Emergency Department Malpractice Claims Analyzed in New Coverys Report

Report provides data-driven insight into the root causes of claims occurring in the ED

Boston, MA - June 25, 2019 - Coverys, a leading provider of medical professional liability insurance, released its latest Dose of Insight report, providing a data-driven look at the state of emergency care in the United States. The report analyzed more than 1,300 hospital emergency department (ED) closed Coverys claims across a five-year period from 2014-2018 to identify areas of greatest vulnerability during the ED episode of care – when and where risk is the highest, why, and for whom.
 
Every year in the United States, there are more than 138 million visits to the ED. Care and treatment in the ED have the potential to impact a patient’s entire medical journey including the patient’s decision to seek specialty care or follow up with a primary care provider.
 
“The steps that will be taken by the patient long after the patient is transitioned to another department in the hospital, transferred to another facility, or discharged from the ED are impacted by the visit to the ED,” said Tara Gibson, ARe, CPCU, RPLU, vice president of risk management at Coverys and co-author of the report. “Paying close attention to specific risks in the ED can and will enhance patient care and safety overall.”   

The report identifies root causes of claims occurring in the ED. The authors provide data-driven recommendations for reducing risk and improving outcomes related to the emergency department episode of care – including new processes, practices, communication, and training.

Key findings from the report include:
  • To reduce diagnostic risks in the emergency department, practitioners should focus on three key areas:
    • History and physical examination.
    • The diagnostic decision-making process.
    • Ensuring that the patient evaluation is ongoing throughout the ED episode of care.
  • Implementing a formal medication management and safety program specific to the ED as 49% of all medication-related allegations involved antibiotics, opioids, and anticoagulants.
  • A key recommendation to mitigate diagnostic risk between history and physical evaluation of a patient is to implement clinical decision support tools, such as practice guidelines for high-risk presentations. Practitioners and staff should work to enhance communication handoffs at all transitions of care based on policy.
  • To lessen the risk of permanent or grave injury and/or death, it is recommended practitioners ensure patient evaluations are ongoing throughout the ED episode of care, communicating clearly and efficiently between lab and radiology professionals, ordering physicians, and other providers. 
 
“Claims data should serve as signals for greater vigilance for all who contribute to the complex patient care ecosystem in the ED,” said Maryann Small, MBA, director of data governance & business analytics at Coverys and co-author of the report. “By learning from historic data and identifying the areas most prone to error, we can proactively reduce errors, improve patient safety, and decrease emergency department risk.”

This is the fourth report in Coverys’ Dose of Insight series, which has previously explored medication errordiagnostic accuracy, and obstetrics. The report, co-authored by Tara Gibson, vice president of risk management; Ann Burke, RN, CPHRM, CPPS, director of risk management; Maryann Small, director of data governance & business analytics; and Solveig Dittmann, RN, BA, BSN, CPHRM, senior risk specialist, is available for download on the Coverys website here.