Workshop 1

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Workable Solutions for High-Stake Risks

Robert S. Gold, MD; Anne M. Menke, RN, PhD
OMIC (Ophthalmic Mutual Insurance Company)
San Francisco CA

Purpose/Relevance: Tracking and following up on patient appointments and tests, and coordinating care with other physicians are challenging tasks. The stakes for the patient, the ophthalmologist, and the practice are high, especially if the patient is a premature infant. Through the lens of lawsuits against pediatric ophthalmologists, we will analyze these vulnerable points in the care process.

Target Audience: Pediatric ophthalmologists

Current Practice: Infants being screened for ROP miss key examinations because of inadequate tracking systems. The decision to treat ROP has been delayed when ophthalmologists in an ROP screening team do not conduct a hand-off discussion. Pediatric patients with possible neurological conditions do not get needed diagnostic tests when parents do not make or keep the appointments.
Data source ROP: Risk Analysis (at and OMIC claims data base

Best Practice: Infants being screened for ROP are tracked by the ophthalmologist, an ROP coordinator in the hospital, and an ROP coordinator in the office. Diagnostic tests are tracked until the results are received, the patient is informed, and follow up care is arranged. ||Data sources at : ROP Safety Net: Hospital and Office Toolkits, Noncompliance Toolkit

Expected Outcomes: Participants will collaborate with the speakers to explore solutions that ophthalmologists and practices can readily implement for their patients.

Format: Malpractice claim presentations|Group discussion of specific scenarios|Risk management recommendations and resources

Summary: We will analyze malpractice claims and discuss scenarios. We will identify vulnerabilities in systems designed to track ROP infants during the screening process, clarify follow-up obligations of ophthalmologists and other members of the team treating the patient, and determine a safe, efficient way to coordinate care when multiple physicians are treating a patient.

References: These articles may be accessed at ||Menke AM et al. ROP: Create a Safety Net (available at|Menke AM. Noncompliance: A Frequent Prelude to Malpractice Lawsuits

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