Research Topics

CRICO/RMF is interested in the following high risk areas:

Diagnosis

• Failure to fully assess the patient’s clinical status (e.g., not obtaining an updated history and physical)
• Failure to order diagnostic tests/imaging due to a narrow diagnostic focus
• Incorrect interpretation of clinical data

Obstetrics

• Management of prolonged second stage labor
• Miscommunication during labor (e.g., failure to communicate worrisome signs to an attending physician, failure to respond to elevated concerns)
• Incorrect interpretation of clinical data

Surgery

• Problems with technical performance due to inexperience, distraction, and other human factors
• Miscommunication among surgeons, nurses, and technicians in the OR, leading to a failure to recognize and respond to emerging complications
• Lapses in clinical judgment

Medication-related

• Lack of medication management and monitoring of patients with complex medical histories
• Unreliable processes for ensuring that the correct medication is administered to the correct patient in the correct dose at the correct time.

Resident Supervision

• Inadequate supervision when residents are assessing and treating patients
• Resident communication with other providers, patients, and family members
• Documentation

Emergency Department

• Inadequate assessment of the patient resulting in premature discharge
• Miscommunication among providers regarding the patient’s condition leading to delays in diagnosis and treatment
• Failure to order diagnostic tests/imaging due to a narrow diagnostic focus
• Lack of accountability for admitted patients who remain in the ED because of the unavailability of inpatient beds

Highest priority is given to projects that:

• directly address the issues listed above;
• have the broadest applicability across the Harvard system;
• have a defined and direct path to implementation;
• utilize data to validate the efficacy of a particular concept; and
• employ innovative methods of education and training to improve patient safety.