Safety Net
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Money for Safety: CRICO Pushes Hard to Prevent Medical Harm
June 30, 2014 09:00 - 10 minutes - 9.36 MBAmbulatory care is the focus of a dozen research and intervention projects at Harvard, totalling $2.1 million in 2014. Through a little-known patient safety grant program designed at Harvard's medical malpractice insurance company, CRICO, this year's projects range from tracking incidental lung nodule findings to helping reduce medication errors in children. Researchers describe their efforts to make care safer for patients and providers.
Q and A: Does Following a Clinical Guideline Help Later in Court?
May 29, 2014 16:20 - 5.93 MBIf health care providers use a clinical guideline when they evaluate a patient--and the patient has a bad outcome, are the providers legally free and clear?
Q & A: Does Following a Clinical Guideline Help Later in Court?
May 29, 2014 09:00 - 6 minutes - 5.93 MBIf health care providers use a clinical guideline when they evaluate a patient—and the patient has a bad outcome, are the providers legally free and clear? And what if they don’t follow the guidelines? It turns out to be an under-studied area of the law. So CRICO asked a leading defense attorney in Boston for some insights. Ellen Epstein Cohen is a partner with Adler, Cohen, Harvey, Wakeman, Guekguezian, LLP (Duration 6 min 28 seconds)
Risks All Their Own: Outpatient MDs See Patient Safety Hurdles
May 16, 2014 20:53 - 55.7 MB VideoIt's not quite the wild west, but the outpatient setting is a very different environment for patient safety than inpatient care. From across the Boston area, Harvard-affiliated physicians share the unique challenges and potential pathways to making care outside of the hospital safer for themselves and their patients.
Simulation Leader Touts Harvard Model
February 12, 2014 21:00 - 43.5 MB VideoAnesthesia safety pioneer Jeffrey Cooper speaks to Harvard's malpractice insurer about its own successes in patient safety over three decades, and how the link between CRICO and its hospital owners should be a model around the world.
Burnout Stalks Clinicians, Relief Explored
December 20, 2013 10:00 - 9 minutes - 8.3 MBWith widespread job burnout among clinicians, new studies look at ways to reduce the prevalence and the harm. CRICO interviews researchers and doctors who have left medicine, to share their insights and ideas.
Bold and Wrong: Doctors Often Too Confident with Diagnoses
October 07, 2013 09:00 - 8 minutes - 7.55 MBDoctors are less accurate with difficult diagnoses, yet research shows that their level of confidence in in their conclusions remains high in those cases. The situation is ripe for poor patient outcomes and medical malpractice litigation.
What Keeps These Physicians Up at Night?
September 09, 2013 22:09 - 124 MB VideoSick patients, self-doubt haunt physicians during off-hours.
Eyes Wide Open: Lessons from HMS Patient Safety Fellows
July 22, 2013 15:09 - 39.7 MB VideoHarvard fellows get intensive patient safety and quality training with CRICO.
Trying M&Ms for Outpatient Care
May 17, 2013 09:00 - 8 minutes - 7.64 MBMorbidity and mortality rounds are a time-honored method of learning from difficult hospital cases. Now that most care—and most lawsuits—happen in ambulatory settings, the Harvard teaching hospitals are trying M+Ms at their out-patient sites.
Physicians, Patient Safety Experts Dream of a Better EMR
April 10, 2013 16:15 - 38.3 MB VideoElectronic medical records are supposed to make care more efficient and less prone to mistakes that hurt patients. But physicians complain that EMRs are poorly organized and overly burdensome for caregivers. Is there a better system out there or is it time to dream big?
Physician Voice: Why and How Did You Become a Doctor?
January 30, 2013 16:45 - 38.3 MB VideoWhether it was from humble beginnings or high expectations or both, six Harvard physicians share how they decided to enter the healing profession. Their individual journeys are as unique as they are, and the path was not always straight.
Dana-Farber Docs, Nurses, Pharmacists, Techs Make Med Order Changes Safer
January 03, 2013 21:25 - 44.7 MB VideoMissing chemotherapy orders drop from 30 percent when patients arrive for treatment, down to two percent. This means patients aren't delayed and doctors aren't scrambling.
Accuracy at Issue in New MA Disclosure Law
December 05, 2012 17:25 - 6.95 MBDisclosure and apology after an adverse event is encouraged a lot, protected a little, and admissible if the clinician does a bad job of it.
