Evaluate your agency's visit quotas -- or else
Evaluate your agency’s visit quotas or else
Quotas cost pharmacy $16 million
Maintaining a balance between staff productivity and profits can be tricky. Do you try to squeeze as many visits as you can out of each nurse? Or do you allow nurses to remain comfortable, never challenging their current quotas?
Both approaches have problems, but you may want to rethink your answers to those questions in light of a South Carolina personal injury case. In a multi-million dollar award, a jury found against Rite Aid of South Carolina, largely because of an unrealistic workload placed on a staff pharmacist whose error resulted in severe brain damage to a child.1
Seven-year-old Gabrielle Hundley, being treated for hyperactivity, suffered permanent brain damage when a Rite Aid pharmacist filled a Ritalin prescription with Glynase. As a result, the child received more than 16 times the recommended Glynase starting dose for adult diabetes patients. Her blood sugar dropped dramatically, causing seizures and a hypoglycemic coma. She now is classified as mentally retarded with an IQ of 69.
According to James C. Anders, JD, a trial lawyer with James C. Anders, PA, in Columbia, SC, and the plaintiff’s lead attorney in the Rite Aid case, it all comes down to workload.
It’s not uncommon for home infusion agencies to fine-tune operations, institute new policies, or even add computers to increase nursing visit quotas. But at what point are you sacrificing income and efficiency for patient and staff safety?
Avoid extreme circumstances
The Rite Aid case resulted in the jury awarding Anders’ client the state’s highest-ever personal injury award $16 million.
He says the workload of Rite Aid’s pharmacists stunned the jury. The pharmacist in error was 67 years old yet was working five 12-hour days each week. A second pharmacist, age 72, worked two 12-hour days each week.
"We portrayed the pharmacist, and rightfully so, as a victim along with our client," notes Anders.
Sound like a bizarre case that could have no effect on your agency? Anders says otherwise.
"If the profit motive overtakes the operation whether it is home infusion or a pharmacy if they try to overly maximize profits, they’re going to have problems," he says. "I can see the same thing happening in a home infusion agency that happened here."
A Rite Aid official would not comment on the case, telling Home Infusion Therapy Management only that an appeal has been filed. In the meantime, interest is accumulating at $6,144.66 a day, as required by South Carolina law.
Anders isn’t the only one who sees the trend toward increasing productivity as a time bomb.
"It’s the same thing if the nursing staff in a hospital is reduced to the point that staff are asked to do 4,000 things and then they have malpractice as a result: Clearly, the institution would be biting the bullet," says Mark Kadzielski, JD, head of the West Coast health practice for Epstein Becker & Green, a law firm in Los Angeles.
Reference
1. Hundley v. Rite Aid of South Carolina, 95-CP-46-405 (S.C. Court of Common Pleas, Oct. 11, 1996) and Peggy W. Hundley and Ron Hundley v. Rite Aid of South Carolina, Inc. and Howard Jones 95-CP-46-405 (S.C. Court of Common Pleas, Oct. 11, 1996).
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