RM principles can protect you from liability

Proactive steps include documentation

Detailed documentation can help case managers minimize their risk if a patient or family member sues the organization for which they work, says Susan Gilpin, JD.

"Documentation is important because you never know when a situation can go dramatically wrong. Case managers may end up being named in lawsuits along with anyone else who ever touched the patient because attorneys tend to take a shotgun approach when litigating," adds Gilpin, chief executive officer of the Commission for Case Manager Certification based in Rolling Meadows, IL.

Even if a case manager is not found liable or if the judge dismisses the case manager as a defendant before the trial occurs, the attorney fees are likely to be substantial, Gilpin points out.

That’s why she advises case managers to take proactive steps to avoid being named in lawsuits and to protect themselves from liability in the event they are named. These steps not only help protect the case manager, but also lead to better services being rendered to individuals as well, she adds.

In today’s litigious society, it’s more important than ever for all members of the health care team to take steps to protect themselves.

"Patient rights are getting a lot of attention. There are reports in the media about people suing their HMO because they didn’t get appropriate diagnostic tests early on," Gilpin points out.

She advises case managers to start by explaining their role to the family and patient and clearly documenting that they provided appropriate information about case management services and received informed consent for case management.

This may not keep case managers out of a lawsuit, but it may mitigate their role in it by showing that they attempted to inform the patient and family exactly what the case manager’s role is so they don’t have unrealistic expectations about case management services or expect a case manager to provide hands-on treatment, Gilpin says.

Work with your employer to develop a handout to inform patients and family members about the role of a case manager, she suggests.

"A lot of times, lawsuits occur when there is a misunderstanding with regard to someone’s specific role. People hear different things in a stressful situation. Case managers should have something to hand them that they can look at later," she adds.

Creating a document could just be a matter of taking your job description and making a bullet-point sheet out of the parts where you deal directly with individuals. For example, it could say, "I will coordinate your care. I will work with you on getting appointments with specialists . . ."

However, make sure you actually are doing the tasks that you list, Gilpin cautions.

Use the handout as a checkout sheet to help you document that you cover each issue. Make sure that your documentation is objective with no personal comments, she cautions. For instance, even if you don’t believe the person is telling you the truth, don’t put it down on paper.

"Any time you veer away from objective reporting, you could be putting yourself in personal jeopardy," she adds.