Analysis of emergency medicine incidents and completed closed claims /[Theses] by Anne Marie Oglesby

Hdl Handle:
http://hdl.handle.net/10147/79833
Title:
Analysis of emergency medicine incidents and completed closed claims /[Theses] by Anne Marie Oglesby
Other Titles:
A dissertation submitted as partial fulfilment of the Degree of Master of Science in Health Care (Risk Management and Quality) with the Department of Forensic and Legal Medicine, School of Medicine and Medical Sciences, University College Dublin
Authors:
Oglesby, Anne Marie
Affiliation:
State Claims Agency - Clinical Indemnity Scheme
Publisher:
University College Dublin (UCD)
Issue Date:
Mar-2009
URI:
http://hdl.handle.net/10147/79833
Item Type:
Thesis
Language:
en
Description:
Within the public health service in the Republic of Ireland, the specialty of emergency medicine accounts for 4.7% of all adverse patient events reported onto the national clinical incident reporting system. However, emergency medicine is responsible for 15% of all medical negligence claims. The focus of this study was to review those claims that were settled by clinical claims managers in the Clinical Indemnity Scheme. Settled claims are those claims that were settled out of court and as such may offer opportunities for learning. Summary: Of all the closed claims (n=203), 53.6% did not proceed to claim. 25% were settled out of court. Of these, 59% were as a result of a diagnosis event; 94% as a result of failure to diagnose. The in-depth analysis of these claims indicates that 74.2% were fracture and musculo-skeletal related. Closed claims analysis revealed that the SHO grade was most likely to be involved in a claim at 74% versus registrar at 14% and consultant at 8%. Failure to diagnose fractures occurred most commonly in the SHO grade at 32%. 57% of these errors in the SHO grade had a primary root cause specifically related to staff skill / knowledge / competence. Main Conclusions: In the specialty of emergency medicine missed diagnosis is the most common type of claim. SHO’s were most likely to be involved in a claim. The predominant type of claim was due to missed fractures, therefore an increased emphasis on-going education and feedback regarding accurate radiological interpretation is essential for all emergency medicine rotations. Follow up with more senior colleagues, timely radiologist reviews and comprehensive reporting and follow up mechanisms need to be developed between radiology and emergency medicine. A standardised reporting system is crucial so that missed fractures identified by other personnel (i.e. radiology consultant) are immediately alerted to the relevant emergency department physician for immediate action and follow up.
Keywords:
EMERGENCY MEDICINE; CLAIMS

Full metadata record

DC FieldValue Language
dc.contributor.authorOglesby, Anne Marie-
dc.date.accessioned2009-09-04T13:06:27Z-
dc.date.available2009-09-04T13:06:27Z-
dc.date.issued2009-03-
dc.identifier.urihttp://hdl.handle.net/10147/79833-
dc.descriptionWithin the public health service in the Republic of Ireland, the specialty of emergency medicine accounts for 4.7% of all adverse patient events reported onto the national clinical incident reporting system. However, emergency medicine is responsible for 15% of all medical negligence claims. The focus of this study was to review those claims that were settled by clinical claims managers in the Clinical Indemnity Scheme. Settled claims are those claims that were settled out of court and as such may offer opportunities for learning. Summary: Of all the closed claims (n=203), 53.6% did not proceed to claim. 25% were settled out of court. Of these, 59% were as a result of a diagnosis event; 94% as a result of failure to diagnose. The in-depth analysis of these claims indicates that 74.2% were fracture and musculo-skeletal related. Closed claims analysis revealed that the SHO grade was most likely to be involved in a claim at 74% versus registrar at 14% and consultant at 8%. Failure to diagnose fractures occurred most commonly in the SHO grade at 32%. 57% of these errors in the SHO grade had a primary root cause specifically related to staff skill / knowledge / competence. Main Conclusions: In the specialty of emergency medicine missed diagnosis is the most common type of claim. SHO’s were most likely to be involved in a claim. The predominant type of claim was due to missed fractures, therefore an increased emphasis on-going education and feedback regarding accurate radiological interpretation is essential for all emergency medicine rotations. Follow up with more senior colleagues, timely radiologist reviews and comprehensive reporting and follow up mechanisms need to be developed between radiology and emergency medicine. A standardised reporting system is crucial so that missed fractures identified by other personnel (i.e. radiology consultant) are immediately alerted to the relevant emergency department physician for immediate action and follow up.en
dc.language.isoenen
dc.publisherUniversity College Dublin (UCD)en
dc.subjectEMERGENCY MEDICINEen
dc.subjectCLAIMSen
dc.titleAnalysis of emergency medicine incidents and completed closed claims /[Theses] by Anne Marie Oglesbyen
dc.title.alternativeA dissertation submitted as partial fulfilment of the Degree of Master of Science in Health Care (Risk Management and Quality) with the Department of Forensic and Legal Medicine, School of Medicine and Medical Sciences, University College Dublinen
dc.typeThesisen
dc.contributor.departmentState Claims Agency - Clinical Indemnity Schemeen
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