Ambulatory/Outpatient Care Facilities

Jan 03, 2022
COVID-19 and Patient Safety in the Medical Office
Debbie Kane Hill, MBA, RN, Senior Patient Safety Risk Manager, The Doctors Company, Part of TDC Group
Due to the rapid spread of the COVID-19 Omicron variant into 39 states in just two weeks, the CDC issued a warning that healthcare providers should prepare for a potential “tidal wave” of infections in January. Medical offices must make preparation as the winter months approach—the peak season for respiratory illness.

Professional Education
Clinical Presentations Cause Delays: Failure to Diagnose Myocardial Infarction
In reviewing closed malpractice claims, The Doctors Company identified missed or delayed diagnosis of myocardial infarction (MI) in the ambulatory internal medicine setting as a reoccurring problem. This course highlights the importance of recognizing the varying clinical presentations of MI and contributing factors associated with failure to diagnose and treat. Assumptions, lack of a thorough history and physical, communication failures, and failure to recognizing atypical signs and symptoms are highlighted in this case study.
0.5 credit

Professional Education
Delayed Diagnosis of Stroke
In reviewing closed malpractice claims, The Doctors Company identified diagnostic failure as a reoccurring problem and one of the top three leading allegations that result in malpractice claims. This failure often leads to a delay in treatment and causes significant harm to patients. The following highlights the importance of recognizing the signs and symptoms of a stroke.
0.5 credit

Professional Education
Cervical Cancer Claims: A Review in Gynecology
Cervical cancer medical negligence claims are reviewed over a ten-year period to identify the major case types in which the gynecologist is the responsible party. The factors that contributed to those claims as identified by plaintiff and defense physician experts are discussed through case examples with learner questions. Risk mitigation strategies are identified to guide gynecologists in further providing the safest patient care and thereby improving their risk profile.
1.0 credit

Professional Education
Alzheimer's – 4 Addressing Patients' and Families' Needs through the Disease Stages of Dementia
This activity includes seven video lectures and is the fourth in a series of four courses that seek to educate clinicians on standardized screening, evaluation, and disease management of Alzheimer’s disease and related dementias. This fourth course covers life planning through disease stages, assessing and assisting caregivers, improving communications, utilizing community resources, and end of life decision-making. These sensitive conversations with patients. The course finishes with a focus on dementia resources, effective communication strategies, and understanding when it is time to make a referral to a specialist.
1.8 credits

Professional Education
Alzheimer's – 2 Evaluation and Diagnosis of Alzheimer’s Disease and Related Dementias
This activity includes eight video lectures and is the second in a series of four courses that seek to educate clinicians on standardized screening, evaluation, and disease management of Alzheimer’s disease and related dementias. This second course introduces the Alzheimer’s project evaluation algorithm and evaluation instruments and focuses on differential diagnoses. Finally, the course discusses how to prepare and engage in a sensitive dementia diagnosis disclosure with patients and caregivers.
1.5 credits

Professional Education
Alzheimer's – 3 Addressing and Managing Behavioral and Environmental Symptoms of Dementia
This activity includes eight video lectures and is the third in a series of four courses that seek to educate clinicians on standardized screening, evaluation, and disease management of Alzheimer’s disease and related dementias. This third course focuses on using the DICE method to assess behavioral symptoms of dementia and create and evaluation treatment plans. This course also covers the careful use of medication during disease management as wells as common behavioral issues with dementia patients including tools for management of these behaviors.
1.3 credits

Video Jun 11, 2021
Why It’s Vital to Choose a Doctor-Owned Medical Malpractice Insurer
Robert E. White Jr., chief operating officer of The Doctors Company and TDC Group, discusses how a doctor-owned company offers benefits that shareholder-owned companies can’t match

Professional Education
Dictation Errors in the Emergency Department
The Doctors Company identified dictation errors as a significant patient safety risk factor. The following case highlights the importance of timely recognition of dictation errors to ensure accuracy of the permanent electronic health record (EHR). This is particularly important when using a voice recognition program to document encounters in the busy emergency department. In this case, the voice recognition system was Dragon Direct Voice Recognition Program.
0.5 credit

May 14, 2021
Managing Healthcare Practice Operations during COVID-19
Debbie Kane Hill, MBA, RN, Senior Patient Safety Risk Manager
As COVID-19 cases continue to rise and fall across all regions of the United States, practices must adapt and adjust their operations according to regional mandates, which can transition overnight with the shifting environment. For areas where there is a resurgence of the virus or as new strains of the virus emerge, you will need to be attentive to newly imposed restrictions. If disease transmission slows further, authorities may lift additional restrictions.

