A large community hospital's experience with an obstetrics-gynecology risk management committee: quality assurance.

In an era when medical-legal suits and awards are escalating, a major metropolitan hospital in Seattle, Washington, has developed a plan to identify and effectively deal with problem physicians, improve patient care, and reduce medical liability for the institution. The Department of Obstetrics and Gynecology of The Swedish Hospital Medical Center formed a risk management committee that met regularly to monitor and evaluate clinical complications and questions of professional incompetence or physician impairment. A system for detecting such cases was established through liaison with other hospital peer review committees or any physician or nurse who was privy to specific information and willing to submit it in writing. Cases were carefully and objectively analyzed and evaluated as to their significance and severity. Single serious errors in case management were brought to the attention of the offending physician. Chronic offenders had privileges restricted or revoked with the approval of the hospital executive committee. This has resulted in improved medical care for patients and a reduction in medical-legal action against the hospital.