Hospitalists

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

Professional Education
Prevention of Medical Errors – Florida (2023–2025 Edition)
This activity is specific to Florida statutes and reflects regulations effective February 2022. 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 that reflect on the most common issues identified by Florida: wrong site surgery, surgery complications, cancer, gastroenterology conditions, cardiology issues, neurological issues, and adverse drug events, which will serve as the focal point of this patient safety and risk management course.
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

Mar 03, 2022
Challenges of Cultural Diversity in Healthcare: Protect Your Patients and Yourself
Susan Shepard, MSN, RN, Senior Director, Patient Safety and Risk Management Education, The Doctors Company
A clinician’s cultural competence is critically important in helping to eliminate health disparities and social disadvantages for all patients, regardless of their ethnicity or race.

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.

Feb 03, 2021
Curbside Consultations: Patient Safety and Legal Risks
Susan Shepard, MSN, RN, Senior Director, Patient Safety and Risk Management Education; and Richard Cahill, JD, Vice President and Associate General Counsel, The Doctors Company
Physicians should be aware of the potential liability of informal "curbside" consultations, especially if expectations between the physicians are not clearly communicated.

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.

Jan 08, 2021
Communication Breakdowns Lead to Missed Spinal Epidural Abscess: Case Study
Michelle Swift, JD, RN, Senior Patient Safety Risk Manager, The Doctors Company
Experts weigh in on this case involving poor communication and failure to diagnose spinal epidural abscess.

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

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
Cauda Equina Syndrome: A Failure to Diagnose
Failures of systems often prevent physicians from making timely diagnoses. Failures may result when patient assessments are incomplete, having a narrow diagnostic focus, or diagnostic test issues. Other factors that hinder timely diagnoses include failure to appreciate signs and symptoms, lack of consults, and failure to respond to repeated patient concerns/symptoms.
0.5 credit

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
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.

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

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.

Mar 23, 2020
Preventing Falls in Patients with Morbid Obesity: Case Study
Julie M. Brightwell, JD, RN, Director, Healthcare Systems Patient Safety
It is imperative that hospitals provide employees with training and guidance that specifically addresses caring for morbidly obese patients.

Mar 09, 2020
Patient Safety Strategies for Hospitalists
Kathleen Stillwell, MPA/HSA, RN, Senior Patient Safety Risk Manager
Hospitalists face liability risks based on their role as an inpatient’s attending physician, covering physician, consultant, and/or co-manager. Two common problem areas are confusion regarding the hospitalist’s role in the patient care continuum and miscommunication during the different phases of inpatient care, especially during handoffs.

Dec 01, 2019
Dilaudid-Related Morbidity and Mortality from Respiratory Depression
Howard Marcus, MD, FACP, Chairman, Texas Alliance for Patient Access
Patient safety organizations and the FDA are focusing on ways to reduce patient harm from opioids.

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

Professional Education
Saline Overdose Cases
This activity delivers insights from malpractice claims involving severe hyponatremia. The recommendations and strategies outlined here can help physicians avoid adverse outcomes when treating patients with this particularly difficult and complex condition.
0.5 credit

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.

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

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.

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