(2) Custodial risk - the risk encountered from being in proximity to the medical
treatment facility. Custodial risk applies to patients, staff, and visitors. For example, a
patient or a staff member may slip on a wet floor, trip over an unprotected electrical cord on
the floor, or a visitor may catch a heel on an unsecured carpet.
b. The AMEDD risk management program is defined by AR 40-68, which
delineates the establishment of a risk management committee and its responsibilities.
(1) All malpractice claims shall be reviewed. Data shall be extracted from every
claim and reported to the National Data Bank. The Department of Defense (DOD) has an
implementation policy on hand.
(2) Original medical or dental records will not be released directly to the patient
or his authorized representative in cases of potential compensable events (PCEs) or
Federal tort claims. The medical claims judge advocate (MCJA) or U.S. Army Claims
Service (USARCS), as appropriate, will release copies of the records. Original records
will not be released unless requested by a Government attorney defending the United
States in a malpractice lawsuit.
(3) When an adverse event is determined to be a PCE by the risk manager
after consultation with the CJA, it will be entered into the Automated Quality of Care
Evaluation Support System (AQCESS) Risk Management Monitoring and Evaluation
(events option) Menu with reports archived as support for possible future malpractice
3-11. RESPONSIBILITIES FOR QUALITY ASSURANCE.
The overall responsibility for the quality of medical care lies with the medical officer.
Everyone on the MTF staff including nursing, support services, and administrative
personnel is responsible for assuring high quality patient care. Individual staff members
are not only accountable for the quality of care provided patients, but also are accountable
for appropriateness of care. However, the MEDDAC/MEDCEN commander has ultimate
authority and responsibility for quality assurance.
3-12. QUALITY ASSURANCE PROGRAM COMMITTEES
The complexity of committee organization will depend upon the size and
composition of the medical staff and the size and mission of the MEDDAC or MEDCEN.
Each separate activity with a Medical Corps (MC) officer commanding will have a QAP,
and the following committees will be formed.