This resource was made available to MIEC through our partnership with Candello. It was written by Hannah Tremont, MPH In today's complex health care environment, preventing harm requires more than reviewing past events; it requires identifying risks before they lead to safety incidents or malpractice claims. At Candello's 2025 Summit session, Raising the Bar for Risk Assessments, three subject matter experts examined the evolution of CRICO and Candello’s Risk Assessment Program and shared strategies to strengthen safety culture across organizations. They outlined two primary assessment models—the Risk Appraisal Process (RAP), which evaluates entire organizations, and the Service Line Risk Assessment...
California SB 1451 and Impacts on Independent Nurse Practitioners
Among the new legislation in California that went into effect in 2025, one law includes some important changes that are likely to further stimulate the growth of independent nurse practitioners (NPs) in California. In 2023, the California Board of Registered Nursing (BRN) began accepting applications for a certification that allows experienced NPs to practice without the need for standardized procedures that outline scope of practice. The new designation, known as a “103” NP, requires NPs to have worked in good standing in California for at least 3 years and requires independently practicing 103 NPs to work in a group setting...
This case study was made available to MIEC through our partnership with CRICO. It was originally written by Margaret Janes, JD,RN, CRICO. Description A 41-year-old woman presented to the ED with a headache; she was treated and discharged within three hours with a diagnosis of migraine. Later the same day, she had an acute event. A CT revealed a subarachnoid hemorrhage from a ruptured aneurysm. Key Lessons Each provider owes it to the patient to make an independent assessment. Effective bias can narrow a clinician’s judgment and consideration of a patient’s complaints. Clinical Sequence A 41-year-old woman with a history...
This case study was made available to MIEC through our partnership with CRICO. It was written by CRICO Staff. Description A newborn died shortly after her birth, which was complicated by prolonged labor and a delayed diagnosis of chorioamnionitis. Key Lessons Determination for consultation in-person versus remote should be criteria-based. Prolonged labor without significant progress must trigger assessment by a (clinical) third-party. Unresolved concerns (e.g., maternal fever, fetal tracings, stagnant dilation) have to be regularly assessed and the care plan adjusted accordingly. Clinical Sequence A morbidly obese 26-year-old in the 41st week of her first pregnancy was admitted to Labor...
This case study was made available to MIEC through our partnership with CRICO. It was written by Kathy Zigmont, BS, RN, CPPS Description A 61-year-old female with a complex medical history died after being administered contraindicated medications. Clinical Events A 61-year-old female with a complicated medical history was admitted for an evaluation of a large right ventricular thrombus with Automatic Implantable Cardioverter Defibrillator (AICD) lead involvement. Her history included non-ischemic cardiomyopathy with ventricular tachycardia, an AICD placement, atrial fibrillation, and recurrent pulmonary emboli. The patient was also taking the antiarrhythmic Dofetilide (500mcg/day), which is associated with QT interval prolongation, a...