CBS Report: Malpractice Risks of Routine Medical Procedures

Cambridge, MA, December 17, 2013 – Mistakes made during common procedures in the course of medical treatment may be less likely to make headlines than wrong-site surgery or a brain-damaged baby, but they still impact the patients and caregivers facing the consequences. In CRICO Strategies 2013 Annual Benchmarking Report: Malpractice Risks of Routine Medical Procedures, 1,497 cases are analyzed which alleged malpractice related to a non-surgical procedure. While the majority (88%) of these cases highlight skill-based errors, the analysis explores two correlative issues: rules of practice (policy and protocol), and inadequate knowledge or judgment demonstrated by clinicians or administrative personnel.

Clinicians are dismayed when a patient is injured, especially when the triggering event is a “routine” task or common medical procedure. This study—mined from CRICO Strategies Comparative Benchmarking System (CBS)—highlights six primary medical procedures: scopes, injections, punctures, biopsies, insertion of tubes, and imaging. While the very nature of procedure-related claims implies some technical or skill-based failure, it is critical to understand how rule and judgment-based errors contribute to the actual point of injury.

These medical procedure-related cases were filed from 2007-2011 and represent $215M in incurred losses. Unfortunately, for thousands of patients each year, seemingly benign screening, diagnostic, or therapeutic procedures lead to a significant injury or death. And, while more than two thirds of the injuries were relatively minor or temporary, 14 percent of the procedure cases involved patients who died.

CRICO Strategies CBS database currently holds 275,000 medical malpractice cases from 500 hospitals and provides a unique insight into what goes wrong, and why. Analyzing malpractice data offers health care providers opportunities to change specific clinical systems or clinician behaviors and reduce those dominant risks.

One of the challenges to improving procedure safety is that the problem is not isolated in the ED, the OR, or the ICU. The risks are ubiquitous and decentralized, and the first step toward risk reduction is recognizing a recurring problem and understanding its breadth and depth.

“In the past, patient safety efforts have focused on inpatient areas, such as the operating room,” says Tejal Gandhi, MD, President National Patient Safety Foundation. “Now, however, medical procedures are frequently performed in settings outside of the hospital, with an increased number of adverse events being identified. We need to translate the lessons learned in hospital safety to these other settings of care to ensure that procedures are performed as safely as possible.”

The next hurdle is finding clinical leadership to champion the remediation of such a diffuse problem. “Moving the needle on patient safety improvement is hard work,” says Mark E. Reynolds, CRICO President. “In order to get health care leaders’ attention, to convince clinicians to carve time out of an already overburdened schedule, to motivate insurance providers to fund solutions, you have to show up with credible evidence that you are tackling the right problems. Our CBS database and the surrounding expertise enable CRICO and CRICO Strategies members to be proactive and effective in addressing patient safety over the long term across an entire organization.”

Malpractice Risks of Routine Medical Procedures is available online as a PDF or hard copy. For more information about the origin of the data (the CBS database) and Strategies services and products, contact: Mike Paskavitz

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