Becker's Clinical Quality & Infection Control

15 PATIENT SAFETY & OUTCOMES Hospital hires firm to review surgery program after physician's 21 malpractice settlements By Alexis Kayser C atholic Medical Center in Manchester, N.H., has hired Pittsburgh-based law firm Horty Springer & Mattern to conduct an "independent, external review" of its cardiac surgery program. The move comes after the hospital allegedly protected a surgeon with 21 malpractice settlements. The firm will evaluate the safety and quality of the hospital's cardiac surgery program, according to an Oct. 13 news release from the hospital shared with Becker's. The firm will also investigate processes related to its staffing, administration and board, including how leadership handles physician concerns. The review will take several months and will be facilitated by a special committee of the board of trustees, according to the release. No members of the administration or medical staff will sit on the special committee. On Sept. 7, The Boston Globe released a two-part investigation into the practices of Yvon Baribeau, MD, a cardiac surgeon who served at Catholic Medical Center until his retirement in 2019. Dr. Baribeau had one of the worst medical malpractice records in the country, according to the Globe. Physicians frequently expressed concerns about Dr. Baribeau's malpractice — one cardiologist filed a whistleblower suit against him in 2018, and physicians took the case to the Catholic Church — but according to the Globe, the hospital protected and continued to celebrate Dr. Baribeau, who could earn up to $200,000 off one case. In 2018, Dr. Baribeau committed five surgical errors in five weeks that led to patient injury or death, the Globe reported. In 2020, he settled 17 claims made against him, spanning six years of surgeries. On Sept. 14, one week after the initial Globe piece was released, the newspaper published an update: Catholic Medical Center told employees it would hire an outside firm to review its "clinical oversight and accountability, peer review and reporting processes." "This review will help us understand what could have been done better in the past but, most importantly, it helps us chart a future based on industry-leading best practices," Tim Riley, chair of the hospital's board, said in the release shared with Becker's. n Despite hospitals' prioritization and attention dedicated to these events, falls have proved to be an incredibly difficult challenge to get ahead of simply because of all the contributing factors tied to them. Hospitalized patients are oen not feeling their best and in unfamiliar environments. Some may be disoriented and require medications that worsen those feelings. And even when patients are aware that they shouldn't try to get up from bed on their own, inevitably, there are times when it happens. "At moments, for example, when you really need to get up and go to the restroom and feel like you could do it, or perhaps have a suspicion that if you ring the call bell, it won't work, people take it [upon] themselves to climb over the bed rails which almost always guarantees that they'll be higher off the ground … and succeed in falling," Albert Wu, MD, professor of health policy and management at Baltimore- based Johns Hopkins Medicine, told Becker's. While tech-powered interventions are exciting and certainly have a place, on their own, they're oen too late at actually reducing falls since the patient is already moving around by the time an alert is provided, underscoring the need to pair them with other strategies. "ere are reviews of rigorous studies — that is to say clinical trials — that in general have failed to find any effect of these interventions on reducing falls," Dr. Wu said. "I love a cool gadget as much as the next person, but the killer app would be some intervention that actually works [at reducing injurious falls]." While there's no single strategy to prevent all patient falls, one thing is clear: "We have to have different types of options," Ms. Ramsey said. at means having a combination of interventions individualized to the patient. Such combinations may include a bed exit alarm, rearranging furniture in a patient's room and lining the floor with fall mats. At Northwestern, once care teams are aware that a patient has a greater potential to fall — perhaps because of certain medications they're taking or a history of falling at home — and are alerted of the interventions put in place, the next step is to clear communication with the patient and their family. "We say, 'OK, do you agree to this plan?'" Ms. Ramsey said. "You know to always use the call light. You know not to get up by yourself. If there's family in the room [we tell them] you know you're not to get the patient up without our assistance." e most important component is individualizing the care plan, she said. at includes an assessment of how many people are required to get a patient up and whether li equipment is necessary. "ere's not a one size fits all in preventing falls," Ms. Ramsey said. "It [requires] an individualized care plan with many different types of interventions." n

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