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Comment & Response
August 12/26, 2013

Perceptions of Safety Are Shaped by the Hospital Environment

Author Affiliations
  • 1Division of Hospital Medicine, Northwestern University Feinberg School of Medicine, Chicago, Illinois
  • 2Division of Hospital Medicine, Northwestern University Feinberg School of Medicine, Chicago, Illinois
  • 3Operations, Northwestern Lake Forest Hospital, Lake Forest, Illinois
JAMA Intern Med. 2013;173(15):1471-1472. doi:10.1001/jamainternmed.2013.7741

To the Editor We commend Michtalik and colleagues1 for surveying hospitalists about how their workload affects patient care, but our own experiences in academic, community, veterans, and international hospitals lead us to question the reported “safe” census of 15 patients per shift, especially since the standard deviation for this number is not reported. We contend that the real threshold for safety diverges from this value based on the clinical setting and support structures in place.

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