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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.

The early identification of the subtle signs of increased bioburden in a wound enables timely and appropriate treatment and therefore improved patient outcomes. The rising costs of antimicrobial dressings and the growth in antibiotic-resistant organisms increase the need for correct diagnosis. Indiscriminate use of antibiotics is a significant contributory factor in bacterial resistance. This article describes a new tool devised by a professional working group of tissue viability nurse specialists which is designed to help healthcare professionals to identify and manage bacterial burden in wounds. It is hoped that this will assist prompt diagnosis and help to reduce patient morbidity with appropriate and timely interventions. Author