In this blog series, Lori Duffy discusses the top drivers of risk and malpractice claims and explores strategies to mitigate risk and enhance patient safety.
In my blog series, Top Drivers of Risk, I discuss the top malpractice allegations across all healthcare settings and explore risk strategies to enhance patient safety and minimize risk.
In this month’s blog, I'll explore medical treatment allegations and malpractice claims. At Curi, we analyze our malpractice claims to identify and examine the top allegations to help clinicians and their organizations implement strategies to reduce adverse events and claims.
Medical Treatment Claims
In the subset of Curi claims analyzed, medical treatment allegations (these include both therapeutic and diagnostic procedures/treatments) are the second most frequent allegation and fourth in cost. The majority of these claims (57%) involved medium-severity patient injuries such as infection, pain, bleeding, burns, nerve damage, and delayed recovery.
Nearly half (43%) of these allegations involved improper performance of a procedure, with technical performance issues as a contributing factor. Allegations of improper management of treatment (40%) often centered around patient assessment issues and improper selection of the treatment. These claims represented a broad cross-section of specialties. The top procedures involved were scopes, injections, biopsies, and excisions.
The top locations of care included:
- Medical office – 39%
- Patient hospital room – 18%
- Emergency department – 12%
- Special procedures area – 10%
- Radiology – 4%
Risk Reduction Strategies
Understanding the top risk drivers in our claims provides data-driven insights into where to prioritize your organization’s risk management efforts. Strategies to reduce medical treatment allegations include:
Informed Consent
- Thorough explanation of the procedure, including its purpose, expected outcomes, potential risks, and alternative treatments
- Written documentation of the informed consent discussion in the patient’s medical record
- Patient understanding verified by encouraging questions and confirming comprehension before proceeding
Checklists and Time-outs
- Use standardized checklists to make sure all pre-, intra-, and post-procedural steps are taken
- Conduct thorough pre-procedure evaluations to assess the patient’s risk factors, such as pre-existing medical conditions (e.g., bleeding disorders, diabetes, obesity), allergies, medications (blood thinners), or lifestyle habits (smoking)
- Perform a time-out to confirm the patient’s identity, procedure, and procedural site before starting the procedure
- Ensure that all team members agree about the procedure and their roles
- Allow team members to voice any concerns or questions before proceeding
- Monitor patients closely following procedures for known complications such as bleeding or infection
Injection and Biopsy Protocols
- Use appropriate techniques and anatomical landmarks to avoid nerve damage or vascular injury.
- Ensure all syringes and specimens are properly labeled.
- Provide regular training using simulation on safe injection/biopsy practices, including aseptic techniques, and the management of potential complications.
Ongoing Training
- Employ scenario-based education and simulation training for all procedures, including managing potential complications and emergency responses
- Provided supervised hands-on training for new clinicians and nursing team members during orientation
- Pair an experienced clinician to assist new clinicians and nursing team members in procedures and protocols
- Periodically evaluate clinician and nursing team member procedural skills
Patient Education and Follow-up Care
- Provide clear, written post-procedure instructions with an opportunity for patients to ask questions
- Instruct patients on signs and symptoms that require immediate medical attention
- Arrange follow-up appointments to monitor recovery and address any concerns promptly.
Accurate Documentation
- Document all aspects of the procedure, including pre-procedural evaluations, intra-procedure events, and post-procedure care
- Note any complications or adverse events, how they were addressed, and the patient’s response to interventions
- Thoroughly document the informed consent process including the discussion with the patient
- Document follow-up instructions and any additional care provided
Curi Resources
Curi clients, sign in to our Risk Solutions Resource Catalog to take one of our Risk Assessments, explore the Risk Management Guide on Informed Consent and Informed Refusal, access our Informed Consent Toolkit, and download our Informed Consent templates, with 400+ customizable forms available.
If you have questions about this topic, please call 800-328-5532 to speak with one of Curi Advisory's Risk Solutions Consultants.
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