Blog & Articles

[9 MIN READ]

Updated: March 18, 2020

Working on the front lines of an obstetric unit is fraught with vulnerability and uncertainty during these early stages of the unprecedented COVID-19 pandemic. Your obstetric team has never before been so codependent in maintaining safety for you and your entire community. Arming yourself and teammates with the most current knowledge will help to keep you, your family, and your patients as safe as possible.

Since much is unknown about the novel coronavirus, review of daily updates and evolving information from our health experts is important. Staying knowledgeable and well-informed will require ongoing review of CDC updates and government notifications, as well as guidelines from our own health professionals like AWHONN and ACOG. All healthcare providers and frontline OB staff should work together to help ensure that everyone is practicing using the most current information. Teamwork along with shared learning will help everyone stay informed.

To keep yourself and your obstetric peers current on COVID-19, The Sullivan Group is providing this summary of recent information from the CDC and ACOG (last updated March 18, 2020).

[3 MIN READ]

As concerns for COIVD-19 continue to escalate in many areas of the country, it is imperative that triage staff remain alert to their role in early identification of potential infection. 

[3 MIN READ]

Apology laws have always been a quandary. I have repeatedly said they make docs feel more comfortable about apology but have little legal value. Most would assume apology laws reduce medial malpractice claims but a study by Stanford Law Review shows that this is not the case. In states with apology laws, non-surgeon physicians saw higher rates of medical malpractice lawsuits and dollars paid out. Defense lawyers should want to use the evidence created in a disclosure process if a case goes to trial.

[3 MIN READ]

Do your clinicians have a plan for how to address a patient’s family if a medical error occurs?

Consider this true case that was shared with me by a California risk manager – a routine test that goes tragically wrong:

"Mrs. Woods is a 53-year old woman who goes to the hospital for a CT-guided biopsy of the liver. The staff assures Mrs. Woods the test is ‘no big deal’ so she tells her husband to go across the street to do some shopping during the test. The clinical team assures Mr. Woods they will call him when the test is complete. Mr. Woods is standing in Macy’s when his cell phone rings … he answers to hear a nurse frantically screaming, 'Come quickly!' Mr. Woods races across the street to the hospital where he learns his wife is dead."

After reading this case in my training programs, I challenged my healthcare audiences with the following: 

[6 MIN READ]

Is there really such a thing as a normal day on the OB unit? Highly doubtful. Unpredictability and uncertainty loom from the beginning of your shift to the end. But what if you could achieve some control over your day and try to decrease both your personal stress level and the stress of those in your immediate environment? While keeping your day 100% stress-free may not be possible, at least lowering the stress level for yourself and others is achievable and can help you to maintain stellar composure through the most grueling of patient scenarios.

[7 MIN READ]

As heightened U.S. maternal morbidity and mortality rates gain national attention, AWHONN and ACOG, as well as state perinatal quality collaboratives, notably California, have emphasized that hospitals need to focus on improving outcomes with specific attention to the leading causes of maternal mortality.

The RSQ® Assessment – Obstetrics provides the framework for the creation of a comprehensive obstetrics safety program within your organization, as well as the foundation for an obstetric culture of safety surrounding the key drivers of maternal mortality and morbidity.

[3 MIN READ]

The incidence of spinal epidural abscess (SEA) has doubled in the past 2 decades due to the epidemic of MRSA infections, the spread of IV drug use, and the increased number of spinal and vascular access procedures. Delayed or missed diagnosis of SEA leads to profound disability or death; lawsuits in this arena are exceptionally costly.

[3 MIN READ]

Patients with abdominal pain are a common and constant challenge to practitioners in primary care, pediatrics, urgent care, and emergency medicine. During the period of 2006 to 2014, there was a 32% increase in ED visits for the complaint of abdominal pain, so that as of 2014, abdominal pain is the most frequent diagnosis for an ED visit. The clinical presentations may be confusing; the differential diagnoses for abdominal pain are myriad; and not all patients with abdominal pain will have a serious underlying etiology.

Medical errors and litigation involving the care of patients with abdominal pain are all too frequent and can be costly for both patients and physicians. The cornerstone of high-quality, defensible care consists of a systematic approach coupled with compulsive documentation. The essence of liability reduction in the care of patients with abdominal pain is to construct a medical record that provides a thorough, clear and logical explanation for your thoughts and actions. Here are a few key items to address in the chart documentation.

[4 MIN READ]

Child physical abuse exists in all corners of the country and affects children of all ages, ethnicities, and socioeconomic groups.

Consider the following facts:

• More than 2 million reports of suspected child maltreatment are investigated each year in the United States. These reported cases represent only a fraction of the abuse that children experience.
• Child maltreatment includes neglect and abuse that may be physical, sexual, emotional, or psychological.
• There are more than 650,000 substantiated cases of child maltreatment annually.
• About 18% of child maltreatment involves physical abuse.
• More than 1,500 children die each year due to abuse or neglect. 80% of these deaths are children under 4 years old.
• The incidence of child abuse is underestimated since 17% of adults in the U.S. report that they were physically abused as a child.

[6 MIN READ]

Physicians, nurses and other “healers” have had special relationships with patients for centuries. This unique bond between those who provide medical treatment and those who receive their care is currently being endangered by a massive and impersonal healthcare delivery system that is becoming more dependent on automation and technology with each passing year. The good news is that patient attitudes, impressions, and subsequent compliance with treatment plans can be positively influenced when healthcare professionals improve their communication skills with their patients.

Studies show that there is a clear relationship between high patient satisfaction and healthcare organizations that provide safe, quality care. A report by Health Grades (May 2012) noted that hospitals that were ranked (by patients) in the top percentages for nursing and physician communication had lower rates of adverse patient safety events. For example, bed sores occurred approximately 46% more frequently in hospitals that patients had ranked in the lowest 10% for provider communication.