David M. Gaba M.D.
Associate Dean for Immersive and Simulation-based Learning
Professor, Department of Anesthesia
Stanford University
Email: gaba@stanford.edu
Discipline: Medicine
Expertise: Health Risks, Patient Safety
Investigator Award 
Organizational Structures, Cultures, and System Aspects of Safety in Tertiary Health Care: A Comparison with Other High Risk-IndustriesAward Year: 1996 Preventable accidents occur frequently in health care, especially in comparison with the rate of serious mishaps in commercial and military aviation, space flight, and nuclear power production. Dr. Gaba's systematic comparison of health care to these industries is guided by a synthesis of recent theoretical models of safety and error in complex organizations. Among the issues the project addresses are the structure of the health care industry, regulatory processes, and cultures of reliability concerning the care of hospitalized patients. The influence of malpractice litigation on safety, the connection between fatigued personnel and error in health care, and the effects of production pressure at work are also studied. By mapping features of health care to similar features of high-risk industries, Dr. Gaba formulates an integrated view of the implications for safety in health care. Project results provide recommendations for short and long-term policy changes to strengthen safety systems in health care.
Background 
David Gaba is a professor of anesthesia and associate dean for Immersive and Simulation-based Learning at the Stanford School of Medicine, as well as a CHP/PCOR fellow. He is interested in a wide variety of topics related to patient safety, including high-fidelity patient simulation; the effects of fatigue on clinicians' performance; and organizational learning through adverse-event reporting and analysis. He directs the Patient Safety Center of Inquiry at the VA Palo Alto Health Care System, which does work in the following areas: the theory of organizational safety applied to health care; teamwork and simulation training of healthcare personnel; the effects of fatigue on healthcare personnel; evaluating the "culture of safety" in healthcare institutions and seeking to improve the safety culture through specific interventions; organizational learning through adverse-event reporting and analysis systems; the connection between patient safety issues in routine clinical care and in research involving human subjects; and the human factors involved in the use of medical equipment. Gaba is also secretary of the Anesthesia Patient Safety Foundation. He received a BS in biomedical engineering from Northwestern University, an MD from Yale University, and completed a residency in anesthesiology at Stanford.
- Hartmann, C.W., Rosen, A.K., Meterko, M., Shokeen, P., Zhao, S., Singer, S., Falwell, A., Gaba, D.M. An Overview of Patient Safety Climate in the VA. Health Services Research, 2008, 43(4): 1263-84.
- Singer, S.J., Falwell, A., Gaba, D.M., Baker, L.C. Patient Safety Climate in U.S. Hospitals: Variation by Management Level. Medical Care, 2008, 46(11): 1149-56.
- Rosen, A., Gaba, D.M., Meterko, M., Singer, S., Shokeen, P., Zhao, S., Labonte, A., Falwell, A. Recruitment of Hospitals for a Safety Climate Study: Facilitators and Barriers. Joint Commission Journal on Quality and Patient Safety, 2008, 34(5): 275-84.
- Singer, S., Meterko, M., Baker, L., Gaba, D., Falwell, A., Rosen, A. Workforce Perceptions of Hospital Safety Culture: Development and Validation of the Patient Safety Climate in Healthcare Organizations Survey. Health Services Research, 2008, 42(5): 19
- Gaba, D.M., Singer, S.J., Rosen, A.K. Safety Culture: Is the Unit
- Gaba, D.M., Singer, S.J., Sinaiko, A.D., Bowen, J.D., Ciavarelli, A.P. Differences in Safety Climate between Hospital Personnel and Naval Aviators. Human Factors, 2003, 45(2): 173-85.
- Gaba, D., Howard, S. Patient Safety: Fatigue among Clinicians and the Safety of Patients. NEJM, 2002, 347(16): 1249-55.
- Gaba, D. Anaesthesiology as a Model for Patient Safety in Health Care. BMJ, 2000, 320(7237): 785-8.
- Gaba, D.M. Structural and Organizational Issues in Patient Safety: a Comparison of Health Care to Other High-Hazard Industries. California Management Review, 2000, 43(1): 83+.