Hospitalists

Jul 11, 2023
Patient Safety Strategies for Hospitalists
Kathleen Stillwell, MPA/HSA, RN, Senior Patient Safety Risk Manager, The Doctors Company
Hospitalists face liability risks based on their diverse roles as an inpatient’s attending physician, covering physician, consultant, supervising physician, and/or co-manager. Common problems include confusion regarding the hospitalist’s responsibilities in the patient care continuum and miscommunication during different phases of inpatient care.

Apr 26, 2023
Curbside Consultations: Patient Safety and Legal Risks
Richard Cahill, JD, Vice President and Associate General Counsel, The Doctors Company
Informal consultations are tempting to busy healthcare practitioners because they are convenient and speedy, but these situations also include inherent liability risks for the consulting practitioner.

Feb 10, 2023
Communication Breakdowns Lead to Missed Spinal Epidural Abscess: Case Study
Michelle Swift, JD, RN, Senior Patient Safety Risk Manager, The Doctors Company
Experts discuss a case involving multiple communication breakdowns that contributed to the patient’s poor outcome and provide strategies to improve processes.

Professional Education
Prevention of Medical Errors (2023–2025 Edition)
Few medical errors are attributed to faulty medical judgment. More commonly, they are attributed to system failures inherent in healthcare delivery. By drawing on our professional liability closed claims data, we have identified common performance and diagnostic errors. We analyzed loss prevention measures in tandem with the elements necessary to conduct a credible and thorough root cause analysis to reduce system failures, respond to sentinel events, prevent medical errors, and improve patient safety. The purpose of this program is to provide clinicians with the most current information regarding the prevention of common performance and diagnostic errors.
2.0 credits

Aug 04, 2022
Miscommunication and Hurried Handoffs Threaten Patient Safety
Julie Brightwell, JD, RN, Director, Healthcare System Patient Safety, The Doctors Company
Miscommunication and missed opportunities resulting from hurried handoffs can produce fatal results.

Professional Education
Administrative and Regulatory Actions: Protecting Your Practice
Healthcare practitioners, including physicians, dentists, and advanced practice clinicians, need to understand the roles of their professional licensing board and state and federal agencies to protect the public.
0.5 credit

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
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

Mar 23, 2021
Prescribing Opioids Safely: How to Have Difficult Patient Conversations
Roneet Lev, MD, Chief of Scripps Mercy Emergency Department, Chair of Prescription Drug Abuse Medical Task Force, and President of Independent Emergency Physicians Consortium
Drug overdose is the leading cause of accidental death in the U.S., and opioids account for over 60 percent of those deaths. Building a strong doctor-patient rapport can help facilitate tough conversations with patients about opioid prescriptions and reduce risks that could lead to malpractice suits.

Jan 28, 2021
Missed Diagnosis of Spinal Epidural Abscess
David B. Troxel, MD, Medical Consultant to The Doctors Company
Spinal epidural abscess requires prompt diagnosis and treatment to prevent serious neurological complications.

Jan 20, 2021
Implicit Bias Against Obesity: An Opportunity to Improve Patient Safety
Jacqueline Ross, PhD, Coding Director, Department of Patient Safety and Risk Management, The Doctors Company
Many patients with obesity delay seeking medical care because of previous negative experiences with healthcare providers.

Dec 02, 2020
The Role of Pretest Probability in the Evaluation of Suspected Venous Thromboembolism
Howard Marcus, MD, FACP
The presenting signs and symptoms of venous thromboembolism are often vague and nonspecific, and early diagnosis—often crucial to the patient’s outcome—may be challenging.
From The Doctor’s Advocate

Sep 14, 2020
Hospitalist Closed Claims Study
This review of 238 closed hospitalist claims identifies top allegations and factors contributing to patient injury.

Aug 25, 2020
Distracting Devices in Healthcare: Malpractice Implications
Shelley Rizzo, MSN, CPHRM, Senior Patient Safety Risk Manager, The Doctors Company
Digital distraction in healthcare is a threat to patient safety and physician well-being. Personal electronic devices can create a digital distraction so engaging that it consumes awareness, potentially preventing healthcare providers from focusing on the primary task at hand—caring for and interacting with patients.

Jun 15, 2020
Safely Caring for the Hospitalized Patient with Obesity
Paul Nagle, ARM, CPHRM, Director, Department of Patient Safety and Risk Management, and Shelley Rizzo, MSN, CPHRM, Senior Patient Safety Risk Manager, Department of Patient Safety and Risk Management
Obesity is viewed as a chronic health condition, and patients with obesity pose patient safety issues.

Aug 27, 2019
Electronic Health Records Continue to Lead to Medical Malpractice Suits
Darrell Ranum, JD, Vice President of Patient Safety and Risk Management
We analyzed 216 medical malpractice claims that closed from 2010 to 2018 in which EHRs contributed to patient injury. The pace of these claims grew, from a low of seven cases in 2010 to an average of 22.5 cases per year in 2017 and 2018. As EHRs approach near-universal adoption, they may become a more prevalent source of patient safety risk.

Jun 13, 2019
The Waning of the Physical Examination and Its Impact on Outcomes
Howard Marcus, MD, FACP
The physical exam should remain a central tool for evaluating and managing patients.
From The Doctor’s Advocate

Jun 13, 2019
An Analysis of Malpractice Claims by Physician Gender
David B. Troxel, MD, Medical Consultant to The Doctors Company
A gender-specific analysis of 5,897 claims from six medical specialties.
From The Doctor’s Advocate

Dec 26, 2018
Mitigating the Risk of Osmotic Demyelination Syndrome
Howard Marcus, MD, FACP
Insights into managing patients with severe hyponatremia.
From The Doctor’s Advocate

May 24, 2018
Physician Learning Must Evolve to Keep Healthcare Workforce Prepared
Eric Barna, MD, MPH, Assistant Professor of Medicine, Division of Hospital Medicine/Samuel Bronfman Department of Medicine, Icahn School of Medicine at Mount Sinai Hospital
Funded by a grant from The Doctors Company Foundation, Mt. Sinai is the first hospital in New York that has established a program designed specifically to assess and address some of the unique communication challenges facing hospitalists to improve patient care.

Video Jul 11, 2017
Hospitalists: Innovations in Patient Safety
John R. Nelson, MD, an internal medicine hospitalist at Overlake Medical Center in Bellevue, Washington, describes important data and recommendations for patient safety revealed in The Doctors Company’s Hospitalist Closed Claims Study. The severity of injury is much higher in claims against hospitalists than those against other specialists.

Video Mar 03, 2016
Why Hospitalists Get Sued
A study of 464 claims against hospitalists that closed from 2007-2014 revealed leading patient allegations and the most common factors that lead to patient injury. The goals of the study were to alert hospitalists and patients to the most common risks and identify system weaknesses to encourage collaboration with hospital leadership to improve patient safety.