SEARCH · PubMed Health

Results for “National Practitioner Data Bank”

Explore indexed PubMed citations for clinical trials, systematic reviews and public health research. Read source abstracts and follow each citation to its original PubMed record.

Quote a phrase for an exact phrase match. Source license links do not imply unrestricted reuse.

At least 181 records · Page 10Linked to original sources

PubMed1990

Privacy Act of 1974; new routine use and system of records name change--HHS. Notification of a new routine use and system of records name change.

The Public Health Service (PHS) is publishing notice of a new routine use, responding to comments, changing the system name, providing the contractor's address, and making editorial clarifications for system of records: 09-15-0054, "Health Care Practitioner Adverse Credentialing Data Bank, HHS/HRSA/BHPr", now titled "National Practitioner Data Bank for Adverse Information on Physicians and Other Health Care Practitioners, HHS/HRSA/BHPr."

Civil Rights↗

PubMed2006

What pediatricians should know about child-related malpractice payments in the United States.

OBJECTIVE: The purpose of this study was to examine child-related National Practitioner Data Bank data. METHODS: Data were obtained from the National Practitioner Data Bank. RESULTS: the period from February 1, 2004, through December 31, 2005, a total of 30195 malpractice payments were made on behalf of practitioners in the United States; 14% of those payments (4107 of 30,195 payments) were child related. During the period analyzed, $1.73 billion were paid for malpractice cases involving children. More than 95% of all payments were the result of settlements and only approximately 5% the result of judgments. The average child-related malpractice payment was significantly greater than an adult-related malpractice payment ($422,000 vs $247,000); however, child-related malpractice payments were only one half as likely to occur, compared with adult-related malpractice payments. Significant geographic variability was found in the numbers and sizes of child-related malpractice payments. Failure to diagnose was the leading reason for child-related payments (18%), followed by improper performance (9%), delay in diagnosis (9%), and improper management (6%). Finally, we found that approximately 40% of all malpractice awards were the result of surgical or obstetrical issues. CONCLUSIONS: Practicing pediatricians should be aware of the existence of a mandatory electronic depository that documents all malpractice settlements and judgments involving practitioners.

Adolescent↗

PubMedDate not supplied

Data bank reporting requirements pose vexing issues.

Even though the National Practitioner Data Bank is now more than a year old, health care organizations continue to struggle with its reporting requirements. In some instances, it is possible to achieve the quality goals of the data bank without triggering a report and unnecessarily damaging a practitioner's reputation. This article details some of the cautions that need to be observed.

Documentation↗

PubMed1990

Questions abound as start-up nears for physician data bank.

The start-up of the National Practitioner Data Bank is only weeks away, but hospitals and physicians still are raising questions about the system's pros and cons. While most laud the data bank's original mission--to prevent practitioners from concealing a history of incompetence--many physicians claim the scope of the system has grown too big and fear abuse of the information.

Attitude of Health Personnel↗

PubMedDate not supplied

Disciplining physicians: what every physician and health care administrator needs to know about the Health Care Quality Improvement Act.

This article highlights the critical provisions of the Health Care Quality Improvement Act that must be considered by physicians and health care entities in conjunction with disciplinary actions. These include: when professional review actions are covered by the Act's immunity; what constitutes adequate notice and a fair hearing for affected physicians; when professional review actions should be reported to the National Practitioner Data Bank; and what must be reported.

Employee Discipline↗

PubMed2000

Hospitals won't be able to access HIPAA data bank.

The new Healthcare Integrity and Protection Data Bank, designed to complement the 10-year-old National Practitioner Data Bank, offers a wealth of information on final adverse actions taken against health care providers. The catch? By law, hospitals are barred from accessing the data bank.

Credentialing↗

PubMedDate not supplied

The medical liability crisis of 2003: must we squander the chance to put patients first?

Medical liability reform should be aligned with a patient-centered, systems-based approach to preventing injury. Lessons learned about medical risk are now buried by the legal system, and communication about risk is haphazard among health care providers and across the interfaces of our legal, regulatory, and health care systems. Tort reform can be a vehicle for breaking down systemic barriers. Proposed reforms include (1) requiring disclosure of medical errors and restricting the use of information disclosed as evidence of guilt; (2) outlawing confidentiality agreements when malpractice cases are settled; (3) abolishing the National Practitioner Data Bank; and (4) establishing a national patient safety authority.

Disclosure↗

PubMed1992

International migration and medical credentialling.

The Single European Act of July 1987, coupled with various other regional and national laws, the purposes of which open borders to the free movement of peoples, goods and services, is soon to be put into operation. Although awaited with much eagerness and expectation, there is also a need for strategic planning in order adequately to address new and possibly ominous legal and medical practice problems. In the United States, a National Practitioner Data Bank, which went into full operation in September 1990 was created to monitor physicians, nurses and other health care providers involved in negligence actions which result in the payment of moneys by settlement or by verdict, and to prevent those whose licences have been suspended, revoked or restricted in any fashion in one state from practising in another based upon reciprocity licensure or board certification criteria. In order to protect patients from abuse by uncredentialled individuals or dangerous clinicians, and further to protect institutions from liability incurred by inadequate credentials checks or through ostensible liability, the creation of a practitioner data bank utilizing modern data gathering, storage and retrieval methods is proposed for the European Community. It should be created under the auspices of the United Nations--possibly through the World Health Organization which already accredits medical education and training programmes--and should be charged with creating uniform standards of professional practice; certifying professionals; and serving as a credentials' clearing house for the health care industry.

