Healthcare Risk Management – October 1, 2019
October 1, 2019
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Informed Consent Must Be More Than a Clerical Task
Informed consent is a fundamental part of the healthcare process. Risk managers know the risks that can come with failing to adequately educate patients and document their consent. But the procedure is so common and performed so often that there is potential for it to become routine and less thorough.
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1914 Case Established Informed Consent Principles
A 1914 case from the New York Court of Appeals established some of the foundation for what the healthcare community now thinks of as the informed consent process.
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Provider Stress Can Trickle Down to Affect Patient Safety
The healthcare industry can be stressful for everyone involved, with clinicians sometimes suffering greatly from the workload, time demands, bureaucracy, and the emotional nature of their work. Minimizing stress is important for the health of the caregivers, but also to maintain patient safety. When staff are exhausted, experiencing depersonalization from their work and feeling less effective, they are more likely to fail to follow practices that support high-quality, safer care.
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Stress Decreases Ability to Focus, Increases Errors
Stress can lead to two distinct types of attention problems with clinicians. When under a great deal of stress, some people will focus intently on the one task viewed as primary, such as a surgeon who concentrates so much on the surgical activity that the bigger picture of the patient’s status is neglected. Others may go in the opposite direction and try to divide their attention among so many tasks that none receive adequate attention.
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Hospital Addresses Stress With Healthy Healer Program
A Colorado hospital is addressing stress by reminding clinicians that it is OK to take a moment for themselves and focus only on the patient care at hand. Craig Hospital created its Healthy Healer program two years ago to help nurses address their stress in a positive way, encouraging them to be more at ease during patient interactions and better able to focus on providing proper care. The program has been expanded to include physicians and other clinicians.
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Oncology Unit Improves Safety and Culture With Focus on Relationships
An oncology unit at a Washington, DC, hospital has improved patient safety by focusing on “relationship-based care,” a model that aims to help nurses focus more on caring for and connecting with other people. The 5E Medical Oncology/Hematology Unit at MedStar Washington Hospital Center recently received AMSN Premier Recognition In the Specialty of Med-Surg (PRISM) Award. The unit had made strides in recent years in improving quality and safety on the unit as well as the overall culture.
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MSU Expands Risk Management, Adds Additional Safeguards
Michigan State University has expanded its risk management program after the arrest and conviction of Larry Nassar, a former USA Gymnastics national team doctor and osteopathic physician at the university, for the sexual abuse of minor patients. The university recently signed an agreement with the U.S. Department of Health and Human Services to make further improvements.
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Negligent Thyroid Surgery Results in $2.2 Million Verdict
One of the primary lessons from the case for physicians and care providers is that assistant physicians, including residents, may be subject to liability for failing to provide services within the standard of care as well, and that standard does not change for a resident still in training.
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Physician Not Liable for Alleged Complications After Gallbladder Removal
This successful defense case reveals potent methods for defeating medical malpractice claims. On the substance, the defendant physician successfully challenged one of the necessary elements that an injured patient must prove when alleging medical malpractice: causation. Causation includes factual and legal aspects, where the physician’s actions must have been a “substantial factor” in contributing to the patient’s harm, but there may be an intervening action or event that cuts off the physician’s liability. If the risk of injury exists, even when a procedure is performed correctly, then simply because an injury occurred does not mean that the physician was negligent.