Errors in health care are one of the leading causes of death and injury in this country, requiring new methods for evaluating and promoting quality in health care services. Concern for patient safety, the foundation for quality services, has prompted national initiatives to examine the most basic premise for health care providers: Do no harm to the patient. Few of these initiatives have examined errors from the perspective of those who have been sanctioned for their errors. This descriptive, exploratory study utilized a survey methodology to examine the perceptions of 62 registered nurses (RNs) who had been sanctioned by a board of nursing to ascertain categories of practice errors and identify individual, health care team, patient, and system threats that contributed to an error and/or patient harm. The Threat and Error Management Model (TEMM) was utilized as a framework for examining the phenomena that promote or hinder patient safety. Using a modified version of the Taxonomy of Error Root Cause Analysis of Practice-Responsibilities (TERCAP) instrument, sanctioned RNs selected types of errors associated with a breakdown in their nursing practice. In addition, they identified factors that contributed to their errors, including individual, health care team, patient, and system threats. Associations between the levels of patient harm and types of error were examined. Two open-ended questions provided an opportunity for the participants to describe changes in their practice since the error event. System and health care team factors were the most common items selected as contributing to the error events, while individual factors were the least often selected items. Two types of errors, clinical evaluation and attentiveness/surveillance, were significantly related to the level of harm to patients. Given the opportunity to discuss individual factors through open-ended questions, responses were comprehensive and many were related to issues with trust. Recommendations for nursing theory, policy, practice, education, and research are reviewed.

This dissertation has two objectives. The first is to provide a framework for understanding strategic interactions between an auditor and investors in a competitive rational expectations economy. The second is to provide a welfare analysis of auditor litigation in a costly legal environment. We present a model which captures the following aspects: (i) investors in a competitive capital market form rational expectations about their future litigation opportunities against auditors; (ii) auditors compete for potential clients, and they strategically consider the threat of litigation; (iii) the audited firm's production decision depends on audit quality; and (iv) trial is a costly process, and litigants have settlement opportunities. The market price of the firm and audit quality are endogenized. The welfare analysis provides a rationale why society maintains a legal system which provides an incentive for the investors to recover their ex post financial loss from the auditor through a costly legal process, even if they can price-protect themselves ex ante with or without such a mechanism. We interpret the court system as a decentralized disciplinary mechanism for the auditor moral hazard problem, which enables the potential auditee to use an auditor as a commitment device. We examine the economic consequences of legal policies which potentially influence the size of legal costs. When audit failure is clearly defined, an increase in the auditor's legal costs decreases social welfare. An increase in the investors' legal costs has a more complex impact on the actions of economic agents upon which the social costs and benefits of an audit crucially depend. We also study the economic impact of a change from an American to a British rule of allocating legal costs, which was recently proposed by the accounting profession in the U.S. In contrast to the practitioners' common belief, we demonstrate that the British rule might increase the frequency of lawsuit. Therefore, regulators must be very careful in evaluating the accountants' proposal of the British rule, and it should not replace the American rule unless a careful analysis indicates that the net benefit of audits under the British rule is larger than that under the American rule.

Thesis (M.A. in applied economics)--Washington State University, May 2007. / Includes bibliographical references (p. 47-48).

This dissertation has two objectives. The first is to provide a framework for understanding strategic interactions between an auditor and investors in a competitive rational expectations economy. The second is to provide a welfare analysis of auditor litigation in a costly legal environment. We present a model which captures the following aspects: (i) investors in a competitive capital market form rational expectations about their future litigation opportunities against auditors; (ii) auditors compete for potential clients, and they strategically consider the threat of litigation; (iii) the audited firm's production decision depends on audit quality; and (iv) trial is a costly process, and litigants have settlement opportunities. The market price of the firm and audit quality are endogenized. The welfare analysis provides a rationale why society maintains a legal system which provides an incentive for the investors to recover their ex post financial loss from the auditor through a costly legal process, even if they can price-protect themselves ex ante with or without such a mechanism. We interpret the court system as a decentralized disciplinary mechanism for the auditor moral hazard problem, which enables the potential auditee to use an auditor as a commitment device. We examine the economic consequences of legal policies which potentially influence the size of legal costs. When audit failure is clearly defined, an increase in the auditor's legal costs decreases social welfare. An increase in the investors' legal costs has a more complex impact on the actions of economic agents upon which the social costs and benefits of an audit crucially depend. We also study the economic impact of a change from an American to a British rule of allocating legal costs, which was recently proposed by the accounting profession in the U.S. In contrast to the practitioners' common belief, we demonstrate that the British rule might increase the frequency of lawsuit. Therefore, regulators must be very careful in evaluating the accountants' proposal of the British rule, and it should not replace the American rule unless a careful analysis indicates that the net benefit of audits under the British rule is larger than that under the American rule. / Business, Sauder School of / Graduate

