Hospitalists

Aug 19, 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.

Professional Education
Dementia Q&A: What Physicians Ask About Diagnosis and Treatment
The Alzheimer's Project Series
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

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

Professional Education
Dementia Behavioral and Environmental Symptoms Management
The Alzheimer's Project Series
The third course focuses on using the DICE (Describe, Investigate, Create Treatment Plan, and Evaluate) method to assess behavioral symptoms of dementia and to create effective treatment plans. The course also covers the careful use of medication during disease management, as well as common behavioral issues experienced by patients with dementia, including tools for management of these behaviors.
1.25 Credits

Professional Education
Dementia End of Life Planning: Effective Communications with Patients and Families
The Alzheimer's Project Series
The fourth course covers important end of life planning topics and concepts, and tips for having these sensitive conversations with patients and family members. The course finishes with a focus on dementia community resources, effective communication strategies, and understanding when it is appropriate to make a referral to a specialist.
1.0 Credit

Professional Education
Pharmacotherapy for Patients with Major Neurocognitive Disorder
The Alzheimer's Project Series
This activity includes video lectures and is the fifth in a series of courses that seek to educate clinicians on standardized screening, evaluation, and disease management of Alzheimer's disease and related dementias. This course focuses on the most frequently used prescription medications for Alzheimer's disease and dementias, the current research regarding its use, and guidelines for prescribing and discontinuing medication.
1.25 Credits

Professional Education
Dementia: Pharmacological Management of Behavioral and Psychological Symptoms
The Alzheimer's Project Series
This activity includes three video lectures and is the sixth in a series of courses that seek to educate clinicians on standardized screening, evaluation, and disease management of Alzheimer's and related dementias. This course focuses on the selection and appropriate usage of psychotropic prescription medications to manage the behavioral and psychological symptoms most frequently exhibited by patients with Alzheimer's and dementia diagnosis.
1.25 Credits

Professional Education
Physical Examination and Its Impact on Outcomes
The Doctor's Advocate
Advancements in technology improve the timeliness and accuracy of many diagnoses but the technology does not replace a thorough physical examination. For some diseases, such as Parkinson’s disease, herpes zoster, cellulitis, and Bell’s palsy the PE is the only diagnostic tool available. This short course makes the case for reversing the downward trend for physical examinations.
0.75 Credits

Professional Education
Neurological Case Study: Management of the Surgical Patient
Claims Corner CME
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 Credits

May 13, 2019
Challenges of Cultural Diversity in Healthcare: Protect Your Patients and Yourself
Susan Shepard, MSN, RN, Senior Director, Patient Safety and Risk Management Education
Physicians often care for a multicultural society complicated by literacy issues. To address cultural diversity in healthcare, physicians must understand how each patient’s sociocultural background affects his or her health beliefs and behavior.

Professional Education
Ob/Gyn: Telephone Communications
Claims Corner CME
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 Credits

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
Preventing Adverse Outcomes When Treating Children
The Doctor's Advocate
The Doctors Company studied claims filed on behalf of pediatric patients that closed over a 10-year period from 2008 through 2017. You are provided the most common types of claims and includes expert insights into the specific elements that led to patient injury, and risk mitigation strategies.
1.0 Credit

Professional Education
Opioid Pain Management and Appropriate Prescribing for Older Adults
This activity includes five video segments on effective pain management and appropriate prescribing of opioid medication for older adult patients. Presenters include a family practice physician, orthopedic surgeon, palliative care physician, and a pain management specialist provider.
1.5 Credits

Dec 28, 2018
Curbside Consultations: Patient Safety and Legal Risks
Susan Shepard, MSN, RN, Senior Director, Patient Safety and Risk Management Education, and Carol Murray, RHIA, CPHRM, Patient Safety Risk Manager II
Physicians should be aware of the potential liability of informal "curbside" consultations, especially if expectations between the physicians are not clearly communicated.

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

Sep 28, 2018
Strategies to Reduce Liability Risks 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.

Jul 27, 2018
Distracting Devices in Healthcare: Malpractice Implications
Shelley Rizzo, MSN, CPHRM, Patient Safety Risk Manager II
Digital distraction in healthcare is emerging as a great 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.

