Focus on systemic issues: adopt team approach to prevent obstetric errors.(Obstetrics)

MAUI, HAWAII -- Stop playing the blame game when attempting to reign in obstetric management errors, Lisa A. Miller said at a conference on obstetrics, gynecology, perinatal medicine, neonatology, and the law.

Instead, focus on adopting practices that foster a team approach to obstetrics. Rather than asking, "What's my liability if ...?" clinicians should be asking themselves, "What's the safest thing I can do for this patient in these particular circumstances?" said Ms. Miller, a certified nurse midwife and lawyer who is a perinatal risk management educator and consultant based in Chicago.

She outlined the following three areas in which clinicians can improve their obstetric practices while decreasing their risk of litigation:

* Don't buy into common myths about liability. It's not true that if you do anything wrong, you definitely will get sued. Nor is it guaranteed that if you do everything right, you won't get sued.

Another common myth is that settling a lawsuit implies guilt or malpractice.

Many clinicians also mistakenly see themselves as victims who can't do anything about the malpractice crisis and view plaintiffs' attorneys as greedy ambulance chasers. Neither of these impressions is accurate, she said at the meeting, sponsored by Boston University and the Center for Human Genetics.

* Apply knowledge from high-tech industries to patient safety and system error reduction. An estimated 44,000-98,000 Americans die from medical errors each year, putting the risk of death between 1 in 343 and 1 in 764 hospital admissions. The health care industry could learn from the aviation industry, which decreased the risk of fatal U.S. air plane crashes fourfold since the 1970s, from 1 in 2 million passengers to 1 in 8 million. Ms. Miller noted.