Apr 02, 2021
Pre-Procedural Screening and Testing During COVID-19
Throughout the pandemic, surgeons have faced many challenges in adapting to new situations. Now that facilities have resumed elective surgeries, surgeons are facing additional challenges in evaluating and scheduling patients who have recovered from COVID-19. The strategies highlighted here can help ensure a consistent approach in keeping both patients and providers safe.

Professional Education
Interventional Radiology: Analysis of Closed Malpractice Claims
Studying interventional radiology malpractice claims provides an understanding of drivers of lawsuits and patient injuries that result. By analyzing these claims and identifying the contributing factors involved, risk mitigation strategies can be developed and implemented reducing adverse patient outcomes and increasing patient safety.
0.8 credit

Mar 08, 2021
Are You Prepared for a Medicare Recovery Audit Contractor (RAC) Audit?
Kathleen Stillwell, MPA/HSA, RN, Senior Patient Safety Risk Manager, The Doctors Company
RAC audits can be triggered by innocent documentation errors. These strategies can help you assess your risk for coding and billing errors and establish compliance and practice standards.

Mar 03, 2021
Universal Masking Calls for More Structured Communication in Healthcare
David L. Feldman, MD, MBA, FACS, Chief Medical Officer, The Doctors Company, and for the TDC Group of Companies
COVID-19 calls for the adoption of structured communication systems across the board. Chief Medical Officer Dr. David L. Feldman highlights steps individuals and institutions can take today.
From The Doctor’s Advocate

Feb 26, 2021
Resources for Elective Procedures During COVID-19
Kim Hathaway, MSN, CPHRM, Patient Safety Healthcare Quality and Risk Management Consultant, and Julie Ritzman, MBA, CPHRM, Vice President, Department of Patient Safety and Risk Management
Your patients most likely want to know about the safety of surgery during the pandemic and what occurs if they contract COVID-19 post-procedure. You may have questions about keeping your staff and patients safe, informing patients about new risks the pandemic has created, and potential liability risks you may be facing.

Feb 23, 2021
Medical Gas System Safety
Ernest E. Allen, ARM, CHFM, Senior Patient Safety Risk Manager, The Doctors Company
Incidents involving medical gas systems have resulted in patient injuries and deaths. This safety review can help surgery centers, hospitals, and physician offices comply with requirements.

Feb 23, 2021
Safe Handling of Medical Gas Cylinders
Ernest E. Allen, ARM, CHFM, Senior Patient Safety Risk Manager, The Doctors Company
When incorrectly used, handled, or stored, medical gas cylinders can create dangerous physical and chemical hazards for patients and staff. This review of safety standards can help healthcare facilities and physician and dental offices stay in compliance.

Feb 03, 2021
The Importance of Clinical Health Information at the Point of Radiology Order
Lisa M. McCorkle, MSN, MBA, Senior Patient Safety Risk Manager, The Doctors Company
Having ready access to patients’ clinical information helps radiologists eliminate assumptions and apply their skills and expertise in rendering accurate interpretive reports.

Jan 29, 2021
Pain Management Closed Claims Study
Jacqueline Ross, RN, PhD, Coding Director, and Michelle Swift, RN, JD, Senior Patient Safety Risk Manager
The Doctors Company reviewed medical malpractice claims that closed between 2008 and 2018 and involved pain management physicians as the primary specialty responsible in the claim. That criteria identified 273 claims and lawsuits.

Professional Education
HIPAA Fundamentals: 2021 Edition
This on-demand program provides an orientation to the basic requirements of the Health Insurance Portability and Accountability Act (HIPAA). HIPAA gives patients many rights with respect to their health information.
1.0 credit

Professional Education
Diagnostic Radiology: A Failure to Diagnose
In reviewing closed malpractice claims, The Doctors Company identified delayed diagnosis of a malignancy as a reoccurring problem. The following highlights the importance of recognizing a spinal abnormality and recommending further follow up of a lesion seen on imaging. Contributing factors include misinterpretation of radiologic studies, narrow diagnostic focus, lack of communication and failure to establish a differential diagnosis.
0.5 credit

