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This in-depth study of neurologic malpractice claims indicated authentic, preventable patient harm in 24 of 42 cases, enabling comparison with larger but administratively abstracted summary reports. Principal findings included the common occurrence of outpatient events, lapses in communication with patients and other providers, the need for follow-through(More)
Recent reports have identified medical errors as a significant cause of morbidity and mortality among patients. A variety of approaches have been implemented to identify errors and their causes. These approaches include retrospective reporting and investigation of errors and adverse events and prospective analyses for identifying hazardous situations. The(More)
The integration and large-scale analyses of medical error databases would be greatly facilitated by the use of a standard terminology. We investigated the availability in the UMLS metathesaurus of concepts that are required for coding patient safety data. Terms from three proprietary patient safety terminologies were mapped to the concepts in UMLS by an(More)
BACKGROUND Medical organizations have increased interest in identifying and improving behaviors that threaten team performance and patient safety. Three hundred and sixty degree evaluations of surgeons were performed at 8 academically affiliated hospitals with a common Code of Excellence. We evaluate participant perceptions and make recommendations for(More)
BACKGROUND Missed diagnoses of acute myocardial infarction (AMI) in the ambulatory setting can cause patient suffering and malpractice litigation. Multiple algorithms have been developed to detect the presence of coronary heart disease (CHD) or acute coronary ischemia. METHODS We performed a case-control study of patients with no prior history of CHD(More)
BACKGROUND A study was conducted to examine and compare information gleaned from five different reporting systems within one institution: incident reporting, patient complaints, risk management, medical malpractice claims, and executive walk rounds. These data sources vary in the timing of the reporting (retrospective or prospective), severity of the(More)
BACKGROUND Electronic health records (EHRs) may improve patient safety and health care quality, but the relationship between EHR adoption and settled malpractice claims is unknown. METHODS Between June 1, 2005, and November 30, 2005, we surveyed a random sample of 1884 physicians in Massachusetts to assess availability and use of EHR functions, predictors(More)
OBJECTIVE One of the patient safety goals proposed by the Joint Commission urges hospitals to develop a policy for communicating critical test results and to measure adherence to that policy. We evaluated the impact of an alert notification system on policy adherence for communicating critical imaging test results to referring providers and assessed system(More)
IF A GROUP OF PHYSICIANS WERE ASKED TO LIST THE SPEcialties of clinical medicine that carry the highest risk of malpractice, invariably the first responses would include obstetrics/gynecology, anesthesia, and various surgical specialties. These clinical domains are well recognized to carry risk and have done so for many years. The results of adverse events(More)
OBJECTIVE Identify clinical opportunities to intervene to prevent a malpractice event and determine the proportion of malpractice claims potentially preventable by clinical decision support (CDS). MATERIALS AND METHODS Cross-sectional review of closed malpractice claims over seven years from one malpractice insurance company and seven hospitals in the(More)