Video
The RAP Process was a Gift
Jul 01, 2015
Duration: 57 seconds
Pat Folcarelli, Director of Patient Safety at Beth Israel Deaconess Medical Center, talks about the opportunity the RAP provided for tapping into feedback from colleagues to impact changes.
Episodes
Recent Episodes from the MedMal Insider Series
Med Error Leads to Change in L&D Policy
Podcast
May 14
A 30-year-old woman experiencing her first pregnancy, presented to the Labor and Delivery unit. She was given the wrong drug and required an emergent C-section. The "five rights" of medication administration focuses on individual factors and not necessarily on system flaws. Many organizations are also promoting just culture, which encourages reporting near-misses and patient safety events, and focuses on psychological safety and promoting a non-punitive reporting culture.
Incidental Lung Nodule Overlooked, No Follow-up, Fatal Cancer Advances
Podcast
Dec 30
A patient was imaged for abdominal pain, but the radiologist saw and reported an incidental finding of a nodule on the lower lung that was not pursued or revealed to the patient for 2 years. The cancer had metastasized, and the patient died from lung cancer 18 months later.
Play Episode
Dec 30
Overdose or Poor Documentation?
Podcast
Oct 17
The patient’s family alleged that improper management of the patient under anesthesia resulted in cardiorespiratory arrest, permanent brain damage, and a persistent vegetative state. While the cause of the patient’s cardiac arrest is uncertain, the CRNA failed to note which medications and doses were administered during the procedure, and the case was settled for more than $1 million.
Play Episode
Oct 17
Response to Charges of Discrimination can Help or Hurt a Hospital, Any Employer
Podcast
Jul 12
When hospitals and medical practices face charges of discrimination from employees, the consequences can include litigation, large payments, morale problems, and less quality care for the patients they serve. How an employer responds can make all the difference in outcomes. Based on closed claims in the Harvard medical system, two cases illustrate that point. We interview Megan Kures, of Hamel, Marcin, Dunn, Reardon and Shea, who offers some principles to follow.
Play Episode
Jul 12