Malpractice claimed calls within the Swedish Healthcare Direct: a descriptive - comparative case study

Area of Science:

• Healthcare quality and patient safety
• Medical error analysis
• Telehealth services

Background:

• Medical errors leading to malpractice claims necessitate analysis for patient safety improvement.
• Swedish Healthcare Direct (SHD), a national telephone helpline staffed by nurses, handles approximately 5 million calls annually.
• The COVID-19 pandemic increased SHD call volume by about 30%.

Purpose of the Study:

• To describe malpractice claims and reported measures for calls to Swedish Healthcare Direct (SHD) from 2011-2018.
• To compare these findings with a previous study covering 2003-2010.
• To identify trends in medical errors and organizational responses within a telehealth service.

Main Methods:

• Descriptive, retrospective, and comparative study design.
• Analysis of all reported malpractice claims concerning SHD calls between 2011-2018 (n=35).
• Comparison with reported medical errors from 2003-2010 (n=33).

Main Results:

• Failure to adhere to the computerized decision support system (CDSS) was the primary error cause (n=18) in 2011-2018, unlike 2003-2010 where failure to listen to the caller (n=12) was key.
• Staff education (n=21) and self-call reviews (n=16) were common organizational measures during 2011-2018.
• Work group discussions were more prevalent (n=13) in the earlier period (2003-2010).

Conclusions:

• Malpractice claims remain infrequent relative to patient contacts, suggesting only severe injuries are reported.
• The shift in primary error cause to non-adherence with the CDSS is significant, despite organizational emphasis on its use.
• Healthcare organizations demonstrate a more systematic approach to claims management, utilizing nurse self-reflection for error analysis and learning.