Accuracy at Issue in MA Disclosure Law
December 05, 2012 10:00 - 7 minutes - 6.95 MBIn light of a 2012 disclosure mandate, clinicians are advised to resist the urge to reach a conclusion or speculate when telling patients about care that went wrong.
Residents Just as Liable as Attendings
August 30, 2012 09:00 - 6 minutes - 5.77 MBDoctors-in-training often mistakenly assume they can't be sued if they followed their superior's care plan, but a Boston defense attorney sets them straight.
Patient Safety Effort Looks to Nurses
June 18, 2012 19:00 - 18.5 MB VideoHarvard Hosts Conference for Nurses to Improve Patient Safety
Patient Safety Effort Looks to Nurses
June 18, 2012 19:00Harvard Hosts Conference for Nurses to Improve Patient Safety
Happy? MDs Rate Selves, Share Secrets
June 04, 2012 09:00 - 6 minutes - 6.39 MBAn online Medscape poll reveals which specialty has the most and least happy members, and CRICO interviews physicians to find out how they reduce stress and stay motivated.
Lucian Leape Grades the Patient Safety Movement (Part 2)
December 09, 2011 10:00 - 10 minutes - 7.07 MB(Part 2 of 2) The “Father of Patient Safety” reflects on the impact of the patient safety movement 10 years after the IOM report.... its successes…and its disappointments, from a national vantage point.
Lucian Leape Grades the Patient Safety Movement (Part 1)
June 16, 2011 09:00 - 9 minutes - 8.69 MB(Part 1 of 2) The “Father of Patient Safety” reflects on the impact of the patient safety movement 10 years after the IOM report.... its successes…and its disappointments, from a national vantage point.
Helping MDs Manage Prostate Care
February 03, 2011 16:00 - 8.28 MBA consent discussion with patients leads the PSA testing advice in a Harvard-generated tool to help primary care MDs manage prostate care.
Patient Status Changes "Trigger" Call to MD
November 10, 2010 16:00 - 4.58 MBStrong indicators that telling nurses when to call the doctor to the bedside reduce bad outcomes.
Patient Status Changes “Trigger” Call to MD
November 10, 2010 10:00 - 7 minutes - 6.45 MBStrong indicators that telling nurses when to call the doctor to the bedside reduce bad outcomes.
MD Empathy: Patient Perspective
August 09, 2010 16:00 - 4.58 MBPhysicians who express empathy get higher ratings by their patients on other care issues.
ED Informal Phone Consult Risk, Benefits
July 07, 2010 16:00 - 4.58 MBA physician and a lawyer discuss hazards of increasing the use of telephone advice from specialists.
Court Defines a New Harm for Losing a Chance at Survival in Massachusetts
April 02, 2010 16:00 - 4.58 MBEven if negligence didn't cause a patient's death, it may be compensable if it lessened the chance of survival.
Trying to Manage Outpatient Risks
February 16, 2010 15:00 - 8.65 MBAs more and more health care is provided in the ambulatory setting, the data from malpractice carriers show that more and more lawsuits get their start in the same setting.
Follow Up Falls on Physicians
October 23, 2009 18:00 - 5.45 MBHow are physician responsible when patients don't keep appointments or test results don't come back? Guest commentator John Cassidy, JD of Ficksman and Conley, Boston, MA.
Surgeons Fixing Communication Errors
September 14, 2009 18:00 - 6.36 MBResearch helps surgeons find ways to communicate better to prevent mistakes before, during, and after surgery.
Lost Evidence Loses Cases
June 05, 2009 18:00 - 4.68 MBFetal monitor strips, family history forms, and other non-medical record documents need to be preserved.
New Ambulatory Med Safety Rules
April 02, 2009 18:00 - 8.51 MBJoint Commission pushes new standards for reconciling lists and dosage of medications as patients change settings.
Openness and Caution in Disclosing Adverse Events
December 29, 2008 15:47 - 7.78 MBDuring the CRICO Surgical Summit in Boston, presenters and attendees explored the complexity of disclosure and apology. Panelist Philip Murray shared his perspective from 30 years as an active trial lawyer, and explained his support for open disclosure of adverse events—with some caveats.
How does a malpractice insurer improve patient care?
October 03, 2008 15:47 - 6.83 MBA Q and A with Jack Mc Carthy, president of Harvard's self-insurance medical malpractice company about guidelines, simulators, and the future of patient safety.
Adding Structure for Safer Hand-offs
July 18, 2008 15:47 - 6.4 MBNew research underscores the need, effectiveness of formalizing sign-out and discharge summary processes.
