medical risk management 1 st south american congress risk management santiago, chile august 6 &...
TRANSCRIPT
Medical Risk Management
1st South American Congress Risk ManagementSantiago, Chile
August 6 & 7, 2012
By: Geoffrey HaytonClaims Counsel for Adventist Risk Management
Medical Risk Management
Topics Covered:1. Medical Malpractice2. Risk Management Strategies 3. ARM Claims Process
Medical Malpractice Defined
• Medical malpractice occurs when a medical care provider fails to act as a reasonable medical care provider would have acted under the circumstances.
• (Occurs not merely when there is an error, but when the degree of error exceeds the accepted norm.)
Medical Malpractice Components
1. Duty:The physician has a duty to treat the patient
2. Breach:The physician’s interaction with the patient
falls outside the accepted standard of care3. Causation:
The patient is harmed as a result of this interaction: physician’s actions caused the harm
4. Injury/Damages:Actual damages are suffered by the patient
Hospital Liability
• When the negligent act is committed by a hospital employee (doctor, nurse, etc.) case is controlled by the doctrine of respondent superior.
• The doctrine of respondent superior states that an employer may be held liable for the negligent acts or omissions of its employees, if, the employees were acting within the scope of their employment.
Risk Management and Medical Liability
Why have Risk Management Strategies?• Reduces medical liability exposure• Ultimately provides better care for your
patients• Will provide a more organized office, clinic or
hospital operation• Fewer chances of important details to fall
through the cracks
Medical Risk Management: 3-step Process
1.Identifying risk2.Avoiding or minimizing the risk of loss and 3.Reducing the impact of losses when they occur*Medical Risk Management focuses on risk
reduction through improvement of patient care
Key to Medical Risk Management
Communication….• Although you will not find POOR
COMMUNICATION listed anywhere as an official cause of MEDICAL MALPRACTICE CLAIMS, it underlies almost every malpractice action.
Key to Medical Risk Management
Communication….• Good communication with the patient is
fundamental in achieving a strong physician patient relationship. This relationship requires the physician to provide the patient with the acceptable standard of care.
Key to Medical Risk Management
Communication….• When negligence causes the patient injury,
transparency and openness should be implemented instead of distancing and avoidance.• Negligent actions injuring patients are
primarily due to misinformation and lapse of good judgment and rarely due to malicious recklessness.
Key to Medical Risk Management
Communication….• When injuries or other losses are incurred,
the physician should apologize to the patient.• Compassion and sympathy for patient’s
pain and suffering is not an admission of wrong doing.
Key to Medical Risk Management
Documentation….Serves three purposes:
1. Reminds the healthcare professional what he/she has done for and to the patient
2. Alerts other healthcare professionals what has been done for and to the patient
3. It is a LEGAL RECORD
Key to Medical Risk Management
Documentation….Strengthening the medical record:
1. Write a full note. Write the positives and the negatives.
2. Limit abbreviations.3. Do not ALTER the record.
Documentation of Medical Records
PHYSICIANS
“If the nurses around this hospital would read the medication orders, we would not have medical emergencies like this one.”
NURSES
“If the physicians around this hospital would learn to write so we could read it, there would not be medication emergencies like this one.”
Key to Medical Risk Management
Conclusion….•Risk Management encourages and promotes:– open communication between physicians, nurses,
other medical healthcare providers and their patients
– careful documentation– the development of technical and diagnostic skills– eliminating problem areas in a physician’s practice
and in hospital protocol
Hospital Duties in the Event of a Medical Incident, Claim or Suit
• Every hospital should have an “EVENT REPORTING FORM.”
• Hospital administration must require/mandate that this form be completed.
• Form should be completed as soon as possible following medical incident.
• Form should be completed by all medical care providers involved.
Event Reporting Form
Should include:• Name of person completing form• Name of patient and hospital identification
information• Date and time of medical incident• Description of medical event• Actions taken/Effect/Result• Severity of medical event
When to Use an Event Reporting Form
• Using best medical and administrative judgment, determine the seriousness of the medical incident, or a medical incident “which may result in a claim.”
• A copy of the Event Reporting Form should be sent to Jabson Magalhaes da Silva, General Director of Adventist Risk Management in the South American Division as soon as possible.
Medical Incident is not a “Claim”
• A claim is officially recognized by ARM when the injured party notifies the hospital that they are pursuing indemnity from the “medical incident.”
• The notice by the injured party can be verbal or in writing.
• If an Event Reporting Form has not previously been filed with Mr. da Silva the hospital should do so immediately.
ARM and the Event Reporting Form
• When Mr. da Silva receives Event Reporting Form:– he will notify the Riverside, California ARM office.– local legal counsel will be notified.– legal counsel will contact parties to conduct
further investigation to prepare a defense.– everything possible will be done to resolve the
matter as quickly as possible.
THIS POWER POINT PRESENTATION AND ANY MATERIALS DISTRIBUTED ARE FACT BASED GENERAL INFORMATION AND SHOULD NOT, UNDER ANY CIRCUMSTANCES, BE CONSIDERED SPECIFIC LEGAL ADVICE REGARDING A PARTICULAR MATTER OR SUBJECT. PLEASE CONSULT YOUR LOCAL ATTORNEY OR RISK MANAGER IF YOU WOULD LIKE TO DISCUSS HOW A LOCAL JURISDICTION DEALS WITH ANY SPECIFIC CIRCUMSTANCES YOU MAY BE FACING.