Environment of Care

Professional Education
Patient Relations: Spotlight on Challenging Situations
The Doctors Company’s dedicated patient safety risk managers deliver a wide range of expert services and resources to our members—including personal telephone consultations to help guide members through challenging situations. A recent review of our call data shows that “patient relations” and “patient termination” consistently appear as the top reasons that members request assistance. The following strategies can help prevent challenging patient situations and provide guidance if one occurs.
0.5 credit

Professional Education
Pathologists and Surgeons Can Collaborate to Reduce Diagnostic Error
The Doctors Company has updated the claims filed against pathologists between the years 2015 and 2020. The information provides quantitative and qualitative data that a pathologist and surgeon would find meaningful in reducing diagnostic error. This program provides a breakdown of where patient injuries occur involving pathologists and surgeons and how collaboration between the two disciplines can improve patient outcomes.
1.0 credit

Aug 02, 2021
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
COVID-19 infections, driven by the Delta variant, have jumped nearly 60 percent. With communities around the country taking a variety of approaches to restrictions for public health, what are the latest considerations for keeping patients and staff safe within the medical office setting?

Professional Education
Patient Safety in Spine Surgery
Spine surgery requires a series of best practice patient safety interventions to reduce the frequency and severity of patient harm while giving the care team the resources to mitigate such harm. Evidence-based clinical methods, pathways, and tools coupled with an evolving culture of patient safety through effective communication, teams, and teamwork has shown to reduce patient harm exponentially. Patient and clinical team experiences are enhanced while ensuring a learning culture is built that approaches surgery from both a technical and nontechnical approach alike.
1.3 credits

Professional Education
The Need for Close Monitoring in Hyponatremia: Osmotic Demyelination Syndrome
In reviewing closed malpractice claims, The Doctors Company identified mismanagement of sodium levels during correction of severe hyponatremia as a serious problem that can result in catastrophic permanent neurological injury due to osmotic demyelination syndrome (also known as central pontine myelinolysis). This article highlights the importance of close monitoring of sodium levels during correction of severe hyponatremia, with a slow and controlled pace of sodium correction. Contributing factors discussed include clinical judgment with regard to rate of rise of sodium levels, patient monitoring, choice of practice setting, and communication between providers, especially at points of transition in care.
0.5 credit

Professional Education
Risky Practices: Hidden Liabilities Identified by Medical Office Assessments
Office practice assessments by The Doctors Company's patient safety risk managers uncover hidden liability risks, often exposing areas where patients can "fall through the cracks" and leave the practice vulnerable to a malpractice claim. Our Practice Risk INSIGHT, an assessment tool customized by specialty, zeros in on problematic areas. The assessments have been completed across a range of practice environments around the country—from small offices to practices that are part of large integrated delivery systems. In this course, we analyze the results of the Practice Risk INSIGHT assessments, highlight problem-prone areas and offer strategies to minimize liability.
1.3 credits

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.

Professional Education
Breast Cancer Claims – A Review in Gynecology
Breast 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
Pain Management - A Closed Claim Analysis Looking at Risks and Lessons Learned
For the first time, The Doctors Company has published an analysis of lawsuits and claims filed against pain management physicians. This study completed in 2020 provides quantitative and qualitative information that a physician who practices pain management, including interventional approaches to treatment would find useful in mitigating the risks of unintended outcomes or harms. This study breaks down where most patient injuries occur, what those injuries are, and the lessons learned from those claims.
1.3 credits

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 03, 2021
Flexibility and Communication Save Lives in NYC: Incorporating Lessons Learned Through Waves of COVID-19
Andrew D. Racine, MD, PhD, Systems Senior Vice President and Chief Medical Officer, Montefiore Health System, and Executive Director of the Montefiore Medical Group
Guest author Dr. Andrew Racine shares valuable insights gleaned from treating patients during the first surge of the COVID-19 pandemic.
From The Doctor’s Advocate

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.

Professional Education
TeamSTEPPS® Teamwork Training in the Office Practice
This course provides an overview of the evidence-based TeamSTEPPS® concepts, tools, and strategies based on the four areas of 1) leadership, 2) mutual support, 3) situation monitoring, and 4) communication. TeamSTEPPS training provides teachable/learnable skills that improve communication and teamwork among healthcare professionals in both acute care and ambulatory care environments.
1.5 credits

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
It's the Little Things: An Introduction to Enhancing Patient Relations and Reducing Risks
It's the Little Things is designed to assist medical practices with improvements in patient interactions by looking at how incorporating hospitality as a focus makes a difference. It has been developed to improve multiple facets of patient interaction.
1.3 credits

Professional Education
Lessons Learned – Plastic Surgery Closed Claims Study: An Expert Analysis of Medical Malpractice Allegations
This course is based on the findings of a study conducted by The Doctors Company that analyzed 415 claims that closed against plastic surgeons (from July 2015–December 2018).
1.3 credits

