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A Patient Safety Survey Course

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Even if you are not formally going back to school, September is a good time to consider what knowledge refreshment or expansion might be worthwhile. For health care providers, annually reviewing how you can minimize the risk of patient harm—and allegations of malpractice—is a good habit to get into.

If you’re not sure where to begin, then CRICO’s Comparative Benchmarking System (CBS)—the world’s most robust malpractice database—is a good place to start. Below is a sampling of where a deeper exploration might take you.

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Key Risk Areas

Within the CBS database, overall, allegations of a surgery-related error top the list, but in some settings diagnosis-related errors are more troublesome. Obstetrics-related cases, while less frequent, are generally more costly to defend and resolve.

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Case examples

Surgery-related, Diagnosis-related, Obstetrics-related

Read more

Spotting Risks, Malpractice Risks of Common Medical Procedures




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Clinical Decision Making

Throughout the entire diagnostic process, you and your patients face questions and choices that help or hinder your understanding of their health status. From a malpractice perspective, where clinical decision making most often fails is during the assessment and processing phases.

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Case examples

Breast Cancer, Missed MI, Colon Cancer

Read more

Initial Diagnostic Assessment, Clinical Decision Support

FAQ

If the patient can give a current history, should I review the prior medical record?

Podcast

Does following a clinical guideline help later in court?


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Managing Medications

While the impact of medication errors on malpractice has been held in check through significant technology and systems improvements, the sheer volume of medications ordered and administered keeps medication safety on the list of health care’s constant concerns. From drug ordering to patient monitoring, clinicians of all disciplines and settings remain vulnerable to medication-related missteps.

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Case examples

Undiluted Injection, Dosing Error

Read more

Medication Safety in the ICU, Too Many Clear Liquids

FAQ

Prescribing Over the Phone, Missing Pads or Controlled Substances


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Informed Consent

While the days of asking a semi-conscious patient to sign a consent form he or she has never seen before are (mostly) behind us, “I didn’t know X could happen” is still a common malpractice allegation. The process for explaining risks and alternatives, and aligning the patient’s expectations with your balanced view, has to be considerate to everyone’s concerns and ability to comprehend both the most likely outcome and the potential consequences or complications.

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Case examples

Unexpected Complication During Laparoscopy, Cardiac Ablation

Read more

Improved Informed Consent, Informed Consent Guidelines

FAQ

About Informed Consent

Podcast

Defense Attorney Discusses Informed Consent



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Documentation

Illegible cursive and coffee stained notes may be fading into medical record history, but many of the documentation problems that haunted the paper era continue to hinder safe care. Clinicians in the electronic health record (EHR) era remain at risk for allegations of malpractice based on the what, when, and how of tracking and sharing information about their patients’ care.

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Case example

NPO order not in EHR

Read more

Documentation Dos and Don’ts, Unwanted Blood Transfusion

FAQ

Record Addendum After Adverse Event, What to Do When Questioning Prior Care

         

After an Adverse Event

The immediate aftermath of an adverse event—even if you are just learning about something that happened in the past—requires both action and restraint. While attending to the patient’s immediate health care needs, be careful not to rush the process of fully understanding what happened and—if appropriate—offering a disclosure and apology. As long as the patient or family members know that you will continue to communicate with them, they will appreciate a more thoughtful exchange than one in which you appear to be uninformed or cannot answer their questions.

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Read more

What to After an Adverse Event, Helping Physicians Cope After Adverse Events

FAQ

Is an apology after an adverse event an admission of negligence?


A great deal of patient safety can be boiled down to the basics of good health care: communicate carefully, avoid assumptions in the face of contrary evidence, communicate carefully, and document what your colleagues, and the patient will need to know in order to provide the safest care possible.


August 31, 2016
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