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A Measure of Malpractice tells the story and presents the results of the Harvard Medical Practice Study, the largest and most comprehensive investigation ever undertaken of the performance of the medical malpractice system. The Harvard study was commissioned by the government of New York in 1986, in the midst of a malpractice crisis that had driven insurance premiums for surgeons and obstetricians in New York City to nearly $200,000 a year. The Harvard-based team of doctors, lawyers, economists, and statisticians set out to investigate what was actually happening to patients in hospitals and to doctors in courtrooms, launching a far more informed debate about the future of medical liability in the 1990s. Careful analysis of the medical records of 30,000 patients hospitalized in 1984 showed that approximately one in twenty-five patients suffered a disabling medical injury, one quarter of these as a result of the negligence of a doctor or other provider. After assembling all the malpractice claims filed in New York State since 1975, the authors found that just one in eight patients who had been victims of negligence actually filed a malpractice claim, and more than two-thirds of these claims were filed by the wrong patients. The study team then interviewed injured patients in the sample to discover the actual financial loss they had experienced: the key finding was that for roughly the same dollar amount now being spent on a tort system that compensates only a handful of victims, it would be possible to fund comprehensive disability insurance for all patients significantly disabled by a medical accident. The authors, who came to the project from very different perspectives about the present malpractice system, are now in agreement about the value of a new model of medical liability. Rather than merely tinker with the current system which fixes primary legal responsibility on individual doctors who can be proved medically negligent, legislatures should encourage health care organizations to take responsibility for the financial losses of all patients injured in their care.
This unique and engaging open access title provides a compelling and ground-breaking account of the patient safety movement in the United States, told from the perspective of one of its most prominent leaders, and arguably the movement’s founder, Lucian L. Leape, MD. Covering the growth of the field from the late 1980s to 2015, Dr. Leape details the developments, actors, organizations, research, and policy-making activities that marked the evolution and major advances of patient safety in this time span. In addition, and perhaps most importantly, this book not only comprehensively details how and why human and systems errors too often occur in the process of providing health care, it also promotes an in-depth understanding of the principles and practices of patient safety, including how they were influenced by today’s modern safety sciences and systems theory and design. Indeed, the book emphasizes how the growing awareness of systems-design thinking and the self-education and commitment to improving patient safety, by not only Dr. Leape but a wide range of other clinicians and health executives from both the private and public sectors, all converged to drive forward the patient safety movement in the US. Making Healthcare Safe is divided into four parts: I. In the Beginning describes the research and theory that defined patient safety and the early initiatives to enhance it. II. Institutional Responses tells the stories of the efforts of the major organizations that began to apply the new concepts and make patient safety a reality. Most of these stories have not been previously told, so this account becomes their histories as well. III. Getting to Work provides in-depth analyses of four key issues that cut across disciplinary lines impacting patient safety which required special attention. IV. Creating a Culture of Safety looks to the future, marshalling the best thinking about what it will take to achieve the safe care we all deserve. Captivatingly written with an “insider’s” tone and a major contribution to the clinical literature, this title will be of immense value to health care professionals, to students in a range of academic disciplines, to medical trainees, to health administrators, to policymakers and even to lay readers with an interest in patient safety and in the critical quest to create safe care.
When data from all aspects of our lives can be relevant to our health - from our habits at the grocery store and our Google searches to our FitBit data and our medical records - can we really differentiate between big data and health big data? Will health big data be used for good, such as to improve drug safety, or ill, as in insurance discrimination? Will it disrupt health care (and the health care system) as we know it? Will it be possible to protect our health privacy? What barriers will there be to collecting and utilizing health big data? What role should law play, and what ethical concerns may arise? This timely, groundbreaking volume explores these questions and more from a variety of perspectives, examining how law promotes or discourages the use of big data in the health care sphere, and also what we can learn from other sectors.
