By Susan Carr

As we planned the first issues of Patient Safety and Quality Healthcare, we envisioned a periodical with a broad reach, reflecting the diversity of activities and interests in the field. The variety of relevant topics and interested readers is even greater than I realized then, and still expanding. Articles in this issue feature a wide range of actions that may improve quality and safety: from handwashing (see "World Alliance for Patient Safety" in Pulse on pg. 51) to the integration of best-of-breed clinical information systems (see Lindsy Strait's article starting on pg. 30). The range of constituents for the information is also vast, from Washington politicians (Dave Roberts on page 48) to a Massachusetts wife and mother of three undergoing "routine" surgery and her anesthesiologist (Linda Kenney and Rick van Pelt on pg. 6).

The conferences we attend also reflect many facets of healthcare safety and quality. In December, the Institute for Healthcare Improvement announced a major campaign at its National Congress, and while the campaign includes very specific recommendations and goals (100K Lives on pg. 18), participants and offerings at the Congress represented diverse stakeholders from across the world. This issue of PSQH will ship directly to the annual conference and exhibition of the Healthcare Information Management and Systems Society (HIMSS) in February. Accordingly, features in this issue are weighted toward technology, but it would be a mistake to characterize HIMSS or its meeting as having a narrow focus, as more than 200 educational sessions prove.

Reading Period
My stack of reading materials is another place where the range of topics relevant to safety and quality is evident. Medical writing, like the practice of medicine, has often occurred in "silos," with narrow topics covered in depth by specialists for focused audiences, but especially in the realm of quality and safety, authors are breaking out of traditional silos and producing material that is interdisciplinary and inspiring. Here's a list of recommended articles and books currently in my pile:

Medical Errors and Medical Narcissism by John Banja, Ph.D. (Jones and Barlett, 2004).

"An Information System and Medical Record to Support HIV Treatment in Rural Haiti," by Hamish Fraser, Darius Jazayeri, Paul Farmer and others at Brigham and Women's Hospital and Partners in Health, in the British Medical Journal, November 13, 2004.

Two articles by Atul Gawande: "The Bell Curve: What Happens When Patients Find Out How Good Their Doctors Really Are?" in The New Yorker, Dec. 6, 2004, and "Casualties of War — Military Care for the Wounded from Iraq and Afghanistan" in the New England Journal of Medicine, Dec. 9, 2004.

And one that I haven't read yet, but sought out after re-reading Donald Berwick's essay, "Escape Fire" (Jossey-Base, 2004): Sensemaking in Organizations by Karl E. Weick (Sage Publications, 1995).