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Graham Neale

Publications and source records attributed to Graham Neale.

7 recordsLinked to original sources
PubMed2006

Learning from litigation. The role of claims analysis in patient safety.

Claims for malpractice and medical negligence are a potentially important source of information on the causes of harm to patients and have provided valuable lessons in the past. However today, with many additional sources of information and methods of analysis, the role of claims analysis needs to be reappraised. We consider the role of claims analysis in relation to other methods of studying adverse outcomes, review previous studies of claims and summarize the findings of four recent British specialty claims reviews. Claims analysis has a number of inherent limitations. We suggest that there is now no case for ad hoc claims reviews which rely on data that have been assembled for legal purposes only. Claims review is still potentially useful for rare events or in cases where other sources of data are not available. However, future claims reviews need to meet basic criteria before being undertaken; these include prospective identification of the relevant questions and variables, adequacy and completeness of the data set, availability of expert reviewers and clear protocols for review.

Health Services Research↗
PubMed2006

Not in the BNF.

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Aged↗
PubMedDate not supplied

Recognising adverse events and critical incidents in medical practice in a district general hospital.

A pilot audit of case records of consecutively discharged patients from a district general hospital was undertaken by specialist registrars, SHOs and senior nurses in order to identify adverse events (AEs) and critical incidents (CIs) related to hospital care. Experienced external assessors taught the clinical staff to use a previously validated structured method of case record review that facilitates analysis. The external assessors audited the same case records in parallel. Aggregated data from 154 case records of patients admitted to the general medical wards were collected for analysis. Fifteen AEs and 41 CIs were identified in the case records covering the hospital admission. In addition, 16 AEs and nine CIs were discovered to have occurred before admission or, for three AEs, shortly after discharge. One-half of the episodes related to problems arising during ward care and for one-half of these issues remained unresolved at the time of discharge. One-third of episodes related to medications or the administration of intravenous fluids--and in these cases there were defects in monitoring the patients' clinical progress. This study led to initiatives to improve care at the host hospital and we believe that further programmes along similar lines are indicated.

Adult↗