Professional Education
HIPAA for Managers: The High-Level View
The program explores and defines HIPAA policies and procedures, business associate agreements, security assessment and analysis, training requirements, HIPAA compliance requirements, breach events, and informed consent.
1.0 credit

Professional Education
Prevention of Diagnostic Error in Primary Care
Diagnostic errors occur often in primary care settings and can impact over 12 million outpatients annually. This is a top patient safety concern and a global burden. Significant patient harm can occur due to treatment delay, testing, or misdiagnosis. This course is an opportunity to promote awareness and visibility by identifying where these errors occur most often in the diagnostic process of care framework.
1.0 credit

Professional Education
Spotlight on Diagnosing PE/DVT
The overall incidence of venous thromboembolism (VTE) —including both deep vein thrombosis (DVT) and pulmonary embolism (PE) —is one case per 1000 patient years. Accurate and timely diagnosis of VTE can be improved with the use of diagnostic guidelines such as Wells criteria and scoring for both DVT and PE.
0.5 credit

Professional Education
Medical Error Prevention
The purpose of this monograph and continuing medical education activity is to provide physicians with the most current information regarding the prevention of common performance and diagnostic errors.
2.0 credits

Aug 17, 2020
What Lessons Did We Learn from COVID-19
David L. Feldman, MD, MBA, FACS, Chief Medical Officer, The Doctors Company Group, and Laura Kline, CPCU, MBA, Senior Vice President, Business Development, The Doctors Company
Each year, The Doctors Company assembles healthcare leaders to discuss the most pressing issues affecting physicians, practices, and systems across the spectrum of care. The 2020 Executive Advisory Board meeting gathered top healthcare executives for a virtual discussion of shared pandemic experiences and lessons learned that can help healthcare organizations navigate through COVID-19 and beyond.

Jun 18, 2020
Moderate or Conscious Sedation in the Office Setting
Julie Brightwell, JD, RN, Director, Healthcare System Patient Safety, Department of Patient Safety and Risk Management
Prevent patient injury when providing moderate sedation in the office by incorporating these patient safety and practice improvement strategies.

May 01, 2020
Informed Consent for COVID-19 Risks: Frequently Asked Questions
To support our members and the entire medical profession during this unprecedented time, the following are answers to some frequently asked questions regarding informed consent for COVID-19 risks.

Apr 29, 2020
Patient Safety in Anesthesia Care
Julie Brightwell, JD, RN, Director, Healthcare System Patient Safety, Department of Patient Safety and Risk Management
Anesthesiologists can reduce potential liability by taking risk management steps, such as obtaining separate informed consent for anesthesia care.

Apr 02, 2020
COVID-19: How to Temporarily Close Your Practice While Minimizing Risks
Richard Cahill, Vice President and Associate General Counsel; Todd Zeiter, Vice President, National Underwriting
During the COVID-19 pandemic, with patients and practices postponing care for nonemergent situations, many physicians are wondering how to temporarily reduce their hours or even close their practices—while minimizing risks.

Professional Education
Internal Medicine: When Personal Relationships Interfere with the Standard of Care
Physicians and dentists are often faced with the decision whether to treat friends and families without realizing the inherent risks in doing so. A review of one case will highlight some common circumstances and risks associated with the treatment of friends and family members.
0.8 credit

Video Dec 16, 2019
Artificial Intelligence in Healthcare: Benefits and Risks
A third of U.S. physicians are already using artificial intelligence (AI) in their practices, and many believe there is ample reason to think this advanced technology can help address diagnostic errors—the largest cause of malpractice claims. However, there are still unresolved questions about the risks.

Dec 12, 2019
Making Further Advancements in Anesthesia Care Safety
Susan K. Palmer, MD; Darrell Ranum, JD, CPHRM, Vice President, Patient Safety and Risk Management; and Susan Shepard, MSN, RN, Senior Director, Patient Safety and Risk Management Education
We analyzed 459 claims for new trends in anesthesia care.
From The Doctor’s Advocate

Professional Education
Safe and Effective Opioid Prescribing - Georgia Edition
This three-hour learning activity provides instruction on controlled substance prescribing guidelines, recognizing signs of abuse or misuse of controlled substances, and controlled substance prescribing for chronic pain management, as delineated in Georgia Rule 360-15-.01. It also provides tools and resources to assist in educating staff and informing patients.
3.0 credits