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

Professional Education
Safe and Effective Opioid Prescribing – Florida Edition
The Doctors Company recognizes the opioid epidemic in this country. This course provides insights into the risks of opioid usage, as shown by malpractice claims, and how to reduce those risks both for your patient and for your practice. Approved by the Florida Board of Medicine—Controlled Substance Prescribing.
2.0 credits

Professional Education
Telemedicine to Telehealth: Trends and Emerging Risks
This course explores challenges and risks such as privacy and security, licensure, and technology concerns that might instigate a malpractice claim. The risks overlay the inherent challenge of replicating the interaction of a traditional, in-person encounter between a provider and a patient, without compromising the standard of care. It also provides resources for clinicians and practice managers to consider when making decisions about deploying telehealth services or to improve existing services.
1.3 credits

Aug 25, 2020
Disaster Preparedness for Your Medical Practice
Julie Brightwell, JD, RN, Director, Healthcare System Patient Safety, Department of Patient Safety and Risk Management
Natural disasters can occur suddenly and without warning, highlighting the importance of advance preparation. Make sure your practice has a plan in place.

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.

Professional Education
Making an Informed Consent an Informed Choice: Training for Healthcare Leaders
This activity is designed for healthcare professionals in leadership positions. It covers the principles of informed consent, crafting and disseminating an informed consent policy, and building systems to improve the informed consent process.
2.0 credits

Professional Education
Making an Informed Consent an Informed Choice: Training for Healthcare Professionals
This activity, designed for doctors, nurses, and other providers, examines problems with the process of healthcare informed consent. It describes the principles of informed consent and highlights the benefits gained from a good informed consent process.
2.3 credits

Dec 20, 2019
Burnout Can Affect How Patients Communicate
By Robert D. Morton, BA, ARM, CPHRM, CPPS, Assistant Vice President, Patient Safety and Risk Management, The Doctors Company
If a physician appears burned out, patients may avoid asking questions for fear of adding to the stress.

Professional Education
Interventional Radiology: Communications and Assessments
Ensuring patient safety for any procedure requires communication between the diagnosing physician and the proceduralist. This includes ensuring all physicians are aware of pre-procedural testing that the proceduralist would need to adequately care for the patient and manage complications.
0.5 credit

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
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

Professional Education
Nursing Liability: Preventing Patient Falls
1.0 credit

May 14, 2018
Improving Medical Office Communication and Safety
David O. Hester, FASHRM, CPHRM, Director, Department of Patient Safety and Risk Management
Develop procedures for your staff to help reduce communication errors with hospitals, labs, and other physicians, as well as communications within the office.

Video Feb 27, 2018
A Patient Safety Culture Is Key for Medical Practices
Do your practice's policies and culture promote patient safety or undermine it? Jason W. Miller, MPA, CMPE, chief executive officer at Reiter, Hill, Johnson & Nevin, the largest privately owned OB group in the DC metro area, used The Doctors Company's Practice Safety Culture INSIGHT Service to perform a diagnostic checkup on the practice's culture and its impact on patient safety. This confidential service assesses daily office routines, management practices, policies, procedures, and communication style and benchmarks the results against practices nationwide.

Video Jan 24, 2018
How to Spot Potentially Violent Patients
Healthcare workers face significant risk of job-related violence: 52% of all workplace violence occurs in healthcare. Mitigating the risk of violence includes early identification of high-risk patients.

Video Jan 09, 2018
Finding Hidden Liability Risks in Medical Practices
What risks are you missing? What questions aren't you asking? Ted Abernathy, MD, of Pediatric & Adolescent Health Partners in Virginia, used The Doctors Company's Practice Risk INSIGHT Service to do a full and comprehensive liability evaluation of his practice. The data-driven recommendations from this evaluation helped him find ways to improve safety and reduce his risk, including changes to protocols, policies, and forms, as well as establishing a parent advisory council.

Dec 07, 2017
Teamwork Saves Lives in Bronx-Lebanon Hospital Shooting
Shelley Rizzo, MSN, CPHRM, Patient Safety Risk Manager, The Doctors Company, and Steven J. Weintraub, MD, Chief of Risk Management, North American Partners in Anesthesia
Teams pull together to save lives and provide support during a deadly hospital shooting.
From The Doctor’s Advocate

Aug 15, 2017
Objective Review of Potential Risks in a Medical Practice Can Be Beneficial
Ted Abernathy, MD, Managing Partner, Pediatric & Adolescent Health Partners
Ted Abernathy, MD, Managing Partner of Pediatric & Adolescent Health Partners discusses his experience with an assessment service offered by The Doctors Company which provided his practice with a comprehensive checkup of key areas and customized action plan.

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