BackgroundIn advanced health services, a main objective is to promote the culture of safety and clinical risk management. In this regard, the reporting of sentinel events fits within a perspective of error analysis, attempting to propose solutions aimed at preventing a new occurrence of the harmful event. The purpose of this study is to analyze the contribution of medico-legal litigation in the management of clinical risk and to propose an organizational model so as to coordinate the intervention of clinical risk management and medico-legal services.MethodsRetrospective review of 206 cases of medico-legal litigation, settled against a Hospital of a North-eastern city in Italy from January 1, 2014 and December 31, 2015.ResultsApproximately 20% of cases, that are classifiable as “sentinel events”, were not reported due to various factors. The reason that these events are under-reported is mainly due to the latency between the event itself and its manifestation as a serious damage to health as well as the discomfort in reporting the events of this kind, which is still widespread among healthcare workers.The systematic research of the available documentation for medico-legal purposes permits the acquisition of more information concerning the clinical event, thereby increasing the number and accuracy of the reports to the clinical risk unit.ConclusionThe analysis of medico-legal litigation is a valid tool to enhance the reporting of “sentinel events”. One possible proposal is the implementation of an organizational model to establish a rapid procedure for the reporting of sentinel events during the evaluation of medico-legal litigations.
Introduction: In recent decades, the number of medical professional liability disputes have grown exponentially, becoming a well-studied aspect of public healthcare. Legal medicine is an essential tool in managing this phenomenon. Methods: This article reports the results of the analysis of disputes for medical professional liability in a Level III University Hospital in Italy. The study covers the time period from 01.01.2003 to 31.12.2019. Discussion: The difference in the rate of compensation between the various medical fields or types of error depends on specific medico-legal characteristics. The aim of advanced healthcare systems is to prevent medical liability disputes by analyzing this phenomenon and improving clinical risk management programs. In particular, according to our study, events related to organizational deficiencies are the most preventable. In addition, through the use of a dedicated reporting procedure, medico-legal analysis of malpractice cases may be the key to risk reduction. Conclusion: Every major hospital should set up a medico-legal watchdog responsible for collecting and analyzing information on professional medical liability disputes in order to prevent and manage such events.
On December 2017, Law 219 named Provisions for informed consent and advance treatment directives was approved in Italy, and on one side this law helped the daily medical activity on the other side it enhanced the patient's self-determination. This contribution analyzes the new legislative disposition and the possible medical-legal and practical implications for patients entrusted in hospitals. In particular, it focuses on the usefulness of an early planning of medical care decision in complex pathological situations in order to enhance the patient's self-determination and his eventual impassable refusal. It also safeguards the medical work from disputes and claims, preserving medical autonomy and competence.
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