Trust Clinical Claim Scorecard - Guidance Sheet

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Hortense Bridges
6 years ago
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1 Trust Clinical Claim Scorecard - Guidance Sheet The data presented in these spreadsheets is provided to Trusts to consider their claims and learning that can be determined by using different approaches according to the quadrant description presented below. Selection Criteria: CNST claims received with an Incident Date between /4/ and //6 Total number of claims for this Trust: 9. Total value of claims for this Trust 48,9,85 Data correct at: /9/6 Score Card Explained High = m and over, Low Volume < claims High = m and over, High Volume = claims and over (Low to High) These are high value, low volume claims where learning on an individual basis could be undertaken. Low < m, Low Volume < These are high value, high volume claims. We suggest that this area is a priority area of focus. Not all trusts will have claims in this area and will therefore move their focus to the amber and blue quadrants Low < m, High Volume = claims and over These are low value, low volume claims and you may wish to keep a watching brief on these claims. These are low value, high volume claims grouped by specialty. You may consider reviewing any themes that arise. Volume (Low to high) Qualifications for the Data Presented in this Score Card. Criteria for Claims Selection in this Score Sheet The data has been extracted from the NHS LA Claims Management System (CMS). It covers the years detailed above in the "Selection Criteria" section. A claim will appear if the incident occurred within those years.. Claim s* The value of a claim is the total of: The amount paid in damages, claimant costs, defence costs and, for open claims, the estimated value of the claim at the time when the data was taken from CMS. The date in which the data was taken from CMS is defined "Data Correct at" section.. Data Groupings Claims within Obstetric specialty may contain some Gynaecological claims. These can be identified in the "Specialty" column in the zone data sheet. Report Version: 59

2 Trust Clinical Claim - High /Volume Scorecard Selection Criteria: CNST claims received with an Incident Date between /4/ and //6 Total number of claims for this Trust: 9. Total value of claims for this Trust 48,9,85 Data correct at: /9/6 Nr Nr Anaesthesia,5, Neurosurgery 8 8,85, Cardio Surgery,59, Grand Total 8 8,85, Casualty / A & E,85, Grand Total 4 5,665, (Low to High) Nr Nr Genito-Urinary Medicine,5 Anaesthesia 5,75 Histopathology 5,5 Cardio Surgery,885,45 Neurology, Cardiology 7 8,9 Not Specified - Casualty / A & E 5 4,49,97 Nuclear Medicine 6, Dermatology 4 57,557 Obstetrics 95 Endocrinology, Occupational Physician 8,46 Gastroenterology 5 756,75 Oral & Maxillo Facial Surge - General Medicine 9 79,67 Other,5 General Surgery,5,44 Pharmacy 7,9 Geriatric Medicine 47, Renal Medicine - Intensive Care Medicine 4,4,467 Grand Total 4,48 Neurosurgery 4 4,75,87 Oncology 5 4,5 Opthalmology 6,5 Orthopaedic Surgery 4,8,94 Otorhinolaryngology/ ENT 6 8,6 Plastic Surgery 598,756 Radiology 9 765,667 Respiratory Medicine/ Thoracic M 4 65,6 Surgical Speciality - Other 58, Urology 4,575,9 Vascular Surgery 7 8,854 Grand Total 8,448,9 Volume (Low to high)

3 Scorecard - Red Zone Analyses Cause Failure/Delay Diagnosis,,. Inappropriate Treatment,,. Fail / Delay Treatment 4,4,. Intra-Op Problems 6,,. Inadequate Nursing Care,,. Fail To Recog. Complication Of,78,. Operator Error,55,. Grand Total 8,85,. 8 in M High Volume High Claims Filtered on all relevant specialties CauseL Failure/Delay Diagnosis Inappropriate Treatment Fail / Delay Treatment Intra-Op Problems Cause Inadequate Nursing Care Fail To Recog. Complication Of Operator Error s Selection Criteria: CNST claims received with an Incident Date between /4/ and //6 Total number of claims for this Trust: 9. Total value of claims for this Trust 48,9,85 Data correct at: /6/6

