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

Lemoine N, Dajer A, Konwinski J, Cavanaugh D, Besthoff C, Singh H. 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. 2018 Jul 1; 38(1):48-53.

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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.





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