Avoiding Errors in Adult Medicine: (AVE - Avoiding Errors)

Avoiding Errors in Adult Medicine 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. For more information on the Avoiding Errors series, please visit: www.wiley.com/go/avoidingerrors For more information on the complete range of Wiley-Blackwell medical student and junior doctor publishing, please visit: www.wileymedicaleducation.com To receive automatic updates on Wiley-Blackwell books and journals, join our email list. Sign up today at www.wiley.com/email All content reviewed by students for students Wiley-Blackwell Medical Education books are designed exactly for theirintended audience. All of our books are developed in collaboration with students.This means that our books are always published with you, the student, in mind. If you would like to be one of our student reviewers, go to www.reviewmedicalbooks.com to find out more. More titles in the Avoiding Errors series Avoiding Errors in Paediatrics Raine et al. 2013 9780470658680 Avoiding Errors in General Practice Barraclough et al. 2013 9780470673577 This title is also available as an e-book. For more details, please see www.wiley.com/buy/9780470674383 or scan this QR code:

Table 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 cases v Introduction  35 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

About the Author :
Ian P. Reckless is Consultant Physician and Assistant Medical Director, Oxford University Hospitals NHS Trust D. John M. Reynolds is Consultant Physician and Clinical Pharmacologist, Oxford University Hospitals NHS Trust Sally Newman is a Solicitor and Head of Legal Services, Oxford University Hospitals NHS Trust Joseph E. Raine is Consultant Paediatrician, Whittington Hospital, London Kate Williams is Partner, RadcliffesLeBrasseur Solicitors, Leeds Jonathan 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

Review :
“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)