The culture of cover-up is contradictory to our professional code of ethics Gibson and Singh provided a detailed overview of why medical mistakes happen and they provided rationales behind the culture of cover-up in the health care environment.

They described potential methods of regulation and reporting to better inform patients and consumers about their health care providers. Gibson and Singh also devoted an entire chapter to the use of technology making health care safer.

Examine your own feelings about developing competency in nursing informatics and technology in healthcare.

How do you see these systems impacting nursing practice now and in the future?

1. Explain how patients and consumers find valid and reliable information about health care providers and facilities.
Since each State has each own regulation, consumers can find valid and reliable information about the health care provider by seek out the state web sites. For example, New Yorker can go onto, Californian can go onto, and people in Massachusetts can go onto (Gibson & Singh, 2003).

Consumers log onto to find out whether the hospital is willing to improve by implement new technology to reduce medical errors.
However, there is no tracking of medication errors yet, but it’s something that going to be next.

2. In your experience, do patients and consumers investigate their providers or facilities before making selections? What about you, your friends, and family?
Before reading the Wall of Silence, I didn’t know that we could look up our providers credential, history of malpractice claims, and years of experience. Most of the people I know and for myself, we don’t get to select our providers. We were given a primary provider by our insurance company based on our location. Our primary care provider then refer us specialist that they often have contact or work with.

How do quality improvement systems affect regulatory and accreditation reporting and reimbursement?
According to the, “ACA requires health plans to submit reports each year demonstrating how they reward health care quality through market-based incentives in benefit design and provider reimbursement structures” (, 2015).

Hospital get reimburse by the quality of service rendered. Outcome measures give the consumer an idea of how hospital structures and processes work to reduce morbidity and mortality rate in patient (Dimick, 2010)
“Most quality measures reporting is voluntary, but several private payers and accrediting organizations, including the Joint Commission, require healthcare facilities to report quality measures. These measures are then tied to reimbursement levels and accreditation status” (Dimick, 2010, paragraph 3)
3. What issues come to mind when you reflect on the need for all nurses to use information and technology to communicate, manage knowledge, mitigate error, and support decision- making?

4. How does technology support safety at your facility? Explain how health system safety and technology will influence your practice in the next 10 years.
5. Gibson and Singh compared the current health care system to less flawed, safer industries, like aviation. How do you feel about safety and quality in health care when compared to the aviation industry? Support your entry with quotations from the book as needed and with literature and sources from our course. Follow APA format.

Gibson, R., & Singh, J. P. (2003). Wall of Silence: The untold story of the medical mistakes that kill and injure millions of Americans. Washington, DC: Lifeline Press.