Variables That Impact Medical Malpractice Claims Involving Plastic Surgeons in the United States.

BACKGROUND: Medical malpractice lawsuits contribute directly and indirectly to the cost of healthcare in the United States. Reducing medical malpractice claims represents an often unrecognized opportunity for improving both the quality and affordability of healthcare. OBJECTIVES: The aim of this study was to better understand variables of the informed consent process that may contribute to reducing malpractice claims in plastic surgery. METHODS: A prospective multiple choice questionnaire was distributed via email to all of the 1694 members of the American Society for Aesthetic Plastic Surgery (ASAPS) to evaluate attitudes and practices of informed consent in relation to medical malpractice. RESULTS: A total of 129 questionnaires obtained from plastic surgeons were eligible for analysis (response rate 7.6%). Respondents who provided procedure-specific brochures to their patients were significantly less likely to be sued for medical malpractice (P = 0.004) than those who did not. Plastic surgeons that participated in malpractice carrier-required courses on avoiding medical malpractice litigation had a similarly significantly reduced likelihood of lawsuits. (P = 0.04). CONCLUSIONS: Variables that may reduce malpractice claims, and thereby both improve the quality and affordability of healthcare, include: (1) the use of procedure-specific patient education brochures; and (2) physician participation in malpractice insurance carrier-required courses. These findings should be of interest to physicians, hospitals, and insurance companies.

[Analysis of problems connected with formation of new social security system for workers].

The authors analyzed problems of operating system of workers' social security, among them - insurance payments are provided on basis of experts'lists of productions, work types, occupations without consideration of real work conditions on specific workplaces, health state and performance of workers. Solutions of the problems are suggested.

Responsabilidad profesional en odontología / Professional liability in dentistry

Pese a que es difícil disponer de datos concretos sobre casuísticas de reclamaciones legales contra los dentistas, ya que los datos están muy fragmentados y son poco accesibles, disponemos de series como los datos del Colegio de Odontólogos y Estomatólogos de la I Región, que recoge todas las reclamaciones de los pacientes motivadas por una atención odontológica presentadas ante la Comisión Deontológica del Colegio. También disponemos de series de datos sobre sentencias judiciales debidas a reclamaciones sanitarias analizadas anteriormente en estudios de la Escuela de Medicina Legal de Madrid. Según los datos derivados de estas series, es evidente que la presión legal de los pacientes está incrementando. Así es y así será en el futuro, incluso de forma más acusada. Debemos por tanto, asumirlo e intentar adoptar las medidas que minimicen este riesgo, o limiten sus consecuencias en caso de producirse. ste es el objetivo principal del presente estudio (AU)

It is difficult to provide specific data on of legal claims against dentists on a case-by-case basis due to the data being highly fragmented and not usually accessible. However, we do have available data series, such as the one from the College of Dentistry and Stomatology of Region I, which includes all patient claims motivated by a dental care submitted to the College's Ethics Committee. We also have data series relating to court judgments due to health care claims that had been previously discussed on studies carried out by the School of Legal Medicine of Madrid.Based on data derived therefrom, it is clear that the legal pressure of patients is increasing. This is how it is and how it will be in the future, perhaps even more sharply. We must therefore accept it and try to adopt measures that minimize this risk or limit its consequences, should they occur (AU)

Policy statement­Professional liability insurance and medicolegal education for pediatric residents and fellows.

The American Academy of Pediatrics believes that pediatric residents and fellows should be fully informed of the scope and limitations of their professional liability insurance coverage while in training. The academy states that residents and fellows should be educated by their training institutions on matters relating to medical liability and the importance of maintaining adequate and continuous professional liability insurance coverage throughout their careers in medicine.

Estrategias para la seguridad del paciente. Manejo y administración de medicamentos / Strategies for patient safety in medication management and administration

La seguridad clínica supone uno de los grandes desafíos a los que se enfrentan en la actualidad las organizaciones sanitarias. Constituye un elemento clave en la calidad de los procesos asistenciales, entre los que destacan, por sus repercusiones, la seguridad en el manejo y la administración de medicamentos. Todos los profesionales sanitarios precisan, en el desarrollo de sus competencias, estrategias dirigidas a mejorar la seguridad en la gestión de la medicación, así como incorporar la prevención de errores y de acontecimientos adversos en sus programas formativos y asistenciales: sólo desde una adecuada planificación será posible aproximarse a la excelencia en el cuidado y a la seguridad clínica(AU)

