We identified two overviews of systematic reviews, 18 systematic reviews and 17 primary studies from our searches that were relevant to the questions posed. The primary studies address the first question about risk factors for unsafe clinical practice, and both of the overviews and all of the systematic reviews address the second question about mechanisms to keep a healthy clinical practice. We also included one paper that provides an overview of key systematic reviews from the Cochrane Collaboration Effective Practice and Organization of Care (EPOC) group.(2) Given that this paper provides a succinct outline of the features of interventions designed to optimize clinical practice as well as a synthesis of findings from the highest quality and most up-to-date systematic reviews, our synthesis for the second question primarily draws from the overview, with all of the additional reviews we identified provided in Appendix 1.