Newsletter
A Handful of Opportunities to Reduce the Risk of Being Sued
May 04, 2017
In many lines of business, recognizing that a high percentage of outcomes are driven by a small number of factors helps strategists appropriately align resources with areas of need.
In the realm of patient safety, that rule of thumb suggests that health care leaders working to reduce the risk of medical errors may be well served to focus on a handful of opportunities for improvement.
Analysis of CRICO’s national comparative benchmarking system (CBS) shows that a large majority of malpractice allegations can be attributed to a relatively short list of missteps in technical performance, clinical judgment, or communication. For example, for each CBS case, CRICO’s clinical coding specialists code factors that contributed to the event(s) that triggered the malpractice allegation. In at least nine percent of the 53,439 CBS claims and suits asserted from 2017–2016, one or more of the five contributing factors below was identified. Combined, these factors account for 21 percent of all contributing factors coded for that set of cases.
Top Contributing Factors in MPL Cases
53,439 claims and suits asserted from 2007–2016
A case may have more than one contributing factor.
22% involved a possible technical problem (i.e., a known complication)
This code is assigned to cases in which the complication encountered is a known risk of the operation or procedure and (there is an expectation that) the patient was informed of this during the consent process.
| Responsible Services | Care Setting |
| Injury Severity | Total Incurred Losses |
12% involved a failure or delay in ordering a diagnostic test
This code is assigned to cases in which the correct diagnosis might have been facilitated or expedited by further analysis through (specific) diagnostic testing.
| Responsible Services | Care Setting |
| Injury Severity | Total Incurred Losses |
11% involved a failure to appreciate and reconcile relevant sign/symptom/test result.
This code is assigned to cases in which the clinician(s) failed to recognize the clinical picture from the available information, including patient history, reported symptoms, physical examination, and test results.
| Responsible Services
| Care Setting
|
| Injury Severity
| Total Incurred Losses |
10% involved a failure or delay in obtaining a consult (or referral)
This code is assigned to cases in which the patient’s diagnosis, or an optimal treatment plan, might have been facilitated or expedited by the findings of a (specific) specialist.
| Responsible Services
| Care Setting
|
| Injury Severity
| Total Incurred Losses |
9% involved a breakdown in communication among providers regarding the patient’s condition
This code is assigned to cases in which two or more clinicians failed to follow through with the appropriate communication of clinical information, including across care settings.
| Responsible Services
| Care Setting 56% inpatient |
| Injury Severity | Total Incurred Losses |
Credible evidence about patient safety risks, especially comparative data, enables a medical practice or health care organization to pinpoint which individual and system vulnerabilities are most in need of attention and resources. And, even though common problem may require somewhat varied approaches for different specialties or settings, many of the patient safety tools and tactics can be broadly applied.