Credentialing↗

PubMedDate not supplied

Communication: the key to avoiding query and reporting standards violations.

Without carefully designed communication protocols, hospitals can fail to meet the query and reporting requirements imposed by the Joint Commission on Accreditation of Healthcare Organizations, the National Practitioner Data Bank, and state medical societies. This article tracks the history of the requirements, outlines current standards, and offers specific recommendations for operational procedures to avoid potential pitfalls.

Accreditation↗

PubMed2001

HHS database is risky source for credentialing.

Hospitals are running a considerable risk if they rely too heavily on the National Practitioner Data Bank (NPDB) as a source of information throughout their credentialing process. A report released recently by the General Accounting Office, which found the data bank riddled with problems, only underlines that point. The government watchdog agency says problems of underreporting to the NPDB make it a questionable source of information regarding disciplinary actions taken against health care practitioners by hospitals and other health care providers.

Credentialing↗

PubMed2005

System failure. Most U.S. hospitals have never filed a report with the databank that records doctor suspensions; critics say it's time for a new method.

The National Practitioner Data Bank was born in 1990, touted as an authoritative way to track doctors whose privileges were suspended. Initial predictions expected up to 10,000 reports yearly, but only about 10,800 reports have been made in 15 years. Many believe hospitals skirt the system by just issuing lesser punishments. "It happens," admits Mark Pincus, right, the databank administrator.

Consumer Advocacy↗

PubMed1996

Quality improvement and substance abuse: rethinking impaired provider policies.

Substance abuse is known to be our nation's number one public health problem. Physicians and other health providers can develop chemical dependency problems that create significant quality assurance and risk management dilemmas. Not all of society understands drug dependence to be a treatable medical disease and behavioral problem. Sometimes impaired providers are ignored or punished rather than treated and rehabilitated. This results in an enormous waste of human and monetary resources. In the last 10 years, impaired physician programs have developed focus and credibility. But certain difficulties exist in these programs: namely, that such programs are affected by tensions between medical societies and state licensing boards; that substance-dependent providers escape detection by moving to other states; that existing impaired provider programs have limited practical application within the federal health care system; and that liability risks are incurred if institutions rely on impaired provider policies that do not include all members of the medical staff. Hence, we argue that existing impaired provider policies might be worth rethinking. To promote that dialogue, we offer a sample policy for consideration and review. It includes specific actions and procedures for the identification, referral, and reentry of impaired providers and allows for National Practitioner Data Bank reporting in that process. The Data Bank has been in place for only a few years and offers society and the health community a new opportunity to better control chemically dependent, licensed medical staff without dismantling existing impaired provider programs. The policies for managing chemically dependent health professionals are changing from a focus on stigma and prosecution to one of early identification, rehabilitation, and reentry. We hope to advance that process.

Humans↗

PubMed1994

Constitutional rights versus malpractice insurance settlements.

The increasing costs and complexity of malpractice litigation have created an statutory right that allows malpractice insurance companies to settle malpractice claims regardless of the desires of the defendant physician. In the past, the consequences of settling a malpractice claim out of court were not as important as they are today. The Health Care Quality Improvement Act of 1986 mandates that any settlement in behalf of a physician be documented in the National Practitioner Data Bank (NPDB), which must be consulted every time the physician is credentialed. This NPDB requirement denies due process to health care providers and thus becomes a violation of the federal and many state constitutions. Physician executives and medical leaders must bring these issues to the table and negotiate solutions before damage to practicing physicians and the U.S. health care delivery system caused by this legal paradox become too severe.

Civil Rights↗

PubMed2002

The medicolegal aspects of proctoring.

Virtually every medical staff ensures surgeons technical competency by requiring a proctoring process. However, rarely do medical staff bylaws specify the relationship between completion of proctoring and acquisition of medical staff privileges. For this reason surgeons failing to acquire privileges because of adverse proctor evaluations might be subject to National Practitioners Data Bank reporting. Few proctors understand what their responsibilities are should they witness malpractice being committed. In the State of California, case law has demonstrated that proctors are immune from liability should they allow substandard practices to continue and fail to intervene on the patient's behalf. Alternatively, if the proctor intervenes on a Good Samaritan basis they are most likely protected from malpractice liability. We recommend the implementation of two processes to avoid legal pitfalls: (1) Liability can be minimized if proctoring consents are obtained that clearly delineate the proctor's responsibilities during the operation. (2) Medical staff bylaws should clearly specify the temporal relationship between application of privileges, duration of proctoring process and final acquisition of clinical privileges.

Clinical Competence↗

PubMed2003

Reconsidering medical malpractice reform: the case for arbitration and transparency in non-emergent contexts.

