Use standard data forms, allow narratives
When conducting your own closed claim review, follow this advice for the best results:
- Develop a good standardized data collection form. This can make or break a closed claim review, says F. Dean Griffen, MD, FACS, a surgeon in Shreveport, LA, and the immediate past chair of the American College of Surgeons (ACS) Patient Safety and Liability Committee. Some templates are available from insurers and professional organizations, but the exact makeup of your form may depend on your organization and unique concerns. Be wary of simply using the data collection forms provided by insurers because their focus is exclusively on liability, not necessarily patient safety, Griffen says.
- Allow reviewers to provide a narrative. No matter how well you devise the standardized form, reviewers should have a way to provide additional information. This is the section in which you often find the most useful information, Griffen says. The ACS data collection form was revised in response to the narratives accompanying the first 70 claim reviews.
- Don't be afraid to review the "unsolvable" problems.
"Some problems can't be solved by flipping a switch, but you still need to know what's going on with it," says Cynthia Marcotte Stamer, JD, an attorney with the law firm of Glast Phillips in Dallas. "Falls are going to happen, and mistakes will be made. Don't get the idea that you shouldn't even look at a problem if you don't know how to fix it."
In those cases, document your efforts to move in the right direction. If there are particular obstacles to addressing the problem, such as exorbitant costs, document that clearly. As long as it is a reasonable explanation and not just an excuse, that documentation can only help you in the future, Stamer says.
"Not only does documenting those obstacles mitigate your risk, but it also gives you a pathway for moving forward," she says. "You can revisit those obstacles later and look for a new way around them."
When conducting your own closed claim review, follow the advice mentioned in this article for the best results.You have reached your article limit for the month. Subscribe now to access this article plus other member-only content.
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