4 Scorecard - Red Zone Analyses Injury Brain Damage 8,,. Paraplegia,,. Foot Drop,5,. Tetraplegia/ Quadraplegia 4,45,. Spinal Damage,85,. Grand Total 8,85,. 8 in M Injury High Volume High Claims Filtered on all relevant specialties Brain Damage Paraplegia Foot Drop Injury Tetraplegia/ Quadraplegia Spinal Damage s Selection Criteria: CNST claims received with an Incident Date between /4/ and //6 Total number of claims for this Trust: 9. Total value of claims for this Trust 48,9,85 Data correct at: /6/6 4

5 Scorecard - Blue Zone Analyses Cause Nr of Claims Fail / Delay Treatment 5,55,59 6 Failure/Delay Diagnosis 4,77,6 45 Intra-Op Problems,8,969 6 Failure To Perform Tests,7, Fail To Act On Abnorm Test Res,57,87 Perform. Of Op. Not Indicated,56, Fail To Recog. Complication Of 97,87 Inadequate Nursing Care 865,65 9 Inappropriate Treatment 744,44 Fail/Delay Admitting To Hosp. 75, Fail To Warn-Informed Consent 46,95 7 Operator Error 4,4 Fail To Supervise 49,87 Err With Agnt/Dose/Route/Selec 4,669 4 Sexual Abuse 86,968 4 Failure To Interpret X-Ray 8,79 5 Assault, Etc By Hospital Staff 49,56 Fail To Carry Out PO Observs. 8, Other 54, Medication Errors,944 5 Fail To Follow-Up Arrangements,6 4 Lack Of Assistance/Care 9,75 Inappropriate Discharge 89,5 Foreign Body Left In Situ 84, Diathermy Burns/react. To Prep 79,99 6 Grand Total,58,56 6 in Millions Fail / Delay Treatment Failure/Delay Diagnosis Intra-Op Problems Failure To Perform Tests Fail To Act On Abnorm Test Res Perform. Of Op. Not Indicated Top 5 Low High Volume Claims By Cause Fail To Recog. Complication Of Inadequate Nursing Care Inappropriate Treatment Fail/Delay Admitting To Hosp. Fail To Warn-Informed Consent Operator Error Fail To Supervise Err With Agnt/Dose/Route/Selec Sexual Abuse Failure To Interpret X-Ray Assault, Etc By Hospital Staff Fail To Carry Out PO Observs. Other Cause Medication Errors Fail To Follow-Up Arrangements Lack Of Assistance/Care Inappropriate Discharge Foreign Body Left In Situ Nr of Claims Diathermy Burns/react. To Prep Nr of Claims Selection Criteria: CNST claims received with an Incident Date between /4/ and //6 Total number of claims for this Trust: 9. Total value of claims for this Trust 48,9,85 Data correct at: /6/6 5

6 Scorecard - Blue Zone Analyses Injury Nr of Claims Fatality 5,, Adtnl/unnecessary Operation(s),87,776 Unnecessary Pain,689,64 7 Brain Damage,98, 5 Spinal Damage,69,76 6 Fracture,,58 7 Peritonitis,47,5 Paraplegia,4,975 Nerve Damage 944,8 5 Amputation - Upper 95, Renal Damage/ Failure 88,5 Amputation - Lower 66, 6 Bowel Damage/ Dysfunction 6,46 7 Cancer 56,654 7 Pressure Sores 497,8 Not Specified 465, Perforation 44, Poor Outcome - Fractures Etc. 78,5 7 Liver Damage 8, Sexual Abuse 96,968 4 Partial Paralysis 95,5 Psychiatric/Psychological Dmge 78,8 8 Cosmetic Disfigurement 6,78 4 Tissue Damage 6, Foot Drop, Grand Total,57, 4 in Millions Fatality Adtnl/unnecessary Operation(s) Unnecessary Pain Brain Damage Spinal Damage Fracture Peritonitis Top 5 Low High Volume claims by Injury Paraplegia Nerve Damage Amputation - Upper Renal Damage/ Failure Amputation - Lower Bowel Damage/ Dysfunction Cancer Pressure Sores Not Specified Perforation Poor Outcome - Fractures Etc. Injury Liver Damage Sexual Abuse Partial Paralysis Psychiatric/Psychological Dmge Cosmetic Disfigurement Nr of Claims Tissue Damage Foot Drop Nr of CLaims Selection Criteria: CNST claims received with an Incident Date between /4/ and //6 Total number of claims for this Trust: 9. Total value of claims for this Trust 48,9,85 Data correct at: /6/6 6

