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When Things Go Wrong. Mike Purdon, BSc, BA, MDCM, dip ABFP Director, Faculty Development, SMP. Disclosure. I do not have any financial affiliation with any information presented during this session. No products are endorsed during this session. Outline. Errors Three cases

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When things go wrong

When Things Go Wrong

Mike Purdon, BSc, BA, MDCM, dip ABFP

Director, Faculty Development, SMP


Disclosure
Disclosure

  • I do not have any financial affiliation with any information presented during this session. No products are endorsed during this session


Outline
Outline

  • Errors

  • Three cases

  • Frame, then teach

  • Medico-legal aspects


Errors
Errors

  • “A medical error is anything that happens in my office that shouldn’t have happened and I absolutely do not want to happen again”

  • Rare

  • Institute of Medicine, 1999




Frame
Frame

  • What is the morbidity?

  • Technical

  • Normative

  • Knowledge

  • Individual

  • System


Teaching
Teaching

  • Self correcting?

  • Individual actions

  • System actions

    • …demonstrate an awareness of and responsiveness to the larger context and system of health care and learn to effectively call on system resources to provide care that is of optimal value.


Case 2 post partum patient
Case 2: Post partum patient

  • 30 year old woman, six months post partum

  • Sertraline 50 mg daily

  • “No sex drive”

  • Wonders about medication side effects

  • Resident advises continued use of medication


Case 2 post partum patient1
Case 2: Post partum patient

  • “Look, my wife and I had crazy sex until we had a kid. We tried everything at least once.”

  • “I really haven’t had anything that I would call worthwhile sex with her for two years since our son was born.”

  • “Keep taking your medication and tell your husband not to be a hound dog”


Frame1
Frame

  • What is the morbidity?

  • Technical

  • Normative

  • Knowledge

  • Individual

  • Systems


Teaching1
Teaching

  • Self correcting?

  • Individual actions

  • System actions


Case 3 acute sinusitis
Case 3: Acute sinusitis

  • 36 year old male

  • Stereotypical facial pain, fevers, headache

  • Travelling to Mexico for honeymoon

  • Wants course of antibiotics


Acute sinusitis
Acute sinusitis

  • Debate about antimicrobials in treatment of ABRS/AVRS

  • Sample of moxifloxicin x 14 days


Case 3 acute sinusitis1
Case 3: Acute sinusitis

  • Patient seen in ER in Mexico with torrential epistaxis

  • INR 12

  • Nasal packing, vitamin K


Frame2
Frame

  • What is the morbidity?

  • Technical

  • Normative

  • Knowledge

  • Individual

  • System


Teaching2
Teaching

  • Self correcting?

  • Individual actions

  • System actions


Medicolegal aspects
Medicolegal Aspects

  • Disclosure

  • Apology legislation, 2006

  • Case 1

  • Case 2

  • Case 3


Frame3
Frame

  • What is the morbidity?

  • Technical

  • Normative

  • Knowledge

  • Individual

  • Systems


Outline1
Outline

  • Errors

  • Three cases

  • Frame then teach

  • Medico-legal aspects


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