Professional Education
Prescribing Opioids Safely
Faced with an opioid-related epidemic that continues to bring addiction and deaths, it is important to define the role of opioids for both acute and chronic pain management. This activity spotlights the epidemic and presents the Centers for Disease Control and Prevention (CDC) guidelines, regulations, studies, and emerging solutions to address the epidemic and allow for effective and appropriate use of these drugs.
2.5 credits

Professional Education
Safe and Effective Opioid Prescribing - Michigan Edition
This three-hour learning activity provides instruction on controlled substance prescribing guidelines, recognizing signs of abuse or misuse of controlled substances, and requirements delineated in Michigan’s law. It also provides tools and resources to assist in educating staff and informing patients.
3.0 credits

Nov 26, 2019
How Healthcare’s Transformation Affects Physicians and Patients
Richard E. Anderson, MD, FACP, Chairman and CEO, The Doctors Company
Richard E. Anderson, MD, FACP, chairman and CEO of The Doctors Company, discusses some of the most pressing issues facing providers today, including rising healthcare spending and hospital mergers.

Nov 12, 2019
Closing or Relocating a Healthcare Practice
Physician practices close for many reasons, including physician illness or death or a decision to sell, practice solo, join another group, relocate, or retire. These patient safety and risk management tips can help make the transition easier.

Oct 31, 2019
The Algorithm Will See You Now: How AI’s Healthcare Potential Outweighs Its Risk
A third of U.S. physicians are already using artificial intelligence (AI) in their practices, and many believe there is ample reason to think this advanced technology can help address diagnostic errors—the largest cause of malpractice claims. However, there are still unresolved questions about the risks.

Professional Education
Advanced Practice Providers Closed Claims: What Can We Learn?
A recent study by the Association of American Medical Colleges predicts that the U.S. would need an additional 95,900 doctors, 22,700 NPs, and 12,800 PAs immediately if healthcare use patterns were equalized across race, insurance coverage, and geographic location. More understanding of the liability associated with APPs can help provide insight on the current situation and identify strategies that decrease risk, improve patient safety, and advance patient care.
1.0 credit

Professional Education
Dementia Q&A: What Physicians Ask About Diagnosis and Treatment
This course focuses on the common concerns and questions expressed by physicians about dementia and cognitive impairment. This course covers making the initial observation of cognitive decline and beginning a conversation with older adult patients; overcoming common barriers to making a definitive diagnosis of dementia; and managing the ongoing clinical needs of patients experiencing dementia.
1.5 credits

Professional Education
Neurological Case Study: Management of the Surgical Patient
This Claims Corner examines a neurosurgical case that alleges several failures to assess and treat a patient in a timely manner. It also highlights the importance of communicating with physicians and advanced practice providers involved with post-surgical care.
0.5 credit

Professional Education
Ob/Gyn: Telephone Communications
The most frequent inconsistent practice found in the Practice Risk INSIGHT assessments was telephone communication (22 percent not met). When appropriate and adequate systems are in place, the physician is less at risk for having a suit filed. This case-based study provides insights and risk management techniques to lessen the frequency and severity of such a claim.
0.5 credit

Professional Education
Psychiatry: Preventing Adverse Outcomes
The Doctors Company study of closed claims reveals areas of higher risk in outpatient psychiatry practices. Using this as a foundation, the course provides information to evaluate your practice and make changes to improve decisions about treatment, operational processes, reporting, and documentation.
1.5 credits

Nov 20, 2018
Clinician Burnout: Perspectives, Stories, and Solutions
Growing administrative demands and distractions in our complex healthcare system conflict with how clinicians want to provide care—contributing to alarming rates of burnout and potentially leading to more adverse events and compromising patient safety.

Professional Education
Medical Office Assessments Reveal Hidden Liabilities
The Doctors Company’s patient safety risk managers conducted office practice assessments across a range of practice environments around the country. This activity analyzes the results, highlights problem-prone areas, and offers strategies to minimize areas where patients can “fall through the cracks” and leave the practice vulnerable to a malpractice claim.
1.0 credit

Sep 27, 2018
Medical Office Assessments Uncover Hidden Liability Risks
Susan Shepard, MSN, RN, Senior Director, Patient Safety and Risk Management Education
From The Doctor’s Advocate

Jun 07, 2018
Team Synergy: A Critical Core Competency for Safe Care
Lisa McCorkle, MSN, MBA, Patient Safety Risk Manager, Department of Patient Safety and Risk Management
An account of one group’s efforts to create and sustain a team-oriented culture through teamwork training.
From The Doctor’s Advocate

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