Closed Claim Studies Offer Valuable Insight into Patient Safety, Malpractice Defense

Closed Claim Studies Offer Valuable Insight into Patient Safety, Malpractice Defense

With approximately 78,000 members, The Doctors Company is the largest physician-owned medical malpractice insurer in the United States. And in recent decades, the company has been making the best possible use of that position by conducting a series of in-depth studies on closed claims within their members’ practices.

With the goal of alerting physicians and their practices to the most common risk factors in any given medical specialty, these closed claim studies are useful tools for improving patient safety standards. In the process, they can also be instrumental in helping healthcare providers and facilities establish a more robust malpractice defense strategy.

“Our data-driven approach enables us to anticipate emerging trends and deliver innovative patient safety tools to help our members reduce risk,” the company states in one such study. “And when a member's reputation and livelihood are attached, insights gained from these studies help us provide the most aggressive defense in the industry.”

As a partner with The Doctors Company — with whom we offer free CME courses to our network of locum doctors, dentists, nurses and clinicians (more details here) — Staff Care’s professionals have exclusive access to this in-depth closed claim study data, giving us the power to impart to our clients a high-level understanding of patient safety standards and the intricacies of malpractice defense.

Closed Claim Studies Reveal Consistencies in Patient Safety Complaints

In its emergency medicine closed claim study, The Doctors Company establishes the four most common allegations (with “diagnosis related,” i.e., “failure, delay or wrong diagnosis," topping the list).

"Physician reviewers noted that clinicians sometimes failed to establish a differential diagnosis or to use clinical information that was available to them that should have prompted further investigation,” the report states. “This resulted in a failure to address abnormal findings and order diagnostic tests. A narrow diagnostic focus also influenced clinician decision-making when patients were discharged prematurely.”

Similarly, in its hospital medicine closed claim study, the company found that the most common patient allegation was also diagnosis related, though at a lower percentage than with emergency medicine (at 36%, versus 52%).

"Claims arising from hospitalist care are more likely to have a higher injury severity than other physician specialties,” the authors state. “Hospitalists manage high-acuity patients, have limited access to patients’ past medical histories, and often receive patients with serious conditions.

“These situations require thorough assessments, comprehensive testing, quick diagnoses, timely referrals, and rapid initiation of treatment," the authors add, noting that such factors create unique challenges for establishing patient safety standards applicable to hospitalists.

In its internal medicine study — perhaps the most detailed of its closed claim studies — The Doctors Company found that the most common patient allegation was, again, diagnosis related, commanding 39% of all claims. "Inadequate patient assessments, which contributed to patient injury in diagnosis-related claims, were found in 56 percent of these claims," the authors note.

Similar results are available in closed claim studies for anesthesia, cardiology, obstetrics, orthopedics, and plastic surgery, among others (many ongoing). The Doctors Company’s approach begins by reviewing patients' allegations, for insight into the “perspective and motivations for filing claims and lawsuits.” After that, physician and nurse reviewers examined patient injuries “to understand the full scope of harm."

“Physician experts for both the plaintiffs/patients and the defendants/physicians reviewed claims and conducted medical record reviews,” the company adds. “Our clinical analysts drew from these sources to gain an accurate and unbiased understanding of actual patient injuries.

“We are fiercely committed to relentlessly defending, protecting, and rewarding our members with the industry’s most aggressive claims defense, unrivaled protection, and innovative rewards.”

And we’re fully on board with that sentiment. We’re happy to offer our valued partners more insight into how patient safety standards overlap with a long-term strategic staffing plan. Simply contact us today and we’ll be happy to fill in the blanks.

For more data of this nature, including a comprehensive suite of online resources that features a self-paced interactive guide, visit The Doctors Company website.

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