Medical Malpractice

Published on May 2016 | Categories: Documents | Downloads: 23 | Comments: 0 | Views: 212
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Medical Malpractice
Vithal Vernenkar, D.O St. Barnabas Hospital Department of Surgery

Goals
To understand medical error and appreciate the causes of malpractice claims  To learn ways to reduce medical error and avoid claims  To view Risk Management as a resource when questions involving medical error arise


MEDICAL ERROR
A “preventable adverse medical event”  “adverse event”

 “an

injury that was caused by or is associated with medical management and that results in death or measurable disability”

ELEMENTS OF A MALPRACTICE CLAIM
Physician owes duty to patient  Deviation from “standard of care”  Patient must sustain injury  Physician’s actions are proximate cause of injury


WHY PATIENTS SUE
Dissatisfied with quality or cost of care  Feel they’ve been wrong  Sustain injury or imperfect result  Perceived MDs as rude, unsympathetic  Culture of a litigious society


PHYSICIAN-PATIENT RELATIONSHIP
     

Cornerstone of good medical practice and risk management Often more crucial than outcome Negative perceptions based on health care providers’ attitudes Establish good rapport, concern, and trust Establish open communication and effective listening skills Be aware of limitations

MEDICAL RECORD
Records clinical information  Provides means to communicate among providers  Documents medical necessity of treatment  Supports billing and reimbursement  Helps evaluate cost-effectiveness of care  Serves as a legal document


GOOD RECORD-KEEPING
Use common sense  Make them complete, timely, and accurate  Write legibly, use correct grammar & spelling  Use ink  Abbreviate correctly  Include date, time, and signature


GOOD RECORD-KEEPING PRACTICES (cont’d)



     

Document factually and contemporaneously Write entries chronologically Make entries continuous Be specific Be consistent Be thorough Be clear No underlining or starring

DOUMENTING/CHANGING THE RECORD


DO
 Know

the facility procedure for making corrections  Standard approach:
 Draw

single thin pen line through entry  Record change in chronological order  Date and initial change  Note reason entry is being replaced  Have notation witnessed if possible

DOCUMENTING/CHANGING THE RECORD (cont’d)


DON’T
 Delete

material or destroy record  Use correction take or fluid  Make self-serving statements  Be flip, cavalier, sarcastic or inappropriate  Use the record to “vent” even to defend yourself

DISCLOSURE OF MEDICAL ERROR
Preserves patient trust  Requires balancing of multiple concerns  Respects patient's right to selfdetermination  May cause harm  Difficult area


REPORT TO RISK MANAGEMENT


REPORT:
 Any
 Any  Any  Any  Any

significant complaint or complication attorney inquiry threat of legal action subpoena doubt whether or not to report

BENEFITS OF REPORTING


R/M can assist you with
 What

to disclose  How to make a disclosure  What and how to appropriately document record  Billing adjustment, when appropriate  Flagging and securing medical record

OTHER INTERNAL MECHANISMS
Patient advocate/patient relations dept.  Social work  Hospital ethics/infant care committees  Psych consult re capacity


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