Using medicolegal data to support safe medical care: A contributing factor coding framework

J Healthc Risk Manag. 2019 Apr;38(4):11-18. doi: 10.1002/jhrm.21348. Epub 2018 Aug 3.


Objective: Traditional medicolegal data analysis focuses on physician care, without a full acknowledgment of the effects of team, organizational, and system factors. We developed a patient safety-informed contributing factor framework to strengthen the coding and analysis of medicolegal data.

Materials and methods: We incorporated patient safety theory and human factors science into our medicolegal case coding practices to improve our understanding of the many factors that contribute to medicolegal events.

Results and discussion: A new framework was developed that has at its core, patients and their experience, and looks beyond the provider factors that are often the focus of medicolegal analysis to give greater consideration to the influence of team, organizational, and system factors. We anticipate that this substantial shift will strengthen our knowledge translation efforts to help improve the safety of medical care.

Conclusion: We believe that reframing medicolegal case coding systems to better identify the influence of team, organizational, and system factors will increase the utility of this analysis in patient safety research, and health care quality improvement.

MeSH terms

  • Clinical Coding / standards*
  • Clinical Coding / statistics & numerical data
  • Data Accuracy*
  • Humans
  • Medical Records / standards*
  • Medical Records / statistics & numerical data
  • Patient Safety / standards*
  • Patient Safety / statistics & numerical data
  • Risk Management / methods*