Medmal Defense Attorney: Documentation Saves Shoulder Dystocia Cases
March 19, 2008 15:47 - 8.14 MBBoston attorney Ted Mahoney tells obstetricians that a few notes about evaluating the pelvis before and during labor, and describing shoulder dystocia maneuvers will improve their chances if a lawsuit results from Erb's Palsy.
Part 3: Author Jerome Groopman, MD Discusses How Doctors Think
January 23, 2008 15:47 - 7.71 MBPart 3 of an address by best-selling author and Harvard Professor of Medicine Jerome Groopman to a patient safety symposium in Cambridge about the cognitive processes that lead physicians to make an incorrect diagnosis. Part 1 reviewed the ways physicians seek and process information on their way to making correct and incorrect diagnoses. Part 2 involved how how thinking errors occur. Part 3 looks at how to apply this knowledge to improving diagnoses in medical practice.
Part 2: Author Jerome Groopman, MD Discusses How Doctors Think
October 17, 2007 16:11 - 6.11 MBBest-selling author and Harvard Professor of Medicine Jerome Groopman speaks to a patient safety symposium in Cambridge about the cognitive processes that lead physicians to make an incorrect diagnosis. Part 1 reviewed the ways physicians seek and process information on their way to making correct and incorrect diagnoses. Part 3 will look at how to apply this knowledge to improving diagnoses in medical practice.
Part 1: Author Jerome Groopman, MD Discusses How Doctors Think
August 29, 2007 16:11 - 6.55 MBBest-selling author and Harvard Professor of Medicine Jerome Groopman speaks to a patient safety symposium in Cambridge about the ways physicians seek and process information on their way to making correct and incorrect diagnoses. Subsequent segments Part II and Part III will review how thinking errors occur, and how to apply this knowledge to improving diagnoses in medical practice.
MDs Walk, Learn in Patients' Shoes
May 31, 2007 16:12 - 5.81 MBWhen they became patients, these five physicians found that communication, attention to detail, and willingness to learn from error were all missing sometimes.
Adding Structure for Safer Handoffs
March 01, 2007 10:00 - 8 minutes - 3.98 MBEven the best care in medicine can be undermined when responsibility for the patient is transferred from one provider to the next. Hand-offs—both within the hospital and upon discharge—are the subject of increasing attention by malpractice insurers and patient safety researchers.
Best Practice: Making Sure You See Test Results
December 29, 2006 16:42 - 1.93 MBThe idea is how do you take that big wedge of paper and divide it to the appropriate provider and then how do you stratify what is urgent and what is not urgent?
Expanding Executive Walk Rounds to Ambulatory Sites
December 07, 2006 16:11 - 5.13 MBA technique for using senior hospital executives to improve patient safety is proving so successful that one hospital in Boston is now applying it to ambulatory sites.
What Not to Do After An Adverse Event
November 17, 2006 21:17 - 3.44 MBWhen a patient has an adverse medical event, it may or may not be the result of a medical error. Legal Editor Frank Reardon says that what you do after an adverse outcome has a lot to do with whether a patient wants to sue someone.
Missing Info Hinders Primary Care
November 01, 2006 20:15 - 5.21 MBResearch indicates primary care physicians often lack vital clinical information about patients during office visits. In a study conducted by University of Colorado researchers, physicians reported that one in seven appointments lacked significant clinical information about the patient, such as lab results, medications, and history.
Knowing the Limits of Expertise
October 18, 2006 16:11 - 9.22 MBIn their discussion of imperfection, Malcolm Gladwell and Dr. Atul Gawande will break down the thinking process, and examine how the various components impact health care providers. Gladwell and Gawande explore how "thinking without thinking" can hurt clinicians -- and patients -- and how it can help them.
Hurt by Medicine, Patients Talk
September 25, 2006 16:38 - 3.77 MBDr. Thomas Delbanco of Beth Israel Deaconess Medical Center and Harvard Medical School in Boston has blazed a trail in primary care and patient-centered care for more than three decades. In his film he aims to give viewers some sense of how we might sort out the experience of patients who've had things go wrong for them.
Surgeons and Error Disclosure
July 01, 2006 09:00 - 10 minutes - 9.16 MBWe found that the surgeons did the best in the area of explaining the medical facts of the event. But they struggled in other areas: taking responsibility for the event, apologizing for the event, and explaining to the patients about how recurrences of the error would be prevented.