Commentary Discusses Improving Patient Safety; Reports Examine State Efforts To Expand Coverage

• "Improving Patient Safety by Taking Systems Seriously," Journal of the American Medical Association: In the JAMA commentary, Stephen Shortell and Sara Singer, both of the University of California-Berkeley School of Public Health, examine the challenges to improving patient safety and discuss how improvement must be achieved through a systems-based approach rather than a patient or condition-specific-based approach. According to the authors, the greatest barrier to patient safety is the fragmentation of the U.S. health care system (Shortell/Singer, JAMA, 1/30).
  
  
• New reports, Kaiser Family Foundation's Commission on Medicaid and the Uninsured: New reports released by KCMU describe aggressive efforts by states over the past year-and-a-half to expand coverage to low-income children and their families. However, the reports note that a downturn in the economy, federal failure to reauthorize SCHIP and new federal rules affecting Medicaid and SCHIP eligibility suggest that the recent period of coverage expansion may be over. The studies are based on a 50-state survey of eligibility and enrollment rules in Medicaid and SCHIP for children and families, interviews with Medicaid directors in 10 states representing all regions of the country and recent studies of enrollment in Medicaid and SCHIP (Kaiser Family Foundation release, 1/28).