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Primary Care Docs Try to Up Their Diagnosis Game
By Tom A. Augello, CRICO

The idea of missing something, or finding out that follow up on a lab order or specialty consult fell through the cracks, can haunt providers. Nothing represents these concerns better than a claim from a patient or family that you failed to diagnose their cancer. A recent review of professional liability claims from across the United States shows that diagnosis-related claims account for a higher percentage of dollar costs than any other category.


Part III: Harvard Joins IHI to Cut Referral Mistakes
By Tom A. Augello, CRICO

According to estimates, as many as half of medical specialty referrals are not fully completed. In a study of medical malpractice cases asserted in the Harvard system between 2006 and 2015, 46 cases involved referral breakdowns, with an incurred cost of $11 million. The vast majority involved severe harm to the patient. Closing the Loop... is a guide to prevent this from continuing.


MD Burnout, Avoiding MedMal, and more
By Alison Anderson, Missy Padoll, Wallinda Hutson, CRICO

Insights June 2018: MD Burnout, Avoiding MedMal, and more


Part II: Harvard Joins IHI to Cut Referral Mistakes
By Tom A. Augello, CRICO

Mishandled specialty referrals in ambulatory care can harm patients and lead to litigation if a diagnosis is delayed or missed. Two leading groups hope individual practices and institutions will use the Guide to make their referrals more reliable and reduce mistakes.


Part I: Harvard Joins IHI to Cut Referral Mistakes
By Tom A. Augello, CRICO

In any complex medical system, malpractice cases can arise from failures in the referral process. Typically these are situations in ambulatory care where the doctor recommends that a patient see a specialist, but it either doesn’t happen or nobody acts on the result. A new tool from The Institute for Healthcare Improvement and CRICO helps guide doctors and practices to prevent these referral errors and the harm from resulting diagnostic failures.


Insight: Best Practices in Referral Communication
By Jennie Wright, RN, CRICO

Processes to promote ongoing communication between referring physicians and specialists are essential to providing high quality and safe patient care. To date, maintenance efforts have tended to be provider-specific rather than process based.


NP Misses Fatal Illness on Phone with Patient’s Dad
By Kathy Dwyer, MSN, RN, CRICO, Tom Augello, CRICO

A father called his son’s pediatrician’s office on a winter week-end night and told the nurse practitioner that his nine-year-old had not felt well for three days. The nurse fixated on flu symptoms and told the father to push ginger ale. When the father checked on the boy 12 hours after the call, he had died from diabetic ketoacidosis and his diabetes mellitus was undiagnosed until autopsy.


Cancer Diagnosis, Doctors in the Courtroom, and more…
By Alison Anderson, Missy Padoll, Wallinda Hutson, CRICO

Insight March 2017:  Cancer Diagnosis, Doctors in the Courtroom, and more


Culture Helped, Hurt in this Dosage Error
By Barbara Szeidler, RN, BS, LNC, CPHQ, CPPS, CRICO
Tom A. Augello, CRICO

In this case, an 8-year-old girl experienced a tenfold dosing error of clotting factor, requiring admission and observation due to increased risk of stroke. It could be said that the culture at this hospital both contributed to the error, and contributed to a good response by staff.



Let’s Be Clear About This
By Jock Hoffman, CRICO

The wrong words may be harmful.

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