CRICO Celebrates 40 Years in Patient Safety
Early in its history, CRICO recognized that accessing, analyzing, and learning from claims data required coding it consistently to a taxonomy of contributing risk factors. Reflecting the dynamic nature of healthcare and risk mitigation, CRICO’s proprietary taxonomy is updated regularly, with input from clinicians and patient safety experts. A relatively recent update to the taxonomy allows coders to track claims showing EHR use as a contributing factor. This clinical coding system is what allows CRICO to gain value from the data—identifying emerging risks, understanding current trends, and evaluating the effectiveness of solutions (Siegal & Ruoff, 2015). Jonathan Einbinder, MD, CRICO’s assistant vice president for advanced data analytics and coding, says, “Data has a role at every stage of the process.”
Inspired by an upward trend in medical malpractice cases in emergency medicine, CRICO convened a national council of emergency department (ED) chiefs, nurses, and quality leaders from 19 academic and community hospitals in six states to conduct an in-depth study of ED claims from CBS in 2010. Their assessment identified specific causative factors from which the council developed a series of strategies to mitigate ED risk, which was published in a subsequent white paper (Optimizing physician-nurse communication, 2011).
In addition to providing its national clients with analytics and education, Strategies has published a comparative benchmarking report on a different topic each year since 2009. All of the reports are available to the public on CRICO’s website (https://www.rmf.harvard.edu/Malpractice-Data/Annual-Benchmark-Reports).
Looking to the future
Looking ahead from the perspective of this 40th anniversary, President Mark Reynolds sees CRICO’s strengths and resources as a good match for future challenges. CRICO’s work on patient safety will track with healthcare delivery’s continuing shift to ambulatory settings and include diagnostic safety and other areas that are new or have not received the attention they deserve. Medicine still has much to learn about patient engagement and its role in safety. As networks continue to expand and practices merge, CRICO will work with its members and clients to understand how to evaluate and mitigate acquired risk. And making sure that the infrastructure for data analytics and the knowledge involved in keeping the coding taxonomy are both up to date will demand constant attention.
CRICO is proud of its 40-year history of contributions to patient safety. It may seem obvious that the best way to guard against harming patients, providers, and institutions is by understanding and mitigating risks in healthcare delivery. But the work of learning, teaching, and supporting is, like healthcare systems, complex. CRICO has served members, clients, and other stakeholders with diverse interests largely by honoring relationships and encouraging collaboration even among natural competitors. Carol Keohane, assistant vice president for patient safety, says, “CRICO doesn’t want to compete on safety,” which may be the secret to success.
Susan Carr is a writer and editor specializing in patient safety and quality improvement. She lives and works in Concord, Massachusetts, and may be contacted at susan_carr@mac.com.
References
Arriaga, A., Elbardissi, A., Regenbogen, S. E., Greenberg, C. C., Berry, W. R., Lipsitz, S.,…Gawande, A. A. (2011). A policy-based intervention for the reduction of communication breakdowns in inpatient surgical care: Results from a Harvard surgical safety collaborative. Annals of Surgery, 253(5), 849–854. doi:10.1097/SLA.0b013e3181f4dfc8
CRICO. (2013, August 31). Pharmacy compounding safe practice recommendations. AMC PSO Patient Safety Alert, 14. Retrieved from https://www.rmf.harvard.edu/Clinician-Resources/Newsletter-and-Publication/2013/AMC-PSO-Patient-Safety-Alert-Issue-14
ElBardissi, A. W., Regenbogen, S. E., Greenberg, C. C., Berry, W., Arriaga, A., Moorman, D.,…Gawande, A. A.(2009). Communication practices on 4 Harvard surgical services: A surgical safety collaborative. Annals of Surgery, 250(6), 861–865. doi:10.1097/SLA.0b013e3181afe0db
Optimizing physician-nurse communication
in the emergency department: Strategies for minimizing diagnosis-related errors. (2011, February 14). Proceedings from the CRICO Strategies Emergency Medicine Leadership Council 2010. Retrieved from https://www.rmf.harvard.edu/Clinician-Resources/Article/2011/Optimizing-MD-RN-Communication-in-the-ED
Siegal, D. & Ruoff, G. (2015). Data as a catalyst for change: Stories from the frontlines. Journal of Healthcare Risk Management, 34(3),18–25. doi: 10.1002/jhrm.21161
Smith, R. M., Schaefer, M.K., Kainer, M. A., Wise, M., Finks, J., Duwve, J.,…Park, B. J. for the Multistate Fungal Infection Outbreak Response Team. (2013). Fungal infections associated with contaminated methylprednisolone injections. New England Journal of Medicine, 369, 1598–1609. doi:10.1056/NEJMoa1213978