Journal for healthcare quality : official publication of the National Association for Healthcare Quality
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Catastrophic medical malpractice payouts, $1 million or greater, greatly influence physicians' practice, hospital policy, and discussions of healthcare reform. However, little is known about the specific characteristics and overall cost burden of these payouts. We reviewed all paid malpractice claims nationwide using the National Practitioner Data Bank over a 7-year period (2004-2010) and used multivariate regression to identify risk factors for catastrophic and increased overall payouts. ⋯ Catastrophic payouts averaged $1.4 billion per year or 0.05% of the National Health Expenditures. Preventing catastrophic malpractice payouts should be only one aspect of comprehensive patient safety and quality improvement strategies. Future studies should evaluate the benefits of targeted interventions based on specific patient safety event characteristics.
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The course of sepsis is rapid. Patient outcomes improve when sepsis is diagnosed and treated quickly. The clinical goals of the evidence-based bundled strategies from the International consortium Surviving Sepsis Campaign (SSC) include optimizing timeliness in the delivery of care and creating a continuum for sepsis management that runs from the emergency department (ED) to the acute and critical care settings. ⋯ There was a statistically significant improvement between the phases for lactate completion X(2) = 16.908 (p < .01) after education. Frequency of blood cultures being obtained before antibiotic administration was nearing statistical significance (p < .054). There was an improvement in time to antibiotic administration between phase 2 (182.09 mean average minutes, SD = 234.06) and phase 3 (91.62 mean average minutes, SD = 167.99).