Report analyzes ED malpractice claims

Aug. 2, 2019
To reduce diagnostic risks in the ED, practitioners should focus on three key areas.

Coverys, a provider of medical professional liability insurance, announced the release of its latest Dose of Insight report, providing a data-driven look at the state of emergency care in the United States. The report analyzed more than 1,300 hospital emergency department (ED) closed Coverys claims across a five-year period from 2014-2018 to identify areas of greatest vulnerability during the ED episode of care – when and where risk is the highest, why, and for whom.

“The steps that will be taken by the patient long after the patient is transitioned to another department in the hospital, transferred to another facility, or discharged from the ED are impacted by the visit to the ED,” said Tara Gibson, ARe, CPCU, RPLU, Vice President of Risk Management at Coverys and co-author of the report, in a statement. “Paying close attention to specific risks in the ED can and will enhance patient care and safety overall.”  

The report identifies root causes of claims occurring in the ED. Key findings include:

To reduce diagnostic risks in the emergency department, practitioners should focus on three key areas:

· History and physical examination

· The diagnostic decision-making process

· Ensuring that the patient evaluation is ongoing throughout the ED episode of care

Implementing a formal medication management and safety program specific to the ED as 49 percent of all medication-related allegations involved antibiotics, opioids, and anticoagulants, Coverys said.

A key recommendation to mitigate diagnostic risk between history and physical evaluation of a patient is to implement clinical decision support tools, such as practice guidelines for high-risk presentations. Practitioners and staff should work to enhance communication handoffs at all transitions of care based on policy.

To lessen the risk of permanent or grave injury and/or death, it is recommended practitioners ensure patient evaluations are ongoing throughout the ED episode of care, communicating clearly and efficiently between lab and radiology professionals, ordering physicians, and other providers.

“Claims data should serve as signals for greater vigilance for all who contribute to the complex patient care ecosystem in the ED,” said Maryann Small, MBA, director of data governance & business analytics at Coverys and co-author of the report. “By learning from historic data and identifying the areas most prone to error, we can proactively reduce errors, improve patient safety, and decrease emergency department risk.”