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Aviation model cognitive risk factors applied to medical malpractice cases

Stephen C Stripe1, Lyle G Best, Shirley Cole-Harding

  • 1Center for Family Medicine Minot, University of North Dakota, School of Medicine and Health Sciences, Minot, ND 58701, USA. sstripe@medicine.nodak.edu

Journal of the American Board of Family Medicine : JABFM
|November 9, 2006
PubMed
Abstract

Insights

Cognitive factors, like those in aviation, contribute to medical malpractice. A study found these factors, including IMSAFE (illness, medications, stress, alcohol, physiological, and emotional states), can be reliably identified in malpractice cases.

Area of Science:

  • Medical error analysis
  • Cognitive psychology
  • Legal medicine

Background:

  • Aviation safety has improved by addressing pilot cognitive errors.
  • Medical malpractice cases may stem from similar cognitive factors.
  • Reliable identification of these factors is crucial for prevention.

Purpose of the Study:

  • To determine if cognitive factors contribute to medical malpractice.
  • To assess the reliability of identifying these cognitive factors in malpractice cases.
  • To adapt aviation's cognitive error framework for medical applications.

Main Methods:

  • Physicians reviewed 30 medical malpractice cases from 2004.
  • Criteria for cognitive factors were adapted from aviation safety.
  • Cases were categorized by reviewer agreement, and data were statistically analyzed.

Main Results:

  • 59% of cases showed strong correlation with identified cognitive factors.
  • Factors like IMSAFE (illness, medications, stress, alcohol, physiological, emotional) and team management were reliably identified.
  • Hazardous attitudes and loss of situational awareness had minimal reliability.

Conclusions:

  • The aviation cognitive causative approach is adaptable to medical malpractice.
  • This approach reliably identifies cognitive causes in a significant portion of medical errors.
  • Findings support using cognitive factor analysis to reduce medical errors and malpractice.

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