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.

Apr 24, 2018
Missed Diagnosis of Spinal Epidural Abscess
David B. Troxel, MD, Medical Director, Board of Governors
This case illustrates the importance of promptly diagnosing and treating spinal epidural abscess.

Feb 12, 2018
Safe Handling of Medical Gas Cylinders
Ernest E. Allen, ARM, CHFM, Patient Safety Risk Manager II, The Doctors Company.
These recommendations can help healthcare facilities handle compressed medical gas cylinders safely and stay in compliance with standards.

Professional Education
Spinal Epidural Abscess: A Case Study Review
Designed primarily for hospitalists and other physicians practicing in the hospital setting, this activity explores the problems associated with diagnosing and treating spinal epidural abscess. It defines the most frequent type of risk and the severity of losses, as well as strategies to overcome these risks.
.75 Credit

Dec 15, 2017
Perceptions of Obesity: An Opportunity to Improve Patient Safety
Jacqueline Ross, PhD, RN, Analysis and Coding Manager, Department of Patient Safety and Risk Management
Understanding biases and attitudes toward obese patients can enable providers to improve patient care and outcomes.

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

Oct 24, 2017
Doctors Examine Injury Risks with Malpractice Closed Claims
Robin Diamond, MSN, JD, RN, Senior Vice President of Patient Safety and Risk Management, The Doctors Company
Taking a close look at research into real-life malpractice claims and incorporating some of the findings into their practices is one way physicians are reducing risks of adverse events.

Professional Education
Hospitalist Malpractice Claims Study: Lessons Learned
The findings from The Doctors Company's study of 464 closed claims against hospitalists revealed what motivates patients to pursue claims, where system failures and processes result in patient harm, and what strategies can be used to mitigate risk.
1.0 Credit

Oct 14, 2017
Challenging Communications
Michelle Swift, JD, RN, Patient Safety Risk Manager II
Communication breakdowns are a frequent risk management finding in claims, as highlighted in this case study.

Video Jul 24, 2017
The Opioid Epidemic: A Closed Claims Analysis
Opioids play an important role in pain management—both in the acute and chronic settings. Unfortunately, the dramatic increase in opioid use over the past few decades has resulted in an opioid-related epidemic of addiction and death. To take a deeper look at the epidemic, The Doctors Company reviewed 272 malpractice claims in which patient harm involved opioids.

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.

Jun 06, 2017
Prescribing Opioids Safely
Howard Marcus, MD, FACP
Dr. Howard Marcus discusses guidelines and recommendations for preventing opioid misuse and addiction in patients with acute or chronic pain.
From The Doctor’s Advocate

Apr 17, 2017
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 23, 2017
Caring for the Hospitalized Obese Patient
Paul Nagle, ARM, CPHRM, Director of Physician Patient Safety, and Shelley Rizzo, MSN, CPHRM, Patient Safety Risk Manager II
Obesity is a common comorbidity for hospitalized patients. The challenge is being prepared to accommodate obese patients and care for them with dignity while keeping both patient and staff safe.

Feb 08, 2017
Did Failure to Consider Patient’s Morbid Obesity Lead to Fall?
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.

Nov 30, 2016
Watch for the Signs: Screen All Patients for Suicidal Thoughts
Robin Diamond, MSN, JD, RN, Senior Vice President of Patient Safety and Risk Management, The Doctors Company
Patients with suicidal thoughts or ideation appear occasionally in physician encounters. Any patient, no matter what issue is being treated and in any setting, could be at risk for suicide. A consistent and formal screening process, plus a response plan, will protect both the patient and the physician.

Aug 11, 2016
Missed Opportunities
Susan Shepard, MSN, RN, Senior Director, Patient Safety Education, and Julie Brightwell, JD, RN, Director, Healthcare System Patient Safety.
Miscommunication and missed opportunities resulting from hurried handoffs can produce fatal results.

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.

Mar 01, 2016
Hospitalist Closed Claims Study
This review of 464 closed hospitalist claims identifies top allegations and factors contributing to patient injury.

