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Opioid Prescribing for Chronic Pain: Case Studies and Best Practices

April 27, 2023

More than 68,000 Americans died of opioid-involved overdose in 2020—a 37.6 percent increase over 2019, and the largest yearly increase in opioid-involved overdose deaths in two decades.1,* A total of 16,416 (23.9 percent) of those deaths involved prescription opioids.1 Approximately 21 to 29 percent of patients prescribed opioids for chronic pain misuse them,2 and between 8 and 12 percent of patients prescribed opioids for chronic pain will develop an opioid use disorder (OUD).2 It’s no surprise, then, that overdose death involving opioids is referred to as “a public health emergency” and an epidemic.3,4

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Filed under: Pain Management, Best Practices, Practice Manager, Physician, Opioids, Patient Care, Medication Management, Claims Rx

Surgical Never Event - Retained Needle

January 30, 2023

An unintended retained surgical item (RSI) is an item unintentionally left inside a patient (e.g., sponges, towels, device components, guidewires, needles, and instruments).1 Among surgical never events, RSI is the most frequently reported to the Joint Commission.2 According to the Joint Commission, the most common causes of RSIs include the absence of policies and procedures, failure to comply with existing policies and procedures, and inadequate or incomplete staff education.3 NORCAL Group (now part of ProAssurance) closed claims involving an RSI often involve reporting of correct counts or completed surgeries, despite knowledge of an incorrect count. The following case illustrates an example of how and why RSIs occur.

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Filed under: Case Study, Practice Manager, Physician, Patient Care, Claims Rx, never event, culture of safety

Surgical Never Event - Retained Surgical Towel

January 30, 2023

An unintended retained surgical item (RSI) is an item unintentionally left inside a patient1 (in this case a surgical towel). Among surgical never events, RSI is the most frequently reported to the Joint Commission.2 As in this case, NORCAL Group (now part of ProAssurance) closed claims involving RSIs often involve reporting of correct counts or completed surgeries, despite knowledge of an incorrect count.

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Filed under: Case Study, Practice Manager, Physician, Patient Care, Claims Rx, never event, culture of safety

Surgical Never Event - Retained Lap Pad

January 30, 2023

An unintended retained surgical item (RSI) is an item unintentionally left inside a patient (e.g., sponges, towels, device components, guidewires, needles, and instruments).1 Among surgical never events, RSI is the most frequently reported to the Joint Commission.2 Surgical sponges are the most commonly reported retained item.3 According to the Joint Commission, the most common causes of RSIs include the absence of policies and procedures, and inadequate or incomplete staff education, and failure to comply with existing policies and procedures,4 as we see in this case.

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Filed under: Case Study, Practice Manager, Physician, Patient Care, Claims Rx, never event, culture of safety

Surgical Never Event - Surgery on the Wrong Knee

January 30, 2023

Wrong-site surgery incidents are usually due to multiple processes that combine to cause the event, as opposed to one specific error.

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Filed under: Case Study, Practice Manager, Physician, Patient Care, Claims Rx, never event, culture of safety
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