making mistakes

Question 1

what are the four domains you must make sure your practice as a doctor meets?

Answer 1

1. knowledge, skills and performance
2. safety and quality
3. communication, partnership and teamwork
4. maintaining trust

Question 2

what are six different causes of mistakes in healthcare?

Answer 2

• stress
• fatigue
• covering for colleagues (too little locus support)
• professional culture (unwillingness to use support structures)
• feeling that decisions must be made alone
• unwillingness to admit uncertainty

Question 3

what is the DUTY OF CANDOUR?

Answer 3

this is a statutory obligation on doctors and nurses for a duty of candour so they are open with patients about their mistakes (in scotland the law is an ORGANISATIONAL duty of candour)

Question 4

what is the PROFESSIONAL duty of candour which healthcare professionals must adhere to?

Answer 4

1. tell the patient (Or carer, family where apt) if something has gone wrong
2. apologise to patient (carer etc)
3. offer an appropriate remedy or support
4. explain fully to the patient the short and long term effects

Question 5

what are three components which comprise legal NEGLIGENCE?

Answer 5

the claimant must establish:

1. He/she is OWED A DUTY OF CARE by defendant
2. that the defendant BREACHED this duty of care by failing to provide reasonable care
3. that the breach of duty of care caused the claimants injuries and that those injuries are not too remote

Question 6

what is the BOLAM test?

Answer 6

outlines the fact that reasonable care may be defined so by a responsible body of medical men skilled in that particular area

Question 7

what is the BOLITHO amendment to the BOLAM test?

Answer 7

the professional opinion must be capable of withstanding LOGICAL ANALYSIS

Question 8

what is the modification after the MONTGOMERY CASE in 2015? (three questions)

Answer 8

1. does the patient know the material risks of the treatment?
2. does the patient know about reasonable alternatives?
3. have I taken care to ensure the patient knows this?

Question 9

what are the two key factors which define CAUSATION?

Answer 9

1. proximity (i.e. there must be a clear link between action/inaction of doctor and harm experienced)
2. probability vs possibility

Question 10

what are the two stages of the NHS complaints procedure in scotland?

Answer 10

stage 1: local resolution

stage 2: scottish public services ombudsman