This Article proposes a two-pronged legislative response to the current debate over medical malpractice insurance. The author does not advocate mandatory caps on malpractice damages, nor the imposition of a uniform regime on the field of medicine. Rather, he articulates some of the important legal, medical, and societal benefits that would come from embracing arbitration in the non-emergent medical malpractice context. The author also calls for the reformulation of the National Practitioner Data Bank to achieve greater transparentcy and to leverage advances in information technology and data-mining software to measure the risk levels of individual practitioners. This reform, in turn, would open up the possibility of greater subcategorization of premiums and more effective deterrence in medical malpractice insurance.

Federal Government↗

PubMed1993

Protection of patient data in multi-institutional medical computer networks: regulatory effectiveness analysis.

Privacy protection is one of the major issues in the development of multi-institutional clinical information networks. Judicial decisions have confirmed patient's rights to protection of a "reasonable expectation of privacy". Incorporating this protection into a system requires analysis of appropriate models. The National Practitioner Data Bank (NPDB) contains confidential data concerning physician competence. The medical profession had substantial input into the privacy protection features of the NPDB, which are much more comprehensive than those used in many clinical information systems. The NPDB represents the privacy protection which physicians expect for their own data. Regulatory Effectiveness Analysis can be used to analyze the suitability of the NPDB as a model for patient privacy protection. Judicial opinions set public policy and legal structures for privacy, and the NPDB provides an inventory of useable technical tools. After eliminating minor discontinuities, the NPDB can be used as a model to create a useable standard for privacy for multi institutional data transfers.

Civil Rights↗

PubMed2006

Wrong-side/wrong-site, wrong-procedure, and wrong-patient adverse events: Are they preventable?

HYPOTHESIS: Wrong-side/wrong-site, wrong-procedure, and wrong-patient adverse events (WSPEs) are devastating, unacceptable, and often result in litigation, but their frequency and root causes are unknown. Wrong-side/wrong-site, wrong-procedure, and wrong-patient events are likely more common than realized, with little evidence that current prevention practice is adequate. DESIGN: Analysis of several databases demonstrates that WSPEs occur across all specialties, with high numbers noted in orthopedic and dental surgery. Databases analyzed included: (1) the National Practitioner Data Bank (NPDB), (2) the Florida Code 15 mandatory reporting system, (3) the American Society of Anesthesiologists (ASA) Closed Claims Project database, and (4) a novel Web-based system for collecting WSPE cases (http://www.wrong-side.org). RESULTS: The NPDB recorded 5940 WSPEs (2217 wrong-side surgical procedures and 3723 wrong-treatment/wrong-procedure errors) in 13 years. Florida Code 15 occurrences of WSPEs number 494 since 1991, averaging 75 events per year since 2000. The ASA Closed Claims Project has recorded 54 cases of WSPEs. Analysis of WSPE cases, including WSPE cases submitted to http://www.wrong-side.org, suggest several common causes of WSPEs and recurrent systemic failures. Based on these findings, we estimate that there are 1300 to 2700 WSPEs annually in the United States. Despite a significant number of cases, reporting of WSPEs is virtually nonexistent, with reports in the lay press far more common than reports in the medical literature. Our research suggests clear factors that contribute to the occurrence of WSPEs, as well as ways to reduce them. CONCLUSIONS: Wrong-side/wrong-site, wrong-procedure, and wrong-patient adverse events, although rare, are more common than health care providers and patients appreciate. Prevention of WSPEs requires new and innovative technologies, reporting of case occurrence, and learning from successful safety initiatives (such as in transfusion medicine and other high-risk nonmedical industries), while reducing the shame associated with these events.

Humans↗

PubMedDate not supplied

The US Medical Liability System: evidence for legislative reform.

BACKGROUND: Despite state and federal efforts to implement medical malpractice reform, there is limited evidence on which to base policy decisions. The National Practitioner Data Bank (NPDB) offers an opportunity to evaluate the effects of previous malpractice tort reforms on malpractice payments and premiums. METHODS: For every state and the District of Columbia, we calculated the number of malpractice payments, total amount paid, and average payment from NPDB data reported from 1999 through 2001. We analyzed 44,913 claims using logistic regression to study associations between payments, physician premiums, and 10 state statutory tort reforms. RESULTS: Wide variations exist in malpractice payments among states. The reforms most associated with lower payments and premiums were total and noneconomic damage caps. Mean payments were 26% lower in states with total damage caps (196,495.34 dollars vs 265,554.50 dollars, P = .001). Mean payments were 22% less in states with noneconomic damage caps (219,225.98 dollars vs 279,849.86 dollars, P = .010). Total damage caps were associated with lower mean annual premiums, especially for obstetricians (22,371.57 dollars vs 42,728.68 dollars, P <.001). Hard noneconomic damage caps were associated with premium reductions for obstetricians (30,283.75 vs 45,740.88; P = .039). CONCLUSIONS: Significant reductions in malpractice payments could be realized if total or noneconomic damage caps were operating nationally. Hard noneconomic damage and total damage caps could yield lower premiums. If tied to a comprehensive plan for reform, the money saved could be diverted to implement alternative approaches to patient compensation or be used to achieve other systems reform benefiting patients, employers, physicians, and hospitals.

Cost Control↗