Financial Conflicts Reported Inconsistently
It might be time to consider another approach to transparency on financial conflicts.
Patterns of Egregious Physician Sexual Misconduct Require Ethical Response
If the perception is highly publicized cases of sexual misconduct go unpunished, this could erode public trust of physicians generally. Although those accused of sexual misconduct are entitled to due process and the presumption of innocence until proven guilty, all cases must be taken seriously and investigated thoroughly.
Discussions on Patient Care Could Become Discoverable
Evidence indicating the emergency physician conducted peer review diligently and in good faith could help the defense. Still, considering the possibility of discoverability, providers should avoid inaccurate, sarcastic, or unnecessary comments during peer review.
Ethicists Challenged to Respond to Physicians’ Inappropriate Behavior
If a physician yells at a nurse or patient because of a disagreement over the treatment plan, involvement by human resources or another department is needed. But if a physician’s belligerence or disrespect affects someone’s decision-making, that is an ethical problem.
Care Improved by Providing Better Feedback to Hospitalists
Providing detailed feedback to hospitalists, including key quality metrics, can improve the quality of care they provide patients, according to the results of a program at a Wisconsin medical college.
Rapid Mortality Reviews Improve Quality and Patient Safety
Staff at a California hospital found rapid mortality reviews conducted soon after a patient death resulted in the treatment team identifying opportunities to improve the patient’s care in more than 40% of the cases.
Layers of Legal Protections for Peer Review Committees
A hospital’s executive and officers liability insurance usually will apply to peer review committee members. There also are protections under federal law providing immunity for participation, particularly the Healthcare Quality Improvement Act. There are state-level statutes to provide immunity, although those laws vary widely.
Best Practices for Recruiting Peer Review Committee Members
Well-run peer review committees are essential to maintaining high-quality performance for physicians and nurses, but recruiting for those committees can be challenging. Physicians and nurses may resist the time commitment or fear legal and professional repercussions from passing judgment on their peers. Those fears can be dispelled by educating physicians and nurses about the peer review process. Savvy recruiting techniques can help create effective peer review committees.
Hospital Reduces Episiotomies with Transparency on Peer Rates
Texas Children’s Hospital in Houston is reporting continued success with a program that reduced the rate of episiotomies from 9.11% of births to 3.44%. The hospital used a five-step approach that focused on publicizing the rate of episiotomies and encouraging physicians to improve their individual rates. The hospital’s experience is an example of how some quality improvement efforts may take time to implement, but can produce long-lasting results.
COVID-19 May Be Affecting Nursing Discipline, But No Data Yet
There is some concern about whether the healthcare industry’s response to COVID-19 will affect the way it addresses concerns about nursing performance, similar to recent concerns about an apparent drop in physician discipline since the pandemic began. So far, data related to nursing discipline are not showing any decline.