Transparency and Disclosure.

Disclosure of medical errors and adverse outcomes is expected by regulatory agencies and society as a whole. Disclosure should occur in a systematic way that ensures honesty and transparency regarding the care that has been provided. It is often appropriate to seek professional help from Clinical Risk Management to assist with disclosure of any serious safety event that resulted in harm.

Medicolegal considerations in breast health: the benefits of collaboration between OB/GYNs and radiologists.

A common endeavor shared by physicians practicing in specialty fields of Radiology and Obstetrics and Gynecology is the comprehensive care and diagnosis of women with breast problems and breast disease. Because each specialty provides its respective clinical expertise in breast health, each also shares a concern, which is the high risk of litigation associated with a missed or delayed diagnosis of breast cancer. This shared concern is well documented for both specialties.

Single-site laparoscopic management of a large adnexal mass.

Introduction: Single-site laparoscopy is gaining acceptance in many surgical fields including gynecology. The purpose of this report is to demonstrate the technique and outcome for removing a large adnexal mass through a single site.

Case Description: A 41-y-old female was referred to gynecology oncology for increased abdominal girth for 3 mo.

Klippel-Trenaunay syndrome complicated by ascites and vaginal lymphatic drainage in adolescence: a case report.

Background: Klippel-Trenaunay syndrome is a rare disease characterized by capillary malformationsand soft tissue and bony hypertrophy and atypical varicosities. Management of this syndrome is focused primarily on treatment of the complications that arise from these malformations. Ascites and lymphedema are two of the more common complications in these patients.

Patient safety in the ambulatory OB/GYN setting.

The frequency of surgical procedures in the office setting is increasing, and patient safety in this setting now has an expanded focus. Methods and strategies, including Ambulatory Patient Safety Guidelines, results tracking, communication, and risk management principles, will be reviewed in this chapter.

Evaluation and management of abnormal uterine bleeding in premenopausal women.

Up to 14 percent of women experience irregular or excessively heavy menstrual bleeding. This abnormal uterine bleeding generally can be divided into anovulatory and ovulatory patterns. Chronic anovulation can lead to irregular bleeding, prolonged unopposed estrogen stimulation of the endometrium, and increased risk of endometrial cancer.

Intrauterine contraception in adolescents and young women: a descriptive study of use, side effects, and compliance.

Objective: Describe characteristics, compliance, efficacy, and side effect profile of adolescents and young women who use intrauterine contraception (IC).

Study Design: Retrospective chart review of adolescent and young women who had IC devices placed over a 3-year period. Comparative statistics between devices and population characteristics were performed using the Fisher exact and the t test.

Practice management guidelines for the diagnosis and management of injury in the pregnant patient: the EAST Practice Management Guidelines Work Group.

Trauma during pregnancy has presented very unique challenges over the centuries. From the first report of Ambrose Pare of a gunshot wound to the uterus in the 1600s to the present, there have existed controversies and inconsistencies in diagnosis, management, prognostics, and outcome. Anxiety is heightened by the addition of another, smaller patient.

Expanding the SOAP Note to SOAPS (With S for Safety): A New Era in Real-time Safety Education.

The challenges inherent in medical education are multiple, including recognition of different learning styles among students, incorporation of the Accreditation Council for Graduate Medical Education competencies and outcomes measurement into the curriculum, and compliance with mandated duty hours along with a heightened awareness of patient safety required by our regulatory institutions. With the requirement that safety become an explicit part of the residency curriculum across all specialties, educators are charged with innovative ways of achieving this goal. The following commentary addresses this need and suggests an innovative approach to the traditional daily rounds' SOAP (subjective, objective, assessment, and plan) note to incorporate a second S for safety.

Transparency, apology and disclosure of adverse outcomes.

Medical errors became a common topic of conversation with the release of the Institute of Medicine's "To Err Is Human" in November of 1999. This release reported that as many as 98,000 people die each year from inpatient medical errors. Putting this into perspective, deaths from medical errors surpassed deaths from breast cancer, motor vehicle accidents, and AIDS.

Electronic residency application service scores: do they correlate with the rank order list for the match?

Objective: To investigate the relationship between ERAS-based preinterview scores, residency program postinterview scores and candidate rank order for the match.

Study Design: Two hundred sixty-three candidates' preinterview and postinterview scores and rank order were evaluated. The rank order was stratified as 1-4, 5-8, 9-12, > 13 and unranked.

Episiotomy rates in private vs. resident service deliveries: a comparison.

Objective: To compare the use of episiotomy by private practitioners vs. resident staff and to determine if number of years in practice influences episiotomy use.

Study Design: A retrospective chart review of vaginal deliveries at 35 weeks or greater between January 2001 and June 2001.

How do medical student self-assessments compare with their final clerkship grades?

The purpose of this study was to determine how a medical student's self-assessment at the completion of the third-year Ob/gyn clerkship compares with the institution's final grades at Lehigh Valley Hospital. From November 2002 to November 2003 at completion of each six-week Ob/gyn clerkship rotation, 47 medical students assessed themselves on the following parameters: fund of knowledge, personal attitude, clinical problem-solving skills, written/verbal skills, and technical skills. Additionally, they were asked to predict their performance on the NBME Shelf Exam.