Patient Safety Alert 9: Patient Safety in Labor and Delivery: Managing Complex Conditions in a Complex Environment (PDF)
The AMC PSO in conjunction with CRICO’s Patient Safety Department has continued to analyze OB-related malpractice claims along with real-time root cause analysis information to identify trends, respond to present system vulnerabilities, and educate members on new emerging risks.
Issues related to management of second stage labor predominate and are addressed below:
- Human Factor Issues: Failure to accurately assess and document maternal-fetal status including: cervical dilation, effacement and membrane status, and fetal heart rate pattern
First Published – December 28, 2012
More AMC PSO Content
Publications such as whitepapers and guidelines derived from the AMC PSO convenings.
Informed Refusal Patient Care
Patient Safety Alert Issue 30: The AMC PSO convened to discuss ways to clearly communicate the risks of refusal of an in-person visit to my patient and maintain a therapeutic alliance.
Test Result Notification
Patient Safety Alert Issue 15: The AMC PSO recently held a collaborative convening session of its Ambulatory Patient Safety Leaders in order to both discuss current issues and possible solutions and propagate the natural progression of CRICO's established mission of helping health care providers turn credible data into effective action.
Pharmacy Compounding Safe Practice Recommendations
Patient Safety Alert Issue 14: The AMC PSO recently held its follow up Medication Safety Task Force collaborative convening session to discuss the best practices regarding the issues within compounding sterile preparations and patient safety that were brought up in the first meeting.
Patient Safety Alert Issue 11: The AMC PSO has performed an in-depth analysis of patient safety issues in the ED setting and has identified practices employed to reduce risks that were the result of missed or delayed diagnoses.
Postpartum Malpractice Claims: Can We Understand Preventable Harms and Socioeconomic Factors?
In a multifactorial study, The Doctors Company (a Candello member organization) investigated postpartum claims to develop clinical recommendations to decrease the risks of postpartum morbidity and mortality.
Ambulatory Safety Nets: Protecting Providers and Promoting Safety with Systems to Reduce Delayed Cancer Diagnoses
Ambulatory safety nets (ASNs) are person-centered programs that provide a highly reliable backup system for following up on abnormal test results when the standard follow-up process fails. Co-authored by CRICO’s Pat Folcarelli RN, MA, PhD, and Luke Sato, MD, this article about ASNs was featured in Inside Medical liability Online.
Q&A: Three Experts on the SafeCare Study and Its Implications for Future Patient Safety Action
A new CRICO-funded study underscores the persistence of medical harm based on a review of patient records in 11 Massachusetts hospitals. With the SafeCare Study, researchers revisit the foundational Harvard Medical Practice Study I and II that used health records to identify adverse events in hospital care more than 30 years ago.
The Safety of Inpatient Health Care
Funded by CRICO, "The Safety of Inpatient Health Care" study published in the New England Journal of Medicine on January 12, 2023, is an important follow up to the landmark Harvard Medical Practice Study, published in 1991.
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