PhD Defence Désirée M.T.V. Klemann-Hassani

Keywords: Medical incidents, Liability claims, Network science, Quality and safety of healthcare 
 

"Complexity of healthcare and medical incidents"

This dissertation describes the complexity of healthcare and the (handling of) medical incidents. Our literature review shows that medical incidents often arise at the level of communication, collaboration, organization, and management. An analysis of the (legal) procedures following incident handling reveals that after incidents, the focus is often on the actions of a single individual healthcare provider and on identifying someone responsible or at fault. Incident analysis always takes place on a case-by-case basis, which often prevents the professional community from learning from recurring incidents—and thus from improving quality. 

Trends and developments in the number, costs, and subject of 15 years of liability claims against Dutch hospitals are examined. It is concluded that there has been no increase in the number of claims filed, but there has been a significant increase (fourfold) in the costs associated with claims. The claims are analyzed per medical specialty and compared to the financial turnover of these specialties. A substantive analysis of claims related to gynecology provides insight into the relationship between the type of treatment and the nature of a condition, and the likelihood of damage claims. 

Finally, a method is introduced that, after an incident, does not focus on possible individual errors but instead examines the entire healthcare system, including communication and collaboration among healthcare providers. In this way, strengths and weaknesses in the healthcare system can be identified, and improvement measures can be implemented to organize healthcare in a better and safer way. 

Click here for the live stream.