Journal of healthcare risk management : the journal of the American Society for Healthcare Risk Management最新文献

{"title":"An analysis of medical malpractice claims against medical oncologists from a national database: Implications for safer practice","authors":"Jim W. Doolin MD,&nbsp;Adam C. Schaffer MD, MPH,&nbsp;Roy B. Tishler MD, PhD,&nbsp;Joseph O. Jacobson MD, MSc","doi":"10.1002/jhrm.21563","DOIUrl":"10.1002/jhrm.21563","url":null,"abstract":"<p>Malpractice claims data include valuable information about patient safety. We used mixed methods to analyze claims against medical oncologists (MO) from 2008 to 2019 using a national database. MO claims were compared to a group of other internal medicine subspecialties (OIMS). Logistic regression was used to examine correlates of closing with an indemnity payment. A subset of claims against MO were thematically analyzed using a validated safety incident taxonomy as a framework. 456 claims against MO were compared with 5771 claims against OIMS. MO claims closed with indemnity payments 29.8% of the time versus OIMS 30.3% (<i>p</i> = 0.87). Median MO and OIMS indemnity payments were similar ($190,591 vs. $233,432; <i>p</i> = 0.20). Correlates of MO claims closing with payment included patient assessment, communication among providers, and safety and security as contributing factors. Thematic analysis identified provider cognitive error, adverse drug events and relational problems as the most common safety incidents. MO malpractice claims have similar outcomes to OIMS. We demonstrate the proof-of-concept of applying a safety incident taxonomy to medical malpractice. Finding ways to reduce patient exposure to provider cognitive errors, adverse drug reactions, and communication breakdowns should be strategic priorities for safer cancer care.</p>","PeriodicalId":39819,"journal":{"name":"Journal of healthcare risk management : the journal of the American Society for Healthcare Risk Management","volume":"43 3","pages":"18-28"},"PeriodicalIF":0.0,"publicationDate":"2023-12-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/jhrm.21563","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"138810220","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Medico-legal cases associated with older physicians’ cognitive ability to practice medicine","authors":"Genevieve Casey MSc, MBBS, FRCPC,&nbsp;Karen Lemay RN, CPPS,&nbsp;Jun Ji MHA,&nbsp;Qian Yang MSc,&nbsp;Anna MacIntyre RN,&nbsp;Dianne Heroux BScN,&nbsp;Gary Garber MD FRCPC FACP FIDSA CCPE","doi":"10.1002/jhrm.21562","DOIUrl":"10.1002/jhrm.21562","url":null,"abstract":"<p><b>Background</b>: Dementia increases as individuals age. Aging physicians represent a growing population. Studies have demonstrated there are physicians with cognitive impairments practicing medicine. The medico-legal consequences of physicians with cognitive impairments have not been investigated.</p><p><b>Methods</b>: The Canadian Medical Protective Association (CMPA) is a national medical association with 108,000 members who advise and assist doctors with medico-legal matters. They maintain a national repository of legal actions and complaints to regulatory bodies and hospitals. We looked at civil-legal and regulatory college cases closed over a 10-year period associated with physicians aged ≥55. A word search of the cases was conducted using “Dementia, Alzheimer, Cognitive impairment, Cognitive decline, Memory loss, Memory issues, Fit for/to practice.”</p><p><b>Results</b>: The CMPA closed 67,566 cases between 2012 and 2021 and 16% (10,599) involved members ≥55. A mixed methodology approach identified 65 cases associated with physician's cognitive ability to practice medicine. Of these 65 cases, the average age of physician was 71.3 (56.1–88.5). The proportion of cases where concern was associated with a physician's cognitive ability to practice medicine increased, from 0.2% of cases in 55–60-year-olds, to 7.7% in physicians over 80.</p><p><b>Interpretation</b>: As physicians age, concerns about cognitive impairment are more likely to contribute to medico-legal matters.</p>","PeriodicalId":39819,"journal":{"name":"Journal of healthcare risk management : the journal of the American Society for Healthcare Risk Management","volume":"43 3","pages":"14-17"},"PeriodicalIF":0.0,"publicationDate":"2023-11-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/jhrm.21562","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"138296206","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A health system's journey to preventing workplace violence: Use of multidisciplinary teamwork to unify efforts across a health system","authors":"Jamie E. Malone MSN, RN, NPD-BC,&nbsp;Thomas P. Campbell MD, MPH,&nbsp;Ann M. Curtis MS","doi":"10.1002/jhrm.21557","DOIUrl":"10.1002/jhrm.21557","url":null,"abstract":"<p>Workplace violence (WPV) is known to threaten the safety of patients and staff. In 2018, a wellness survey showed many employees had not received training on WPV prevention and felt unprepared to manage aggression. The health network's leaders knew they needed to take action. From various multidisciplinary committees, the leaders were able to create a comprehensive WPV prevention program. Some of the highlights of this program include forming a centralized security department, codes of conduct, and crisis response process, adopting tools to predict violence, and providing a range of education. Data from WPV events showed the health network had a statistically significant reduction in WPV events from 2020 to 2021. However, WPV events increased in 2022. This increase in 2022 mirrors national trends in WPV. There are a number of factors that may have impacted this increase. Regardless, the leaders at the health network are dedicated to continuously improving the WPV prevention program. Some of the ongoing projects include improving data collection methods and building a long-term notification for highly violent individuals. This WPV prevention program relies on the commitment of its multidisciplinary team members and focuses on taking care of patients while also prioritizing the wellness of the staff.