Background and Principles

CRICO is the medical malpractice insurer for the Harvard medical community and is working to develop a multi-year programmatic initiative to reduce risks in primary care. The overarching goal for Primary Care Risk Reduction is to ensure that primary care providers have the opportunity to practice in an environment where patient safety is a primary tenet of care delivery.


CRICO has been working with subject matter experts in the CRICO community and developed six key safety principles in primary care. With the support of its parent organization, a safety-centered practice:

  1. is committed to a culture of safety and learning;
  2. supports effective, team-based care;
  3. employs strategies for patient and family partnership;
  4. applies tools for patient tracking and panel management;
  5. facilitates diagnostic processing and follow-up; and
  6. follows reliable and standard processes for internal and external communication and information sharing.

What We Wish for in Primary Care Patient Safety


In May 2015, we asked a gathering of primary care providers to name their top wish for patient safety in primary care. We share this list to remind all of us of our shared goals in this effort. If you would like to add your wish to the list—or endorse someone else’s—send us a note and we will post it.

  • Better reliability and communication
  • Blame-free and shame-free environment that allows practices to engage in redesigning care
  • Clear, standardized, and less human processes to close the loop
  • Collaborative and seamless primary care safety program
  • Demonstrating how successful initiatives were developed and how they will improve work for front line providers
  • Education, collaboration, and patient-centered medical homes
  • End reliance on memory, post-it notes, and workarounds
  • For safety practices to become more organic or natural to front-line providers
  • Have a similar culture to the airline industry
  • To freely talk about vulnerabilities
  • Support of systems and single point of contact 
  • Relieve provider stress and burn out
  • Operationalize team-based care
  • Opening doors to allow patients to understand their physicians’ thought processes
  • More reliable closure on critical lab values
  • More focus on medication safety in an assistive living environment
  • More connection to fellow physicians
  • Looking at cognitive adjuncts to address diagnostic error
  • Improved transition of care
  • Improved automation to track routine screens and abnormal tests