Clinical safety is one of the greatest challenges currently facing healthcare organizations. Is a key element in the quality of care processes, care processes among which noted, by its impact, the medication management and administration. All health professionals need, in developing their professional competence, strategies to improve safety in medication management and to incorporate the prevention of errors and adverse events in their training programs and assistance: only from proper planning will be approached for excellence in clinical care and safety(AU)

Estrategia para mejorar la seguridad del paciente en un servicio de neonatología / Strategies to improve patient safety in a neonatology service

Fundamento. La práctica de la medicina, cada vez más compleja,aumenta el riesgo de acontecimientos adversos. La seguridad delpaciente en la atención sanitaria exige que esté libre de cualquiermal evitable.Objetivo. Analizar los errores detectados en un servicio de neonatología.Método. Se realiza un plan de estudio consistente en:1) Sesión clínica informativa sobre los errores asistenciales. 2) Creaciónde un sistema de notificación de errores anónimo. 3) Períodode reflexión para analizar los errores declarados de manera retrospectiva,con la finalidad de sensibilizar a todo el personal. 4) Creaciónde un grupo de estudio (dos médicos y dos diplomados en enfermería)para analizar de forma prospectiva los errores declaradosy establecer las estrategias necesarias para su prevención.Resultados. Durante el período de reflexión (15 días) se recogen28 errores agrupados en: errores de práctica asistencial (19), secundariosa factores humanos (7) y atribuibles al sistema (2).Durante los tres primeros meses del estudio prospectivo se notifican25 errores: de tratamiento (9), de comunicación (2), en determinacionesanalíticas (1), en la alimentación (2), de asepsia (1), deprocedimientos (7) y de identificación e información (3).Se analizan las causas que pueden producirlos, entre las cualesdestacan la falta de comunicación, la sobrecarga asistencial y lafalta de atención y rutina en el trabajo diario.Conclusiones. Debemos ser conscientes de que evitar el error está ennuestras manos. La notificación anónima del error y su análisis permiteponer en marcha medidas preventivas que repercutirán en unamejor calidad de la asistencia y seguridad de nuestros pacientes(AU)

Background. The increasingly complex practice of medicine augmentsthe risk of adverse events. The principles of patient safety inhealth care demand that the patient be spared of all avoidable harm.Objectives. To analyze the medical errors detected in a neonatologyservice.Methods. The following initiatives were implemented: 1) Trainingseminar on medical errors; 2) Implementation of a system for anonymousreporting of medical errors; 3) Review period to analyze anddiscuss the reported medical errors with the ultimate goal of raisingawareness among the personnel; 4) Establishment of a study team(two physicians and two nurses) to analyze prospectively medicalerrors and to develop the necessary preventive strategies.Results. Twenty-eight medical errors were recorded during the retrospectivereview period (15 days). The errors were grouped intothe following categories: treatment errors (19), errors secondary tohuman factors (7), and factors attributable to the system (2). Duringthe first three months of the prospective evaluation phase, 25 errorswere recorded, which corresponded to treatment (9), communication(2), laboratory errors (1), nutrition (2), antisepsis (1), procedures(7), and identification and information (3). The potential causes forthe errors were analyzed; among them were lack of communication,patient care overload, lack of attention, and daily routines.Conclusions. We must be aware that avoiding medical errors is inour hands. The anonymous reporting and its analysis allow for theimplementation of preventive measures that will lead to an improvementin patient care and patient safety(AU)

Professional indemnity insurance and the practice of medicine during bullfights in France.

Bullfighting can provoke strong reactions, for fans and laymen alike. Risks to the health of participants are inseparable from the spectacle. Organisers call on a medical team whose main task is to treat the bullfighter's injuries. Despite the special features of this medical practice doctors are not exempt from the possibility of the question of their liability being raised in the event of medical malpractice and large financial damages for the bullfighter if he is harmed. The doctor's public liability and professional indemnity insurance contract is therefore all the more important, in fact, this insurance covers damages for harm caused by the policy holder from the moment he is declared liable. In the statute of 4th March 2002, the French legislature brought in compulsory insurance for health professionals with the aim of achieving the best possible compensation for harm. While public liability and professional indemnity insurance is compulsory for doctors, the purpose of making this insurance compulsory is to cover compensation for harm suffered by the victim. In the case of bullfights, faced with insufficient legal regulation and the fact that more often than not the medicine practised in this field is on a voluntary basis, it might be interesting to offer some thoughts on the special features of the insurance contract that ought to be adapted to these extreme working conditions.