Avoiding Errors in Adult Medicine

Informationen zum Autor Ian P. Reckless is Consultant Physician and Assistant Medical Director, Oxford University Hospitals NHS TrustD. John M. Reynolds is Consultant Physician and Clinical Pharmacologist, Oxford University Hospitals NHS TrustSally Newman is a Solicitor and Head of Legal Services, Oxford University Hospitals NHS TrustJoseph E. Raine is Consultant Paediatrician, Whittington Hospital, LondonKate Williams is Partner, RadcliffesLeBrasseur Solicitors, LeedsJonathan Bonser is Consultant in the Healthcare Department of Fishburns LLP, Solicitors, London, and former Head of the Claims and Legal Services, Department of the Leeds office of the Medical Protection Society Klappentext Some of the most important and best lessons in a doctor's career are learnt from mistakes. However, an awareness of the common causes of medical errors and developing positive behaviours can reduce the risk of mistakes and litigation.Written for junior medical staff and consultants, and unlike any other clinical management title available, Avoiding Errors in Adult Medicine identifies and explains the most common errors likely to occur in an adult medicine setting - so that you won't make them.The first section in this brand new guide discusses the causes of errors in adult medicine. The second and largest section consists of case scenarios and includes expert and legal comment as well as clinical teaching points and strategies to help you engage in safer practice throughout your career. The final section discusses how to deal with complaints and the subsequent potential medico-legal consequences, helping to reduce your anxiety when dealing with the consequences of an error.Invaluable during the Foundation Years, Specialty Training and for Consultants, Avoiding Errors in Adult Medicine is the perfect guide to help tackle the professional and emotional challenges of life as a physician. "My experience as an expert witness in clinical negligence cases, MPTS Panel chairman, medical adviser to a Public Inquiry and as a sometimes commissioned independent reporter on adverse incidents tells me that these are excellent books, valuable for all clinicians, not just those in high-risk specialties; and all NHS managers involved in maintaining or improving the quality of care. The case vignettes, alone, are useful source material for teaching medical trainees on what can go wrong and how to deal with it when it does." ( Harvey Marcovitch, Clinical Risk journal ) Zusammenfassung Some of the most important and best lessons in a doctor s career are learnt from mistakes. However, an awareness of the common causes of medical errors and developing positive behaviours can reduce the risk of mistakes and litigation. Inhaltsverzeichnis Contributors  viii Preface  ix Abbreviations  x Introduction  XI Part 1 Section 1: Errors and their causes 1 A few words about error 1 Learning from system failures - the vincristine example  1 Evidence from the NHSLA database 8 The patient consultation 10 Failure to identify a sick patient  12 Inability to competently perform practical procedures 13 Failure to check test results or act on abnormal findings  14 Prescribing errors 14 Sources of error in the case of vulnerable adults 16 References and further reading  18 Section 2: Medico-legal aspects 19 Error in a legal context 19 Negligence  19 Clinical negligence 20 Issues around consent 23 An attorney refusing treatment 27 A patient without capacity refusing treatment 27 Emergency treatment 28 Deprivation of liberty safeguards 29 Part 2 Clinical cases v Introduction  35 Section 1: Civil liability  negligence and compensation  36 Case 1 A shaky excuse 37 Case 2 Making matt...

