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About CRICO Decision Support Tools

At the request of the institutions insured by CRICO, and in conjunction with clinical experts from those health care organizations, CRICO develops and maintains evidence-based decision support tools for physicians and nurses whose patient encounters align with high-severity malpractice risks. These guidelines, algorithms, and other tools are designed and periodically updated to help clinicians identify risk prone steps in specific diagnostic or treatment processes, and suggest protocols.

We encourage physicians and nurses to use these as critical checks and re-checks to provide the safest, most effective patient care possible. As with all clinical decision, documentation of adherence to a specific guideline, or the rationale for an alternate course of action, is crucial for ongoing care and for the defense of any subsequent challenge of a patient’s diagnosis or treatment plan.


Are CRICO Decision Support Tools the Standard of Care?

CRICO is often asked if a guideline, algorithm, or similar decision support tool can be cited in a medical malpractice lawsuit as the standard of care. Generally, the answer is no: the standard of care, as determined in court, is the consensus among experts of the typical practice of an average clinician in the local setting. A guideline or algorithm by itself is not a de facto standard of care.

Decision support tools developed by CRICO in conjunction with the Harvard-affiliated medical institutions are not mandatory but rather, advisory—serving as references (similar to medical text books) clinicians can employ for cognitive support. They do not dictate or establish a standard of care for physicians and nurses who may consider them in their medical practice.

In some cases an organization or a clinical department may adopt all or part of any decision support tool as policy or protocol, which could then be construed as the care standard for clinicians in that organization or department. Under those circumstances, clinicians who make diagnostic or treatment decisions less thorough than or contrary to the adopted algorithm or guideline, are advised to consistently document the rationale for their decisions.

For additional background, see: Do practice guidelines help or hurt the defense of a malpractice claim?

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