Dec 08, 2015
New Early Warning Criteria Could Reduce Maternal Mortality
Susan Mann, MD, The Doctors Company OB Advisory Board Member
Guest author Dr. Susan Mann reports on a new initiative to address the significant increase in maternal deaths.
From The Doctor’s Advocate

Sep 03, 2015
Minimizing Surgical Errors
Jonathan Jones, MD
From The Doctor’s Advocate

Sep 03, 2015
Teamwork in the OR
Susan Shepard, MSN, RN, Director, Patient Safety Education, The Doctors Company
From The Doctor’s Advocate

Feb 14, 2014
Interactive Guide for Hospitals: Ancillary Care Areas: Radiology

Nov 18, 2013
Interactive Guide for Hospitals: Ancillary Care Areas: Diagnostic Ultrasound
Diagnostic ultrasound can create areas of potential malpractice exposure; this guide can help uncover risks.

Nov 18, 2013
Interactive Guide for Hospitals: Ancillary Care Areas: Pharmacy
The pharmacy department can create areas of potential malpractice exposure; this guide can help uncover risks.

Jul 22, 2013
Interactive Guide for Hospitals: Credentialing and Privileging: Medical Staff
Credentialing and privileging of medical staff can create areas of potential malpractice exposure, and this guide can help uncover risks.

Jul 22, 2013
Interactive Guide for Hospitals: Credentialing and Privileging: Non-Physician Practitioners
Credentialing and privileging of non-physician practitioners can create areas of potential malpractice exposure, and this guide can help uncover risks.

May 29, 2013
Interactive Guide for Hospitals: Physical Plant: Biomedical/Preventive Maintenance
Physical plant services can have areas of potential malpractice exposure, and this guide can help uncover risks.

May 28, 2013
Interactive Guide for Hospitals: Physical Plant: Environment of Care
Physical plant services can have areas of potential malpractice exposure, and this guide can help uncover risks.

May 27, 2013
Interactive Guide for Hospitals: Physical Plant: Patient Rooms
Physical plant services can have areas of potential malpractice exposure, and this guide can help uncover risks.

May 26, 2013
Interactive Guide for Hospitals: Physical Plant: Security
Physical plant services can have areas of potential malpractice exposure, and this guide can help uncover risks.

Feb 01, 2013
Interactive Guide for Hospitals: Clinical Departments: Surgery and Operating Room
The surgery and operating room can have areas of potential malpractice exposure, and this guide can help uncover risks.

Dec 14, 2012
Interactive Guide for Hospitals: Clinical Departments: Obstetrics (OB) Units
This guide can help uncover areas of potential malpractice exposure in the obstetrics (OB) unit.

Nov 20, 2012
Interactive Guide for Hospitals: Clinical Departments: Special Care/Intensive Care Units
Special care/intensive care units can have areas of potential malpractice exposure, and this guide can help uncover risks.

Nov 18, 2012
Interactive Guide for Hospitals: Clinical Departments: Nursing Services
Nursing services can have areas of potential malpractice exposure, and this guide can help uncover risks.

Aug 04, 2012
Interactive Guide for Hospitals: Clinical Departments: Anesthesia
The anesthesia department can have areas of potential malpractice exposure, and this guide can help uncover risks.

Feb 08, 2012
Imperative Conversations: Managing Transitions of Care in the Hospital
Susan Shepard, MSN, RN, Director, Patient Safety Education.
Standardizing the handoff process has been shown to lower rates of perceived near-miss events and adverse outcomes.

Sep 01, 2011
Patient-Centered Communications: Building Patient Rapport
Wendy G. Anderson, MD, MS, Assistant Professor, Division of Hospital Medicine, University of California, San Francisco.
Communication skills can help hospitalists overcome barriers to care by ensuring a clear exchange of information that engenders patient trust.

Aug 01, 2010
Interactive Guide to Patient Safety for Hospitalists
The practice of hospital medicine can have areas of potential malpractice exposure, and this guide can help uncover risks.

Jun 22, 2010
Dilaudid-Related Morbidity and Mortality from Respiratory Depression
Howard Marcus, MD, FACP, a general internist in Austin, Texas, and chairman of The Doctors Company Physician Advisory Board in Texas.
Patient safety organizations and the FDA are focusing on ways to reduce patient harm from opioids.

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