The Cognitive Autopsy
January 9, 2017
Ever since the Institute of Medicine’s report To Err is Human was released in 2000, healthcare has seen a surge in patient safety initiatives. Analysis of medical errors has become increasingly widespread, with several different methods being used by hospitals and practitioners. Of these methods, I suggest that cognitive error analysis may prove to be…Read More
The Ultimate Loss Prevention Strategy: 4 Key Areas for Allocating Your Risk Management Budget
January 5, 2017
As the healthcare industry constantly evolves and “return on investment” remains a focus, it is becoming more imperative that risk managers allocate their budgets in areas that have the greatest impact on mitigating claims and litigation. Fortunately, The Sullivan Group has the luxury of working with many large, sophisticated, self-insured hospital systems as well as…Read More
The Focus of Patient Safety in 2017
January 3, 2017
healthcare industry will continue to have its radar locked on the issue of Patient Safety in 2017. Some of the targets and goals are only vaguely visible from the 30,000-foot level, while others are in clear focus on the ground before us. Depending on where you stand (or fly), opportunities abound to improve patient safety. Let’s take a forward…Read More
The Deceptive Pied Pipers: “Bedside Maneuvers” for Chest Pain
December 5, 2016
Malpractice claims related to the chief complaint of chest pain continue to plague clinicians. Foremost among these claims is the allegation of “missed MI,” which has now been expanded to include missed unstable angina as well as missed actual myocardial infarction. Although the evaluation of the adult with chest pain is fraught with many pitfalls,…Read More
Case: Failure to Diagnose Sepsis
November 28, 2016
Download audio of this case here. Download case as a PDF here. Sepsis is a regular visitor in the news as cases of flesh-eating bacteria and the dramatic speed with which victims deteriorate hit the headlines. The failure to diagnose sepsis remains a critical issue as delays in diagnosis significantly increase morbidity and mortality….Read More
Veterans Healthcare: What Civilian Physicians Need to Know
November 7, 2016
There are approximately 21 million living U.S. military veterans, and the Veterans Health Administration (VHA) is the largest health care system in the country. Despite its size, the VHA is overwhelmed by the need to provide healthcare to the huge number of eligible veterans. As a consequence of this high demand for care, Congress enacted…Read More
The Chief Complaint of Pain: A Pain for You and Your Patient!
October 31, 2016
A chief complaint of pain is one of the most common encountered by practitioners in any specialty. The pain may be acute or chronic. It may be located in the abdomen, chest, head or any other body part. It may be spontaneous in onset or may be due to an injury. It can range from…Read More
Cognitive Bias: The Near-Miss Case of “Lazy Boy”
October 3, 2016
Many diagnostic errors involve some degree of cognitive bias or errors; here is an actual case that illustrates this point. Case Presentation L.B. is a 46-year-old man with onset of illness 12 days prior that started with cold symptoms, sore throat, rhinorrhea, cough, and fever up to 100.7°F (38.1°C). Since then, he has been getting…Read More
Case: Failure to Diagnose Spinal Epidural Abscess
August 29, 2016
Failure to diagnose is the most common medical error in the practice of emergency, urgent care and primary care medicine. Spinal epidural abscess (SEA) is one of the most difficult conditions to diagnose, but there are common threads among failure to diagnose spinal epidural abscess cases. This case is presented to provide perspective and to increase our vigilance for catching this disabling and possibly even fatal diagnosis.
Confessions of an Antibiotic Abuser
May 23, 2016
The discoverer of penicillin, Sir Alexander Fleming, warned many decades ago that the “public will demand [the drug and]…then will begin an era…of abuses.” His prophecy has been realized, and I readily confess that I am guilty. During my 37 years in family practice and emergency medicine, I admit that I prescribed antibiotics for viral…Read More