</p>","PeriodicalId":39819,"journal":{"name":"Journal of healthcare risk management : the journal of the American Society for Healthcare Risk Management","volume":"43 3","pages":"29-38"},"PeriodicalIF":0.0,"publicationDate":"2023-09-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"41139134","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Natural disasters are you prepared?","authors":"Rebecca Cady Esq., BSN, CPHRM, DFASHRM, FACHE","doi":"10.1002/jhrm.21559","DOIUrl":"10.1002/jhrm.21559","url":null,"abstract":"","PeriodicalId":39819,"journal":{"name":"Journal of healthcare risk management : the journal of the American Society for Healthcare Risk Management","volume":"43 2","pages":"7"},"PeriodicalIF":0.0,"publicationDate":"2023-09-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"41147413","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Transforming the transfer process: A quality improvement project to assess and improve transfer notes","authors":"Robert J. DeGrazia Jr. MD, MHS,&nbsp;Meher Kalkat BS,&nbsp;Leslie Miller MD,&nbsp;Timothy Niessen MD, MPH,&nbsp;Souvik Chatterjee MD,&nbsp;Scott Wright MD","doi":"10.1002/jhrm.21558","DOIUrl":"10.1002/jhrm.21558","url":null,"abstract":"<p>Transfer notes (TNs) standardize handoffs from one inpatient unit to another to optimize patient safety. They are especially important when patients are downgraded from high acuity settings such as intensive care units (ICU). Despite this, there is a paucity of evidence around safe transfers. The study objective was to assess the impact of a quality improvement initiative on the completion rate and quality of TNs. A retrospective chart review of TNs was conducted at a single academic center in Baltimore, MD. We analyzed 76 MICU to floor transfers pre-intervention and 73 transfers during the intervention period. Note quality was determined using a novel TN assessment tool; validity evidence was established. Chi-square analysis was used to compare the presence and quality of TNs. There was a statistically significant increase in note completion rate from 19.7% to 42.5 % during the study (<i>p</i> &lt; 0.003). There was a statistically significant increase in mean quality of completed TNs (10.3 pre-intervention vs. 12.3 intervention period: maximum score 15, <i>p</i> = 0.005). This QI intervention appears to have translated into more consistent and higher quality TNs. These improvements should facilitate better and safer care of patients moving from MICU to medical floors.</p>","PeriodicalId":39819,"journal":{"name":"Journal of healthcare risk management : the journal of the American Society for Healthcare Risk Management","volume":"43 3","pages":"6-13"},"PeriodicalIF":0.0,"publicationDate":"2023-09-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/jhrm.21558","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"41172315","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The power of mentoring: For mentors and mentees","authors":"Robert F. Bunting Jr., PhD, MSA, CPHRM, CPHQ, MT(ASCP), DFASHRM, DSA","doi":"10.1002/jhrm.21560","DOIUrl":"10.1002/jhrm.21560","url":null,"abstract":"","PeriodicalId":39819,"journal":{"name":"Journal of healthcare risk management : the journal of the American Society for Healthcare Risk Management","volume":"43 2","pages":"3-4"},"PeriodicalIF":0.0,"publicationDate":"2023-09-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10141391","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Case law update","authors":"Christopher J. Allman JD, CPHRM, DFASHRM","doi":"10.1002/jhrm.21556","DOIUrl":"10.1002/jhrm.21556","url":null,"abstract":"","PeriodicalId":39819,"journal":{"name":"Journal of healthcare risk management : the journal of the American Society for Healthcare Risk Management","volume":"43 2","pages":"48-56"},"PeriodicalIF":0.0,"publicationDate":"2023-08-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10129091","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A tailored, interdisciplinary, multicomponent approach to decreasing workers’ compensation claims and costs in a hospital system: A retrospective study","authors":"Jon Cinkay PT MS, EP MA","doi":"10.1002/jhrm.21554","DOIUrl":"10.1002/jhrm.21554","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Goal</h3>\u0000 \u0000 <p>Healthcare is the leading profession for risk of injury with workers face a number of potential risk factors leading to musculoskeletal disorders. One method to promote safety for healthcare workers is with body mechanics training and ergonomics. Evidence suggests multicomponent interventions are required for successful safe patient handling programs. While numerous studies have considered interventions for nurses and nursing programs, few have targeted both patient handling and non-patient handling employees simultaneously in a healthcare setting. Our main objective is to describe the implementation of a tailored multicomponent program (TMP) to address the needs of each department within a healthcare setting and examine the percentage of subsequent claims and overall costs reported.