Transporting patients can increase legal risk

Question: We transport patients to our clinic on an informal basis sometimes, just letting them ride along with the nurse if she's on her way back from the work site, for instance. It's not offered as an actual service to the client, so we've never made a big deal about it. But now I've heard that this could be a real liability risk if there's an accident and the patient is injured. Should we stop offering rides?

Answer: Yes, you should stop this practice immediately. Providing rides to your clinic in a casual way is a major liability risk for your organization, says Sam Storey, workers' compensation coordinator for WellStar Health System in Atlanta, part of the Promina health system.

This is a good example of how a small "favor" to your clients can blow up in your face. The problem lies in the fact that there is no arrangement for addressing, and reducing, the costs that might be incurred if the nurse is involved in an auto accident or other incident that injures the patient riding along. In the event of an accident, the nurse's auto insurance would be expected to pay first, but the health care facility would be sued for damages if the auto insurance limits were insufficient.

"In reality, they would come after the hospital regardless, because the hospital has deep pockets," Storey says. "The potential payout for an accident like that is significant." Storey says he would put an immediate stop to this practice if he heard about it at one of his facilities. If it were just an isolated incident with one employee, he might meet with that employee and his or her supervisor to explain that the rides violate company policy and why they pose too much of a liability risk. If it were more of a widespread problem, Storey says he would address it by conducting inservices and sending out companywide memos.

And besides the liability concerns with an auto accident, Storey notes it is not safe for a nurse to provide transportation to a patient. Not only might he or she be accosted during the trip, but the assault also could result in a lawsuit against the hospital if the organization had condoned such practices.

A better option is to have arrangements with a local taxi service or non-emergency medical transportation service for taking patients to the occupational health clinic. Those arrangements are common for occupational health providers and should be the only type of transportation provided by the clinic staff.

"Other than putting them in a taxi or an ambulance, you have to leave it up to the employer to drive them to your clinic," Storey says. "It's not acceptable to drive them yourself, even if it seems like you're just doing a favor for someone who's heading that way. The liability risk is too great."

Sam Storey, WellStar Health System, P.O. Box 725522, Atlanta, GA 31139. Telephone: (770) 956-6331.