Florida is one of two states that do not allow ARNPs to prescribe controlled substances. The Florida Legislature has expressed concern regarding the safety of ARNPs prescribing controlled substances. The purpose of this study was to compare malpractice rates of ARNPs and physicians in states with and without controlled substance prescribing. The design was a direct comparison of malpractice rates in states with and without ARNP controlled substance prescriptive authority. Comparison of malpractice claims was made between physicians (MDs and DOs collectively) and ARNPs in the United States and by state ARNP prescribing authority. Comparison of malpractice claims was also made between Florida and states that were demographically similar. The results showed that ARNPs have significantly less malpractice than physicians in the United States. In addition, there were no significant differences in malpractice, whether or not the ARNP was allowed to prescribe controlled substances. Finally, ARNPs working in states that are demographically similar to Florida, but allowed to prescribe controlled substances had no significant increase in malpractice. This study showed that there is no increase in malpractice rates in states where ARNPs prescribe controlled substances, either fully or partially, supporting the hypothesis.

The work focuses on consumer's problems in medicine, pacients's compensation and malpractice in practices. First part of this diploma work content theoretical part which shows the law system of compensation, fault and non -- fault liability in the Czech Republic. Health compensation is being huge and very expencive these days specially in the states of western Europe and USA. That is why the part of the work compares the law rules and system between Czech Republic, Germany and France. Because New Zealand has very unusual non -- fault system and the burden of proof doesn't bear the pacient but the hospital the comparision was made also with this country. This issue is also very interesting from the economic point of view. The whole analyses agrees on hypothesis: Consumers'law protection in medicin is comparable with EU and satisfactory.

In regards to health care, the civil tort system serves to both deter negligent behavior on the part of the provider and compensate victims for losses which must include bodily harm attributable to negligent medical care. Due to the unique malpractice landscape that evolved in the United States, national tort reform has increased over the last several decades and a need for reliable data exists. This paper matches claims from the National Practitioner's Data Bank to an independent state data bank to determine is systematic, nonrandom differences between the observations exist. The paper found that systematic differences existed and their existence was implicitly proven in a paper published in 2013. This calls into question the current state of knowledge surrounding medical malpractice liability reform.

Thesis (Ph. D.)--Florida State University, 2004. / Advisor: Dr. Kevin Eastman, Florida State University, College of Business, Dept. of Risk Management and Insurance. Title and description from dissertation home page (viewed Sept. 22, 2004). Includes bibliographical references.

Please read the abstract (Summary) in the section 21backb of this document / Thesis (LLD (Private Law))--University of Pretoria, 2007. / Private Law / LLD / unrestricted

During the past decade medical malpractice litigation has created problems and concern within the medical and legal professions, the malpractice insurance industry, and for healthcare patients. The purpose of this dissertation was to analyze and evaluate the ability of the negligence standard of civil liability to facilitate efficient resource allocation between physicians and their patients. The analysis also attempted to determine whether or not the negligence rule of liability is an effective means of ensuring that cost-justified levels of precaution will be undertaken and that the efficient levels of iatrogenic injuries will result. The negligence standard is not the appropriate liability assignment for activities involving direct contact between buyers (patients) and sellers (physicians). Transaction and negotiation costs are not so high as to engender significant negative externalities and to result in inefficient resource allocation. Tort liability is a problematic and costly system of victim compensation. The study concluded that most personal injuries arising from medical treatment should be allocated contractually between physicians and patients. Assigning more liability for adverse outcomes to patients would not likely reduce the quality of health care while allowing the parties involved to assume voluntarily the appropriate level of risks. / Ph. D.