7 Scorecard - Yellow Zone Analyses Cause Fail / Delay Treatment,85, Other,8, Inadequate Nursing Care,5, Delay In Performing Oper,, Grand Total 5,665, 4 in M CauseL Low Volume High Claims Filtered on all relevant specialties Fail / Delay Treatment Other Cause Inadequate Nursing Care Delay In Performing Operation Selection Criteria: CNST claims received with an Incident Date between /4/ and //6 Total number of claims for this Trust: 9. Total value of claims for this Trust 48,9,85 Data correct at: /6/6 7

8 Scorecard - Yellow Zone Analyses Injury Amputation - Lower,59,. Brain Damage,85,. Paraplegia,5,. Grand Total 5,665,. 4 Low Volume High Claims Filtered on all relevant specialties in M Amputation - Lower Brain Damage Paraplegia Injury Selection Criteria: CNST claims received with an Incident Date between /4/ and //6 Total number of claims for this Trust: 9. Total value of claims for this Trust 48,9,85 Data correct at: /6/6 8

9 Scorecard - Yellow Zone Analyses Selection Criteria: CNST claims received with an Incident Date between /4/ and //6 Total number of claims for this Trust: 9. Total value of claims for this Trust 48,9,85 Data correct at: /6/6 9

10 Scorecard - Green Zone Analyses Cause Failure/Delay Diagnosis 9,5 Fail To Infrm Test Rslts 8,46 Medication Errors 69,9 Cross Infection 6, Inadequate Nursing Care, Intra-Op Problems,5 Bacterial Infection,5 Fail / Delay Treatment 95 Inappropriate Treatment - Fail To Warn-Informed Consent - Operator Error - Injured By Another Patient - Inappropriate Discharge - Grand Total,48 4 in Low Volume Low Claims Filtered on all relevant specialties Failure/Delay Diagnosis Fail To Infrm Test Rslts Medication Errors Cross Infection Inadequate Nursing Care Intra-Op Problems Bacterial Infection Fail / Delay Treatment Inappropriate Treatment Fail To Warn-Informed Consent Operator Error Injured By Another Patient Inappropriate Discharge CauseL Cause s Selection Criteria: CNST claims received with an Incident Date between /4/ and //6 Total number of claims for this Trust: 9. Total value of claims for this Trust 48,9,85 Data correct at: /6/6

11 Scorecard - Green Zone Analyses Injury Other 7,7 Low Volume, Low Claims showing Injury Filtered by Specialty Unnecessary Pain, Fatality 4,6 6 Adtnl/unnecessary Operation(s),5 5 Perforation - 4 Psychiatric/Psychological Dmge - Deafness - Grand Total, in InjuryL Other Unnecessary Pain Fatality Adtnl/unnecessary Operation(s) Injury Perforation Psychiatric/Psychological Dmge Deafness s Selection Criteria: CNST claims received with an Incident Date between /4/ and //6 Total number of claims for this Trust: 9. Total value of claims for this Trust 48,9,85 Data correct at: /6/6

2015 Detailed Postgraduate Training Report: Grampian

2015 Detailed Postgraduate Training Report: Grampian 2015 Detailed Training Report: Grampian out of hours Aberdeen Maternity Hospital - N161H Community Sexual and Reproductive Health ST 1 Aberdeen Maternity Hospital - N161H Obstetrics and Gynaecology F2