Healthcare Risk Management – December 1, 2009
December 1, 2009
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Rogue nurse highlights dilemma over blame vs. root cause
It has been 10 years since the Institute of Medicine's report To Err is Human revolutionized patient safety by encouraging a focus on systemic flaws that allow errors to occur, rather than blaming the individual who actually made the mistake. From the start, however, risk managers have struggled with the idea of how to avoid a "culture of blame" without letting people get away with extraordinary negligence or deliberate misbehavior. -
Hold people responsible, even when avoiding blame
Risk managers have struggled for years to reconcile the notion of a "no-blame" culture with incidents in which - systemic problems or not - one individual clearly committed a willful violation of procedure. Embracing the philosophy is easier when the evidence suggests the health care worker made a mistake, even a failure of attention or diligence, but willful and even malicious misbehavior seems to pose a dilemma. -
Hospital quick to notify patients of infection threat
Once administrators at Broward General Medical Center in Fort Lauderdale, FL, discovered that a nurse had exposed patients to serious infections by reusing disposable tubing and IV bags, the hospital acted quickly to notify those affected and arrange testing. -
Wi-Fi needs tight security to avoid problems
Free wireless Internet access, known as Wi-Fi, is offered in many retail establishments and public buildings, allowing customers and visitors to access the Internet with their laptop computers and cell phones. But as health care providers venture into offering this convenience, questions arise about network security and possible breaches of sensitive data. -
Data mining can yield treasures for RM
Data are everywhere these days, and you can put it to work for you. Health care providers accumulate huge volumes of data, and some risk managers are learning that the strategic use of that information can improve patient safety, reduce costs, and reduce liability risks. -
Protect key data with digital security
With the Obama administration offering up to $19 billion in incentives as part of the federal stimulus package for medical providers to go digital, and the goal for every American to have an electronic health record by 2014, the potential for data breaches dramatically increases. -
Needlestick prevention still needs attention, diligence
Needlestick injuries were a hot topic in years past, when the health care industry took notice of the risk posed by exposure to hepatitis and HIV in the workplace, but now it is easy to assume that you've taken all the right precautions and lowered the risk as much as possible. But have you really? -
Nurses, housekeeping staff at most risk from needles
The Centers for Disease Control and Prevention in Atlanta reports that data from 60 U.S. hospitals show health care workers suffer about 384,325 sharps and percutaneous injuries annually. These findings were presented recently at the International Conference on Nosocomial and Healthcare-Associated Infections in Atlanta. -
Legal Review & Commentary: Failure to timely diagnose endometrial cancer results in death: $1.1M PA verdict
A woman presented at her gynecologist's office with complaints of post-menopausal bleeding. The gynecologist ordered a pelvic ultrasound, which displayed abnormal findings. -
Legal Review & Commentary: Failure to timely diagnose results in $5M verdict
A woman underwent a hysterectomy. During the procedure, an endotracheal tube was inserted, which resulted in a perforation of the woman's esophagus.