Association of Emotional Intelligence With Malpractice Claims

Shouhed, Daniel; Beni, Catherine E; Manguso, Nicholas; IsHak, Waguih William; Gewertz, Bruce L.

doi:10.1001/jamasurg.2018.5065

Cited by 32 publications

(32 citation statements)

References 84 publications

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“…Research demonstrates that emotional intelligence is positively associated with medical students’ performance in courses on communication and interpersonal sensitivity (ie, ‘bedside manners’),57 residents’ performance in a simulated emergency,58 and nurses’ physical and emotional caring for patients 59. Further, research suggests an indirect and negative relationship between physicians’ emotional intelligence and malpractice risk 60. Thus, emotional intelligence is a critical skill that should be actively cultivated among healthcare professionals and students through formal emotion management, regulation, and skills training 17 58–64.…”

Section: Discussionmentioning

confidence: 99%

“…Further, research suggests an indirect and negative relationship between physicians’ emotional intelligence and malpractice risk 60. Thus, emotional intelligence is a critical skill that should be actively cultivated among healthcare professionals and students through formal emotion management, regulation, and skills training 17 58–64. Considerable evidence65 66 demonstrates that such training interventions increase emotional intelligence in diverse samples, including students, managers, teachers, and police officers.…”

Section: Discussionmentioning

confidence: 99%

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What do emergency department physicians and nurses feel? A qualitative study of emotions, triggers, regulation strategies, and effects on patient care

et al. 2020

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BackgroundDespite calls to study how healthcare providers’ emotions may impact patient safety, little research has addressed this topic. The current study aimed to develop a comprehensive understanding of emergency department (ED) providers’ emotional experiences, including what triggers their emotions, the perceived effects of emotions on clinical decision making and patient care, and strategies providers use to manage their emotions to reduce patient safety risks.MethodsEmploying grounded theory, we conducted 86 semi-structured qualitative interviews with experienced ED providers (45 physicians and 41 nurses) from four academic medical centres and four community hospitals in the Northeastern USA. Constant comparative analysis was used to develop a grounded model of provider emotions and patient safety in the ED.ResultsED providers reported experiencing a wide range of emotions in response to patient, hospital, and system-level factors. Patients triggered both positive and negative emotions; hospital and system-level factors largely triggered negative emotions. Providers expressed awareness of possible adverse effects of negative emotions on clinical decision making, highlighting concerns about patient safety. Providers described strategies they employ to regulate their emotions, including emotional suppression, distraction, and cognitive reappraisal. Many providers believed that these strategies effectively guarded against the risk of emotions negatively influencing their clinical decision making.ConclusionThe role of emotions in patient safety is in its early stages and many opportunities exist for researchers, educators, and clinicians to further address this important issue. Our findings highlight the need for future work to (1) determine whether providers’ emotion regulation strategies are effective at mitigating patient safety risk, (2) incorporate emotional intelligence training into healthcare education, and (3) shift the cultural norms in medicine to support meaningful discourse around emotions.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

What do emergency department physicians and nurses feel? A qualitative study of emotions, triggers, regulation strategies, and effects on patient care

et al. 2020

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“…[27,81] For example, in New Zealand where there is a no fault system, inappropriate use of medical resources still takes place. [82] Increasing clinician understanding of actual risk for lawsuits, and ways to decrease their personal risk such as using open communication [83]and shared decision making [58] may reduce overtesting driven by legal liability fears.…”

Section: Discussionmentioning

confidence: 99%

Why do clinicians overtest? A narrative review and workshop group discussion exploring influences on clinician overtesting as possible causes of overdiagnosis

Lam

Pickles

Stanaway

et al. 2020

Preprint

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Background: Screening and diagnostic tests provide important information to guide clinical management. Overtesting however may cause harm to patients and the healthcare system, including through overdiagnosis. Clinicians are ultimately responsible for test requests, and therefore are ideally positioned to prevent overtesting and overdiagnosis. Through this narrative literature review followed by group discussion at a conference workshop (Preventing Overdiagnosis Conference [PODC], Sydney, 2019), we aimed to identify and categorise factors that influence clinicians to request potentially unnecessary screening and diagnostic tests that could result in overdiagnosis.Methods: Articles exploring factors affecting clinician test ordering behaviour were identified through a systematic search of MedLine in April 2019, forward and backward citation searches and content experts. Two authors screened abstract titles and abstracts, and two authors screened full text for inclusion. Identified factors were categorised into a preliminary framework which was subsequently presented at the PODC for iterative development.Results: The MedLine search yielded 542 articles; 55 were included. Another 10 articles identified by forward-backward citation and content experts were included, resulting in 65 articles in total. Following small group discussion with workshop participants, a revised thematic framework of factors was developed: ● “Interpersonal” – pressure from colleagues and medical culture; pressure from patients and doctor-patient relationship● “Contextual” – clinician knowledge and understanding; cognitive biases and experiences; contemporary medical practice and new technology● “Environmental or workplace” – guidelines, protocols and policies; financial incentives; time constraints, physical vulnerabilities and language barriers; pre-emptive testing to facilitate subsequent care; availability, ownership and ease of access to tests● “Intrapersonal” – fear of malpractice and litigation; intolerance of uncertainty and risk aversion; sense of medical obligation Conclusion: Through this thematic framework, clinicians can become more aware of their test ordering behaviour and feel empowered to limit overtesting and overdiagnosis. This framework may also guide the development of a scale assessing clinician knowledge, attitudes and practices around overtesting and overdiagnosis, to facilitate measurement of the effects of clinician-targeted interventions to prevent overdiagnosis.

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“…It can encourage physicians to avoid treating highly complex conditions or to order additional, expensive tests and services to avert medicolegal action. 1 Congenital cardiac surgeons are at high risk for medical malpractice claims, 2 and as such, it is important for these surgeons to strike a balance between providing optimal patient care and minimizing liability. In a recent article by Palaniappan and Sellke in the Journal of Cardiac Surgery, they reviewed medical malpractice cases in congenital cardiac surgery in the United States from 1994 to 2019 using the Westlaw database and found common reasons for litigation included procedural errors followed by delayed treatment, delayed diagnosis, failure to appropriately monitor the patient, failure to refer the patient to another physician, and lack of informed consent.…”

mentioning

confidence: 99%

“…Studies have revealed a negative correlation between providers with high emotional intelligence and risk for litigation. 1 When errors occur, empathetic and authentic responses from surgeons are paramount.…”

mentioning

confidence: 99%

Commentary: Litigation risk in congenital cardiac surgery

Haywood

Krön

2020

J Card Surg

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The risk of malpractice litigation is substantial for congenital cardiac surgeons. It is important for providers to be equipped with strategies to minimize this risk without compromising patient care. Below, we provide a commentary on a recent article from the Journal of Cardiac Surgery discussing litigation risk in this field. To minimize liability and provide optimal care, it is critical that congenital cardiac surgeons focus on both tangible objectives, such as decreasing procedural errors, and less tangible objectives, such as improving surgeon empathy and emotional intelligence.

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Association of Emotional Intelligence With Malpractice Claims

Cited by 32 publications

References 84 publications

What do emergency department physicians and nurses feel? A qualitative study of emotions, triggers, regulation strategies, and effects on patient care

What do emergency department physicians and nurses feel? A qualitative study of emotions, triggers, regulation strategies, and effects on patient care

Why do clinicians overtest? A narrative review and workshop group discussion exploring influences on clinician overtesting as possible causes of overdiagnosis

Commentary: Litigation risk in congenital cardiac surgery

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