A theoretical and empirical analysis of the disposition of malpractice claims compares the actual outcomes with the legal standard of payment equal to damages, if, and only if, negligence occurred. An economic model of the settlement process assumes that the litigants attempt to maximize wealth, subject to the legal standards of liability and damage, and the costs of litigating. The model predicts that awards in settlements out of court will reflect the expected verdict, the probability of the plaintiff's winning, and the costs of going to court. The probability of the plaintiff's winning in settlement will also reflect the probability of winning in court, the size of the expected verdict, and the costs of going to court. Evidence from three malpractice claims surveys is consistent with the legal standard but departs in ways predicted by the model. Characteristics of the injury, the plaintiff, and the defense influence the outcome.
New Jersey Medical Malpractice Law provides a comprehensive, reader-friendly guide for all medical malpractice practitioners. Discretely focused subheadings allow users to precisely pinpoint relevant discussions, and footnotes highlight helpful resources and explanations. The chapters address issues as they commonly arise through the litigation process--from considering the elements of a malpractice cause of action, through investigating and preparing a case, to managing trial issues. Chapters are organized to address the issues as they commonly arise for the practicing attorney through the litigation process, from evaluation of potential claims and consideration of the elements of a malpractice cause of action, through pretrial investigation and case preparation, and finally, to the trial. Footnotes provide helpful explanatory information and resources, and add to the ease of finding answers quickly. Descriptive and discretely focused subheadings allow the reader to pinpoint precisely the discussion most relevant to his or her concerns. Practice pointers appear at the end of each chapter to aid in navigating complex medical malpractice cases. Chapters 1 and 2 discuss the first essential component of medical malpractice causes of action, the breach of a health care provider's duty of care or failure to obtain informed consent. Chapter 3 addresses related but distinct causes of action such as assault and battery, fraud, breach of contract, medical records alteration or destruction and sexual misconduct. Chapters 4 and 5 discuss the second and third essential components of malpractice cases, causation, and damages. Chapter 4 has been revised to keep pace with the evolving complex case law governing proof of proximate causation in cases involving pre-existing injuries, delayed cancer diagnoses and avoidable consequences. Chapter 5 discusses damages claims in general, and those particular to malpractice and wrongful death causes of action. Chapters 6 through 9 deal with issues related to pretrial proceedings and trial of malpractice cases, including pre-suit investigation of such claims. Chapter 7 has been revised to discuss the rapidly changing case law regarding the affidavit of merit, pretrial discovery, and presents an extremely thorough discussion of expert testimony, particularly as it evolves through the implementation of the New Jersey Medical Care Access and Responsibility and Patients First Act. These chapters also examine the pleadings, defenses including the statute of limitations, voir dire and jury charges specific to malpractice cases. Finally, Chapter 10 provides a thorough discussion of the federal and New Jersey statutes and regulations regarding electronic medical records. ,
Getting the right diagnosis is a key aspect of health care - it provides an explanation of a patient's health problem and informs subsequent health care decisions. The diagnostic process is a complex, collaborative activity that involves clinical reasoning and information gathering to determine a patient's health problem. According to Improving Diagnosis in Health Care, diagnostic errors-inaccurate or delayed diagnoses-persist throughout all settings of care and continue to harm an unacceptable number of patients. It is likely that most people will experience at least one diagnostic error in their lifetime, sometimes with devastating consequences. Diagnostic errors may cause harm to patients by preventing or delaying appropriate treatment, providing unnecessary or harmful treatment, or resulting in psychological or financial repercussions. The committee concluded that improving the diagnostic process is not only possible, but also represents a moral, professional, and public health imperative. Improving Diagnosis in Health Care, a continuation of the landmark Institute of Medicine reports To Err Is Human (2000) and Crossing the Quality Chasm (2001), finds that diagnosis-and, in particular, the occurrence of diagnostic errorsâ€"has been largely unappreciated in efforts to improve the quality and safety of health care. Without a dedicated focus on improving diagnosis, diagnostic errors will likely worsen as the delivery of health care and the diagnostic process continue to increase in complexity. Just as the diagnostic process is a collaborative activity, improving diagnosis will require collaboration and a widespread commitment to change among health care professionals, health care organizations, patients and their families, researchers, and policy makers. The recommendations of Improving Diagnosis in Health Care contribute to the growing momentum for change in this crucial area of health care quality and safety.
n January 2005, President Bush declared the medical malpractice liability system out of control.The president's speech was merely an echo of what doctors and politicians (mostly Republicans) have been saying for years - that medical malpractice premiums are skyrocketing due to an explosion in malpractice litigation. Along comes Baker, direct...

Medical Malpractice

United States. Department of Health, Education, and Welfare. Secretary's Commission on Medical Malpractice

Published: 1973

Total Pages: 884


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