Consider modifying bylaws to reduce locum tenens risk
Consider modifying bylaws to reduce locum tenens risk
Extending temporary privileges to a traveling surgeon can be risky business, says Leilani Kicklighter, RN, ARM, MBA, CPHRM, LHRM, a patient safety and risk management consultant with The Kicklighter Group in Tamarac, FL, and a past president of the American Society for Healthcare Risk Management (ASHRM) in Chicago.
Even if you utilize due diligence in selecting the agency providing the surgeon, the very nature of locum tenens surgery may mean that you have to cut corners in some of your typical process for privileging surgeons. The shortcut may be unavoidable, but it could come back to haunt you. For instance, if your hospital typically requires that surgeons be credentialed individually and proctored before you grant privileges, a plaintiff's attorney could ask why you saw fit to allow this locum tenens surgeon to operate without proctoring.
"You can make the argument at that point that you had no time for proctoring and had to save the patient's life, but if something goes wrong with that patient, the issue will come up when you're sued," she says.
To avoid inconsistency, which can be used against you later in court, Kicklighter says it may be necessary to modify your hospital's medical bylaws to create a special category for the locum tenens doctor. She suggests raising the idea with physician leaders to determine how the bylaws can better accommodate what is becoming a common practice rather than the exception.
"The special category approved by the physician leadership will show that you have considered the need for locum tenens and established under what conditions it is acceptable," she says. "You have that consistency, rather than just making an exception for locum tenens."
Arun Ravi, a health care consultant with Frost & Sullivan, a consulting firm in New York City, offers these other suggestions for mitigating the risk of locum tenens surgeons:
Put most of your effort into choosing the right locum tenens agency. Ensure that the agency's standards and credentialing are good enough to satisfy your needs, so that you don't have to start from scratch.
Draw up an agreement that each locum tenens surgeon must sign before operating. This agreement, which is in addition to the standard contracts and documents that bring the doctor to your facility, can address any particular concerns you have about policies and procedures unique to your hospital. This agreement can alert the surgeon to any protocols you expect him or her to follow.
Require the surgeon to arrive at least 12 hours before the first scheduled procedure, or preferably 24 hours. This will provide enough time for an orientation and rest.
Provide an orientation tour of the hospital, with particular attention to the surgical area and the types of equipment that will be used for the procedure.
Extending temporary privileges to a traveling surgeon can be risky business, says Leilani Kicklighter, RN, ARM, MBA, CPHRM, LHRM, a patient safety and risk management consultant with The Kicklighter Group in Tamarac, FL, and a past president of the American Society for Healthcare Risk Management (ASHRM) in Chicago.Subscribe Now for Access
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