Ask a Medical Malpractice (Defense) Lawyer

[TheRealJoeFish]

Do you have any control or influence over hospital policy, i.e. can you make suggestions for improvements to help staff avoid lawsuits in the first place? The only reason I ask is I read a study a few years ago where surgeons had to follow a checklist before and during the surgery (much like pilots do) and death rates were cut in half: http://content.time.com/time/health/arti...59,00.html

It strikes me that such a simple policy could not only save lives but also reduce the number of lawsuits from families.

Personally, I am not in such a position.  This is a good point to be aware of, though, and I will always look for opportunities to help reduce problems in any way I can.

Organizationally, I believe a large amount of hospital policy is dictated by the legal department.  Generally, a hospital will have an in-house legal department that deals with things like this and also works with the hospital's trial counsel (that's me).  I do know that policies/procedures are generally updated for virtually all departments at least yearly, and often more so.  It's also the nature of the profession - both on the medical side and the legal side - that if someone does something that reduces errors and improves care, most other hospitals also do so quickly.  On the medical side, this is both good doctor sense and good business sense.  On the legal side, this is because whether you're negligent depends on the standard of care, that is, the standard to which we hold doctors and hospitals.  If that standard increases, so too must your care in order to be adequate.

For what it's worth, the article and the work cited on pre-and-post-surgery checklists was written in 2009.  I, having seen surgeries primarily from the last 3 or 4 years, have never seen a surgery in which there wasn't a pre-surgery checklist, which had entries for things like patient ID, right area of body, number of sponges/scalpels/tools used, medications, and all sorts of other things trying to prevent errors, and a post-surgery checklist to make sure that those things are consistent.  These (in slightly different forms) are filled out by the surgeon, the anesthetist, and at least one nurse/assistant. 

I can't say if that's because of the research done above or not, but those sorts of check-list-type things are ubiquitous in the records I've seen.  And, I do think that goes hand-in-hand with what I said in a previous post: doctors and nurses are people, so there will always be instances of bad judgment, and these should be minimized; however, that means there should always be a focus on absolutely eliminating errors based not on bad judgment but on miscommunication or inattentiveness or the like.