Medical Malpractice Claims Investigations: A Step-by-Step Approach.

Medical Malpractice Claims Investigations: A Step-by-Step Approach is a handy desk reference designed to function as a primer for medical malpractice claims investigations. The intended audience is claims investigators, risk managers, attorneys, and others involved with malpractice lawsuits. The

Acerbo-Avalone and Kremer explain the risk management function in lay terms, characterizing it as a means to protect financial assets and reduce liabilities stemming from adverse patient events. They provide a step-by-step approach to medical record evaluation, which defense attorneys will find useful for assessing liability and developing a defense.

Several helpful hints focus on investigations and the review of medical records. One hint suggests the use of an "alert" form to record oral information given to a risk manager by a care giver. The risk manager can screen the form and send it to an investigator, who then can review the form for potential liability.

The book also provides guidelines for responding to attorney request letters, including the suggestion that medical records should be reviewed before being released to allow the hospital to check for adverse events that could have resulted in patient injury and liability to the hospital.

Billing is an integral part of claims investigation. The book explains how patient billing is used by defense counsel to make claims for damages.

Medical Malpractice Claims Investigations includes a chapter on interviewing techniques, from identifying individuals to be interviewed to how to conduct an interview. The book also includes a "how-to" chapter on investigations of equipment-related events.

In addition, the authors provide information on informed consent, claims management, and confidentiality After explaining each subject, the authors offer several practical recommendations that most healthcare organizations will find useful. Medical Malpractice Claims Investigations can help healthcare organizations develop an investigative process and produce comprehensive investigative reports that can be used when mounting a legal defense.

Reviewed by Christopher C. Boutin, FHFMA, CPA, acting director, audit services, Baystate Health System, Inc., Springfield, Massachusetts, and a member of HFMA's Massachusetts Chapter.