A Fault-Based Administrative Alternative for Resolving Medical Malpractice Claims

The recurring crises in medical malpractice litigation have been widely discussed and documented over the past two decades.\u27 In response to these crises, a growing consensus has emerged among legislatures, government agencies, and scholars in favor of tort reform. Indeed, virtually every state has passed some tort reform legislation.\u27Despite the reforms, several serious problems persist in medical malpractice. The current tort system does not compensate injured patients adequately or equitably, nor does it deter negligent practices sufficiently. These failings occur despite the increasingly high costs to society of the tort system. Particularly troublesome is the impact of these crises on the access to and quality of medical care. In response to these persistent problems and the failure of conventional tort reform efforts, the American Medical Association, thirty-one national medical specialty societies, and the Council of Medical Specialty Societies have joined together as the AMA/Specialty Society Liability Project (Liability Project) to propose a new and comprehensive alternative to the existing tort system. The proposal has three components and is designed for implementation on an experimental basis in one or more states. The proposal first calls for an administrative hearing process to re-place the civil jury system in deciding claims of medical malpractice.Second, while fault is retained as the basis for liability, the proposal modifies several of the other legal rules for determining liability. These first two elements of the proposal are designed to bring greater rationality, equity, and efficiency to the tort system\u27s goal of compensation. The proposal also includes reforms of the processes for educating, credentialing, and disciplining physicians. These changes will ensure that physicians are of a high quality which, ultimately, is the purpose of deterrence in the current malpractice system. Part II of this Article discusses the problems with the current tort regime in medical malpractice. Part III describes the medical profession\u27s proposed alternative, and Part IV explains why the proposed system is superior to the current tort system in dealing with medical injury. Part V concludes that the proposed administrative alternative is fair to patients, physicians, and the public and deserves implementation, at least on an experimental basis

Towards an International Classification for Patient Safety: the conceptual framework

Global advances in patient safety have been hampered by the lack of a uniform classification of patient safety concepts. This is a significant barrier to developing strategies to reduce risk, performing evidence-based research and evaluating existing healthcare policies relevant to patient safety. Since 2005, the World Health Organization's World Alliance for Patient Safety has undertaken the Project to Develop an International Classification for Patient Safety (ICPS) to devise a classification which transforms patient safety information collected from disparate systems into a common format to facilitate aggregation, analysis and learning across disciplines, borders and time. A drafting group, comprised of experts from the fields of patient safety, classification theory, health informatics, consumer/patient advocacy, law and medicine, identified and defined key patient safety concepts and developed an internationally agreed conceptual framework for the ICPS based upon existing patient safety classifications. The conceptual framework was iteratively improved through technical expert meetings and a two-stage web-based modified Delphi survey of over 250 international experts. This work culminated in a conceptual framework consisting of ten high level classes: incident type, patient outcomes, patient characteristics, incident characteristics, contributing factors/hazards, organizational outcomes, detection, mitigating factors, ameliorating actions and actions taken to reduce risk. While the framework for the ICPS is in place, several challenges remain. Concepts need to be defined, guidance for using the classification needs to be provided, and further real-world testing needs to occur to progressively refine the ICPS to ensure it is fit for purpos

Towards an International Classification for Patient Safety: the conceptual framework

Global advances in patient safety have been hampered by the lack of a uniform classification of patient safety concepts. This is a significant barrier to developing strategies to reduce risk, performing evidence-based research and evaluating existing healthcare policies relevant to patient safety. Since 2005, the World Health Organization's World Alliance for Patient Safety has undertaken the Project to Develop an International Classification for Patient Safety (ICPS) to devise a classification which transforms patient safety information collected from disparate systems into a common format to facilitate aggregation, analysis and learning across disciplines, borders and time. A drafting group, comprised of experts from the fields of patient safety, classification theory, health informatics, consumer/patient advocacy, law and medicine, identified and defined key patient safety concepts and developed an internationally agreed conceptual framework for the ICPS based upon existing patient safety classifications. The conceptual framework was iteratively improved through technical expert meetings and a two-stage web-based modified Delphi survey of over 250 international experts. This work culminated in a conceptual framework consisting of ten high level classes: incident type, patient outcomes, patient characteristics, incident characteristics, contributing factors/hazards, organizational outcomes, detection, mitigating factors, ameliorating actions and actions taken to reduce risk. While the framework for the ICPS is in place, several challenges remain. Concepts need to be defined, guidance for using the classification needs to be provided, and further real-world testing needs to occur to progressively refine the ICPS to ensure it is fit for purpose

Translation and Evolution: Byzantine Monastic Studies since ca. 1990

While monks were integral parts of the long‐lasting Byzantine world, Byzantine monasticism and its study can be relatively obscure to nonspecialists, given the diversity of monastic forms practiced in the empire. This piece presents a brief primer on Byzantine monastic studies and evaluates key scholarship in this increasingly vigorous field. In particular, it assesses the major impact of critical editions and primary‐source translation projects since the 1990s and 2000s, including both archival materials and hagiography. Furthermore, it evaluates the current state of the field and outlines several opportunities and directions for further research