Understanding diagnostic safety in emergency medicine: A case-by-case review of closed ED malpractice claims

Journal of Healthcare Risk Management : the Journal of the American Society for Healthcare Risk Management
Nancy LemoineHardeep Singh

Abstract

The report Improving Diagnosis in Health Care calls for collaboration between professional liability insurance carriers and health care providers to identify opportunities to improve diagnostic performance. We used this collaborative approach and involved risk management/patient safety professionals and emergency medicine physician reviewers to analyze diagnosis-related emergency medicine closed claims from a large malpractice insurer. Our aim was to identify opportunities for risk reduction and to develop an approach for improving at-risk processes. Analysis of these cases revealed several missed opportunities in the diagnostic process. A collaborative approach offered greater insight into diagnosis process failures that may not have been evident if cases were reviewed in silos. Focused review findings led to a multidisciplinary improvement collaborative to develop clinical guidelines for improving at-risk practices and informed a simulation-based training initiative.

References

Nov 11, 2009·Archives of Internal Medicine·Gordon D SchiffRobert A McNutt
Feb 27, 2013·JAMA Internal Medicine·Hardeep SinghEric J Thomas
Apr 16, 2014·Joint Commission Journal on Quality and Patient Safety·Hardeep Singh
Jan 16, 2015·BMJ Quality & Safety·Hardeep Singh, Dean F Sittig
Nov 5, 2015·Emergency Medicine Journal : EMJ·Laura Medford-DavisHardeep Singh
Nov 13, 2015·The New England Journal of Medicine·Hardeep Singh, Mark L Graber
Jan 21, 2016·Journal of Healthcare Risk Management : the Journal of the American Society for Healthcare Risk Management·Robert F Bunting, Daniel P Groszkruger
Feb 24, 2016·Journal of General Internal Medicine·Aymer Al-MutairiHardeep Singh
May 4, 2016·Journal of Pediatric Urology·Thomas W Gaither, Hillary L Copp

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