The goal is to deliver “parsimonious care,” says the American College of Physicians’ updated ethics manual. The college also offers guidance for online behavior.

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The Laser Spine Institute, a Tampa, Fla.-based endoscopic spine ambulatory surgery center with locations in seven cities, has a sophisticated approach to getting out the word about its treatments for back and neck pain. The institute’s website features videos of its physicians talking about the minimally invasive procedures and includes links to their frequent appearances in news media and the institute’s active social media accounts.

Now the institute, like many other health care organizations, is expanding its marketing beyond the public and aiming at physicians in the community who might send them new patients. To help in the effort, the 25-doctor group is looking to hire four new representatives — called physician liaisons or physician relations associates — who have at least five years’ experience as drug or device-company detailers. The new hires will visit doctors in their offices and discuss how the institute’s services could benefit their patients.

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The Joint Commission has issued a sentinel-event alert saying drowsy health professionals are likelier to be involved in adverse events than their well-rested counterparts. The commission advised the more than 6,500 hospitals and other health care organizations it accredits to take steps to mitigate the risks of such fatigue.

The December 2011 action comes amid more pushback against the Accreditation Council for Graduate Medical Education’s resident work-hour restrictions, with research published in December 2011 linking the limitations with more complications among neurosurgery patients.

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The past decade saw high-profile private and publicly funded initiatives targeted at the patient safety hazards affecting inpatients, including hospital-associated infections and wrong-site surgeries. Now experts are calling for a similar effort focused on the dangers that afflict outpatients.

In 2000, the Agency for Healthcare Research and Quality set an ambulatory care research agenda to help fill the gap. But the subsequent 10 years amounted to a “lost decade” as outpatient safety research and initiatives took a back seat to problems in hospitals, say the patient safety experts who produced a December 2011 report reviewing about 100 outpatient safety studies from 2000 to 2010.

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Most hospitals say the Centers for Medicare & Medicaid Services’ no-pay policy for hospital-acquired conditions has pushed them to make greater efforts to prevent health care-associated infections. But a study says preventing one item on the no-pay policy has gotten less of a push: catheter-associated urinary tract infections.

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