading to adverse outcomes, emphasizing the role that organizational and external cultures contribute to error identification, prevention, mitigation, and defense construction. Subsequently, we discuss the critical contribution health care leaders can make to address error as they strive to position their institution as a high reliability organization (HRO). Finally, we conclude that the future of patient safety depends on health care leaders adopting a system philosophy of error management, investigation, mitigation, and prevention. This change is accomplished when leaders apply the basic organizational accident and health care safety principles within their respective organizations.

Using the example of medication safety, this paper aims to explore the impact of three managerial interventions (adverse incident reporting, ward‐level support by pharmacists, and a medication safety subcommittee) on different professional communities situated in the English National Health Service (NHS).

Semi‐structured interviews were conducted with clinical and managerial staff from two English NHS acute trusts, supplemented with meeting observations and documentary analysis.

Attitudes toward managerial intervention differ by professional community (between doctors, nurses and pharmacists) according to their existing norms of safety and perceptions of formal governance processes.

The heterogeneity of social norms across different professional communities and medical specialties has implications for the design of organisational learning mechanisms in the field of patient safety.

The paper shows that theorisation of professional “resistance” to managerialism privileges the study of doctors' reactions to management with the consequent neglect of the perceptions of other professional communities.

The purpose of this paper is to explore employee perceptions of communication in psychologically safe and unsafe clinical care environments.

Clinical providers at the USA Veterans Health Administration were interviewed as part of planning organizational interventions. They discussed strengths, weaknesses, and desired changes in their workplaces. A subset of respondents also discussed workplace psychological safety (i.e. employee perceptions of being able to speak up or report errors without retaliation or ostracism – Edmondson, 1999). Two trained coders analysed the interview data using a grounded theory-based method. They excerpted passages that discussed job-related communication and summarized specific themes. Subsequent analyses compared frequencies of themes across workgroups defined as having psychologically safe vs unsafe climate based upon an independently administered employee survey.

Perceptions of work-related communication differed across clinical provider groups with high vs low psychological safety. The differences in frequencies of communication-related themes across the compared groups matched the expected pattern of problem-laden communication characterizing psychologically unsafe workplaces.

Previous research implied the existence of a connection between communication and psychological safety whereas this study offers substantive evidence of it. The paper summarized the differences in perceptions of communication in high vs low psychological safety environments drawing from qualitative data that reflected clinical providers’ direct experience on the job. The paper also illustrated the conclusions with multiple specific examples. The findings are informative to health care providers seeking to improve communication within care delivery teams.