List of contents

Contributors, viii
 
Preface, ix
 
Abbreviations, x
 
Introduction, xi
 
Part 1
 
Section 1: Errors and their causes, 1
 
A few words about error, 1
 
Learning from system failures - the vincristine example, 1
 
Evidence from the NHSLA database, 8
 
The patient consultation, 10
 
Failure to identify a sick patient, 12
 
Inability to competently perform practical procedures, 13
 
Failure to check test results or act on abnormal findings, 14
 
Prescribing errors, 14
 
Sources of error in the case of vulnerable adults, 16
 
References and further reading, 18
 
Section 2: Medico-legal aspects, 19
 
Error in a legal context, 19
 
Negligence, 19
 
Clinical negligence, 20
 
Issues around consent, 23
 
An attorney refusing treatment, 27
 
A patient without capacity refusing treatment, 27
 
Emergency treatment, 28
 
Deprivation of liberty safeguards, 29
 
Part 2 Clinical
 
Section 1: Civil liability, negligence and compensation, 36
 
Case 1 A shaky excuse, 37
 
Case 2 Making matters worse, 40
 
Case 3 Chase the bloods, 43
 
Case 4 Falling asleep en-route, 45
 
Case 5 Bad luck or bad judgement, 48
 
Case 6 An opportunity missed, 51
 
Case 7 Better late than never, 53
 
Case 8 Man down, 56
 
Case 9 Cry wolf, 58
 
Case 10 Not a leg to stand on, 60
 
Section 2: Unexpected death: the coronial system and clinical risk management, 62
 
Case 11 A doubly bad outcome, 63
 
Case 12 Difficulty with diarrhoea, 66
 
Case 13 A flu-like illness, 69
 
Case 14 Falling standards, 72
 
Section 3: An approach to complaints, 74
 
Case 15 A woman with chest pain, 75
 
Case 16 Clumsiness, 78
 
Section 4: Competence, 80
 
Case 17 A change in plan, 81
 
Case 18 Starving to death, 85
 
Case 19 An irregular presentation, 88
 
Case 20 Irrational but not incompetent, 90
 
Section 5: Restraint, 92
 
Case 21 A challenging discharge, 93
 
Case 22 Ruling out the organic, 96
 
Case 23 Endless wandering, 99
 
Case 24 Can you please take these handcuffs off?, 101
 
Case 25 Own worst enemy, 103
 
Section 6: Miscellaneous, 105
 
Case 26 All eggs in one basket, 106
 
Case 27 A major mix-up, 108
 
Case 28 Under the radar, 110
 
Case 29 A cantankerous recluse, 113
 
Case 30 Keep an open mind, 115
 
Case 31 Healthcare acquired infection?, 117
 
Case 32 Backing the wrong horse, 120
 
Case 33 A surprising turn of events, 122
 
Case 34 Funny turn, 125
 
Part 3 Investigating and dealing with errors
 
1 Introduction, 127
 
2 How hospitals try to prevent adverse errors and their recurrence, 127
 
3 The role of hospital staff, 132
 
4 The role of external agencies, 134
 
5 Hospital investigations, 137
 
6 Legal advice - where to get it and who pays, 141
 
7 External investigation of errors and incidents, 143
 
8 The role of the doctor, 160
 
9 Presenting oral evidence, 162
 
10 Emotional repercussions, 164
 
11 Conclusion, 164
 
References, 164
 
Index, 167

Report

"My experience as an expert witness in clinical negligence cases, MPTS Panel chairman, medical adviser to a Public Inquiry and as a sometimes commissioned independent reporter on adverse incidents tells me that these are excellent books, valuable for all clinicians, not just those in high-risk specialties; and all NHS managers involved in maintaining or improving the quality of care. The case vignettes, alone, are useful source material for teaching medical trainees on what can go wrong and how to deal with it when it does." ( Harvey Marcovitch, Clinical Risk journal )

Product details

• Authors: Jonathan Bonser, Bonser Jonathan, Sally Newman, Sally et al Newman, Joseph E. Raine, Raine Joseph E., Ia Reckless, Ian Reckless, Ian (Oxford University Hospitals Nhs Tru Reckless, Ian P. Reckless, Ian Reynolds Reckless, Ian/ Reynolds Reckless, Ip Reckless, Reckless Ian, D Joh Reynolds, D John Reynolds, D. John Reynolds, D. John M. Reynolds, Reynolds D. John, Kate Williams
• Publisher: Wiley, John and Sons Ltd
• Languages: English
• Product format: Paperback / Softback
• Released: 25.01.2013
• EAN: 9780470674383
• ISBN: 978-0-470-67438-3
• No. of pages: 192
• Series: AVE - Avoiding Errors; Avoiding Errors; AVE - Avoiding Errors
• Subjects: Natural sciences, medicine, IT, technology > Medicine > Clinical medicine; Medizin, Medical Science, Allgemeine u. Innere Medizin, General & Internal Medicine