Safety Net

What has the patient safety movement achieved over the past 20 years, and what lies ahead? An exit interview with one of its longest leaders as he retires and pushes hard on the use of data analytics.

It's easy to see how patients become confused and dissatisfied in a busy healthcare environment. Multiple risks to patient safety may lie in this scenario; trust, adherence, follow-through, and patient engagement are all on the line. One Harvard graduate and researcher thinks a lot of this can be cleaned up and made safer with a simple card that a physician hands to a patient when they first meet.

Too many healthcare providers are burning out on the job. Electronic health records are a big culprit, and Harvard's patient safety and malpractice company has started a call to action.

Sepsis is common and it's deadly. It accounts for five percent of the patients admitted to the hospital and a third of hospital deaths. The worry: sepsis is often difficult to detect, giving rise to dangerous clinical outcomes and liability.

As the nation copes with an aging population, concern turns to aging surgeons. CRICO’s podcast, Safety Net, interviews one physician expert who is trying to encourage more hospitals to ferret out dangerous diminishing cognitive and physical faculties, with Late Career Practitioner Policies.

A rise in cardiology malpractice cases goes against general malpractice trends across specialties that show significant declines. Most of the errors in outpatient cardiac cases involve failures in the diagnostic process. Diagnosis errors bedeviled providers in the inpatient setting as well.

Understanding “generation codes” gives clinicians insight into their patients’ and colleagues’ mindsets and provides a tool for building the rapport needed for a productive healthcare relationship.

The idea of missing something, or finding out that follow up on a lab order or specialty consult fell through the cracks, can haunt providers. Nothing represents these concerns better than a claim from a patient or family that you failed to diagnose their cancer. A recent review of professional liability claims from across the US shows that diagnosis-related claims account for a higher percentage...

According to estimates, as many as half of medical specialty referrals are not fully completed. In a study of medical malpractice cases asserted in the Harvard system between 2006 and 2015, 46 cases involved referral breakdowns, with an incurred cost of $11 million. The vast majority involved severe harm to the patient. Closing the Loop... is a guide to prevent this from continuing.

Experts: the need to pull families onto the patient safety team will only grow with ongoing trends of shorter hospital stays, and care moving into ambulatory sites and even into the patient's home. Family caregivers will be a big part of safety at each stage.

Mishandled specialty referrals in ambulatory care can harm patients and lead to litigation if a diagnosis is delayed or missed. Two leading groups hope individual practices and institutions will use the Guide to make their referrals more reliable and reduce mistakes.

Each of the providers at the big, annual IHI quality conference heard a personal message loud and clear above the three-day din: doctors and nurses deserve to have joy in their work. More than that, the happiness of clinicians is essential to good patient care.

Better clinical outcomes, lower cost: we’re talking about care transitions and a recently completed research project at Cambridge Health Alliance that identified a patient population that needs specialized help after a hospitalization. Our interview is with Dr. Richard Balaban, who led the care transition project, funded through a grant from CRICO.

On this episode we are at the IHI/NPSF Lucian Leape Institute's 10th Annual Forum. Patient safety luminaries from around the world gathered near Boston to review a new study on public perceptions of medical error, to discuss new trends, and to generate ideas on a singular focus: how to more fully engage a healthcare organization's governing board to make care better and safer.

Research and recent experience show that some babies who show signs of brain injury suffered before or during birth have better outcomes when hospitals cool the baby's body temperature. Thus, early identification and treatment of this condition has the potential for improving patient outcomes and reducing the risk of liability. CRICO has recently awarded grant funding to promulgate guidelines, tit...

Unlike other areas of modern clinical practice, there still isn’t much training in medical school around what to do or what not to do as a malpractice defendant, or an expert witness for someone else’s case. In a one-on-one interview, author and retired Massachusetts Superior Court Associate Justice Hiller B. Zobel offers some sage how-tos and reassurance as he highlights the second edition of his...

For many in the medical profession, some of the basics of law and malpractice claims are a little mysterious. The key question about negligence is whether or not the provider failed to meet the “standard of care.” But how do we know what the standard of care is? We hear from a lawyer and and a doctor about what they've learned working in the world of medical errors and malpractice law.

In Massachusetts, the law recently changed, regarding how juries are selected in civil trials, including medical malpractice cases. Now lawyers can question individual jurors directly.

At a recent gathering of medical malpractice professionals in Boston, health information and international patient safety leader David Bates shared a vision of the next five years of health information and electronic medical records.

A program called “OpenNotes” gives patients direct access to the notes their doctors wrote in their charts. Will they find mistakes and better understand their care plans with this new tool?

From debriefs after surgery to automatic warnings for abnormal vitals at discharge from the ED, Harvard researchers are using CRICO for funding and influence.

In early 2015, an honorary distinction began to appear on web sites and publications for 94 hospitals across the country. They are the nation’s Top Hospitals, according to quality watchdog The Leapfrog Group.

Diagnostic errors out-paced errors in obstetrics, and were costlier than surgical cases in the newest annual CRICO Benchmarking Report. In the five-year period studied, 57 percent of the diagnosis-related malpractice cases from across the country arose in the ambulatory setting. By far, the diagnosis most commonly missed was cancer. And the benchmarking data indicate that improvements should zero...

Social media mis-use by physicians is a new area for intervention by professional health services that were initially founded to help with substance abuse. Increased focus on workplace behavior in an era of team training means that now, inappropriate Facebook postings or texts with sensitive information can also threaten a doctor’s professional life. Physician Health Services in Massachusetts shar...

Ambulatory care is the focus of a dozen research and intervention projects at Harvard, totalling $2.1 million in 2014. Through a little-known patient safety grant program designed at Harvard’s medical malpractice insurance company, CRICO, this year’s projects range from tracking incidental lung nodule findings to helping reduce medication errors in children. Researchers describe their efforts to m...