Risk Management Tools & Resources

 


Case Study: Multiple Lapses Result in Patient Fall and Injury

Case Study: Multiple Lapses Result in Patient Fall and Injury

A male in his mid-sixties presented to his local emergency department (ED) with complaints of shortness of breath and chest pain. He had a history of chronic obstructive pulmonary disease (COPD) and cardiovascular disease (CVD). The patient was admitted to the hospital for exacerbation of COPD symptoms and atypical chest pain.

At various times, the patient was noted to be a fall risk, and he fell twice while in the acute care area of the hospital. After the patient was transferred to the hospital's rehabilitation unit, he was found on the floor and diagnosed with a fractured hip. The patient stated that he tried to contact a nurse for help to the bathroom, but no one responded. The patient's wife alleged that he was overmedicated with acetaminophen/hydrocodone and zolpidem, which increased his risk of falling.

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Reducing Medication Prescribing and Administration Errors: Strategies for Critical Access Hospitals

Laura M. Cascella, MA

Reducing Medication Prescribing and Administration Errors: Strategies for Critical Access Hospitals

Prescribing and administering medications are complex processes, particularly because of the volume of medication orders in hospitals and the increasing number of prescription medications on the market. The Institute of Medicine (IOM) notes that although errors are common throughout the medication process, they are most common at the prescription and administration stages.1

MedPro's malpractice claims data for critical access hospitals (CAHs) confirm these risks. In claims closed between 2006 and 2015, allegations related to medication errors accounted for almost 1 out of 10 claims, and these allegations were associated with prescription and administration issues. Further, 45 percent of medication-related claims for CAHs resulted in outcomes with high clinical severity (i.e., serious patient injury or death).2

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Clinical Judgment: What Is It, and How Does It Contribute to Diagnostic Errors?

Laura M. Cascella, MA

Clinical Judgment: What Is It, and How Does It Contribute to Diagnostic Errors?

Errors in diagnosis are a serious concern in healthcare from a patient safety perspective as well as a medical liability standpoint. MedPro closed claims data show that allegations related to diagnostic errors are prevalent across specialties and healthcare locations. Closed claims data also show that clinical judgment is a major risk factor in diagnosis-related allegations.

Clinical judgment refers to the thought process (clinical reasoning) that allows healthcare providers to arrive at a conclusion (clinical decision-making) based on objective and subjective information about a patient. An article in the Journal of Evaluation in Clinical Practice explains that "Clinical judgment is developed through practice, experience, knowledge and continuous critical analysis. It extends into all medical areas: diagnosis, therapy, communication and decision making."1

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Oversight in Electronic Health Record Causes a Delay in Ovarian Cancer Diagnosis

Laura M. Cascella, MA

Oversight in Electronic Health Record Causes a Delay in Ovarian Cancer Diagnosis

Electronic health records (EHRs) have transformed the ways in which healthcare providers work and communicate. These systems have been both extolled and criticized over the past decade as their use in hospitals, healthcare practices, and other healthcare facilities has skyrocketed.

Like many advanced technologies, EHR systems represent a complex dichotomy — they can be both beneficial and problematic, as illustrated in this case study from the Pacific Northwest.

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Inadequate Test Tracking Process Leads to Delay in Cancer Diagnosis

Inadequate Test Tracking Process Leads to Delay in Cancer Diagnosis

Well-designed office systems are critical to the provision of safe, high-quality patient care. This case study from an OB/GYN practice in the Midwest illustrates how system failures can be detrimental to a patient's health.

The patient was a 37-year-old female who had unwittingly contracted a sexually transmitted disease (STD). The circumstances of her situation did not lead her to suspect an infection. She presented to her gynecologist, Dr. A, in November of Year 1 for a Pap smear test. The results indicated "epithelial cell abnormality, with atypical squamous cells of undetermined significance." The report recommended a repeat Pap smear in 3–6 months if clinically indicated. However, the physician never reviewed or signed off on the report. It was included in the patient's health record, but not flagged as a critical result.

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15 Strategies for Tackling the Top Malpractice Allegation in Gynecology

MedPro Group data show that allegations related to surgical treatment represent the largest claims category for gynecology providers (73 percent of all gynecology claims closed between 2005 and 2014). Surgical treatment allegations also account for almost two-thirds of all dollars paid for expense and indemnity costs in gynecology claims.

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Ensuring HIPAA Compliance in Text Messaging

The use of mobile phones and other wireless technology in patient care — termed "mHealth" — is a significant trend in the healthcare industry. Older technology, such as pagers, is slow compared to devices today; thus, many healthcare providers and staff members find that text messaging provides quick access to the information they need to make healthcare decisions.

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Passwords: A New Approach to an Old-School Security Strategy

In the current healthcare technology landscape — which includes robotics, telehealth, artificial intelligence, virtual reality, and more — password security might seem like a mundane topic. Clinicians and other healthcare workers have used passwords for years to log in to various organizational systems, and these actions have likely become second nature. In recent years, however, cyberattacks and data breaches have heightened security concerns for healthcare organizations, emphasizing the need to develop new security strategies and revisit old protocols.

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