ABSTRACT
A fatal incident in Denver illuminates the critical intersection of patient safety and reliable EI&K transfer. The Denver case highlights how the five rights of medication checking exponentially expand safety measures when used in parallel with the five rights of evidence, information and knowledge delivery: the right resource, to the right person, for the right patient or purpose, through the right modality, at the right time. Evidence supports the use of multidisciplinary teams as a means of improving quality indicators, better patient experience and preventing errors. Multidisciplinary teams and activities can break down silos created by specialization and departmentalization to enable cross-professional knowledge and information exchange. Evidence is developing regarding the use of medical librarians in assisting clinicians, in teams or on their own, with information needs. An example of knowledge transfer between the blunt and sharp ends is in the case of venous thromboembolism (VTE), a common preventable cause of hospital death, increased morbidity and length of stay.