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>The TMP was designed to combine department specific and employee specific evaluations and interventions to address workplace needs for all employees. Physical therapists implemented a combination of tailored hands on inservices, orientations, ergonomic assessments, physical therapy screens, return to work appointments, and education sessions over a period of six years. By tailoring the approach for each department, the TMP could focus on employee safety and environmental awareness, ultimately lower the risk of injury, claims and costs.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Principal Findings</h3>\u0000 \u0000 <p>Results demonstrated a statistically significant decrease in workers’ compensation claims and overall costs in the years following the implementation of the TMP. Changes were immediate and continued over several years, indicating the effectiveness of the TMP.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Practical Applications</h3>\u0000 \u0000 <p>Healthcare continues to be the most dangerous profession, with workers facing risk of injury from a number of possibilities. The TMP effectively addressed those risks. As the health care institution grew and evolved, so, too, did the TMP, altering itself and the needs and risks for each department changed. Interdisciplinary collaboration and communication were key to the success of the program. Continued reassessment is required to address the changing needs and institutional growth to ensure future success.</p>\u0000 </section>\u0000 </div>","PeriodicalId":39819,"journal":{"name":"Journal of healthcare risk management : the journal of the American Society for Healthcare Risk Management","volume":"43 2","pages":"19-26"},"PeriodicalIF":0.0,"publicationDate":"2023-08-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10483881","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Which information locations in covered entities under HIPAA must be secured first? A multi-criteria decision-making approach","authors":"Amir Fard Bahreini PhD, MBA, MSc, CIPP/US","doi":"10.1002/jhrm.21555","DOIUrl":"10.1002/jhrm.21555","url":null,"abstract":"<p>Creating adequate safeguards for physical and online locations (e.g., desktop computers, network servers) where protected health information (PHI) may be breached is critical for management within entities compliant with the Health Information Portability and Accountability Act (HIPAA). With the increasing complexity of cyber breaches and budgetary issues, prioritizing which locations require the most immediate attention by top management through a data-driven model is more important than ever. Using CORAS threat modeling and five methods for multi-criteria decision-making, these locations were ranked from greatest to least risk of data breaches. Statistical methods were subsequently used for consistency and robustness checks. The findings illustrate that each type of covered entity under HIPAA must prioritize a different set of locations to safeguard first: health care providers must focus on the security of network servers, other portable electronic devices, and category of others (i.e., miscellaneous locations); health plans must focus on the security of paper and films, network servers, and others; and business associates must focus on the security of category of others, network servers, and other portable electronic devices. Combined with data on the source of the breaches (external vs. internal) and type of threats (e.g., hacking, theft), these findings provide recommendations for risk identification for privacy officers across health care.</p>","PeriodicalId":39819,"journal":{"name":"Journal of healthcare risk management : the journal of the American Society for Healthcare Risk Management","volume":"43 2","pages":"27-36"},"PeriodicalIF":0.0,"publicationDate":"2023-08-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/jhrm.21555","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10050971","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A guide to mitigating audit log-related risk in medical professional liability cases","authors":"Dean F. Sittig PhD,&nbsp;Adam Wright PhD","doi":"10.1002/jhrm.21553","DOIUrl":"10.1002/jhrm.21553","url":null,"abstract":"<p>Following the American Recovery and Reinvestment Act in 2009, use of electronic health records (EHRs) has become ubiquitous. Accordingly, one should expect most medical professional liability cases to involve review of patient records produced from EHRs. When questions arise regarding who was involved in care of a patient, what they knew and when, or the meaning, completeness, integrity, validity, timeliness, confidentiality, accuracy, or legitimacy of data, or ways that the EHR's user interface or automated clinical decision support tools may have contributed to the alleged events, one often turns to the EHR and its audit log. This manuscript discusses lines of defense incorporated into the design, development, implementation, and use of EHRs to ensure their integrity and the types of EHR transaction logs (e.g., audit log) that exist. Using these logs can help one answer questions that often arise in medical malpractice cases. Finally, there are “best practices” surrounding EHR audit logs that health care organizations should implement. When used appropriately, EHRs and their audit logs provide another source of information to help hospital risk managers, legal counsel, and EHR expert witnesses to investigate adverse incidents and, if needed, prosecute or defend clinicians and/or health care organizations involved in the patient's care.</p>","PeriodicalId":39819,"journal":{"name":"Journal of healthcare risk management : the journal of the American Society for Healthcare Risk Management","volume":"43 2","pages":"37-47"},"PeriodicalIF":0.0,"publicationDate":"2023-07-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9867686","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}