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Protect your team from lawsuits

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Protect your team from lawsuits Protect your team from lawsuits Presentation Transcript

  • Protect Your Team From Lawsuits: Tips for Managing Your Risk of Claims
  • Overview• Patient Selection & Screening• Risks of Emerging Technologies• Patient Education & Informed Consent• Surgery & Post Operative Care• Dissatisfaction & Complaint Management• Angry, Non-Compliant Patients & Threats to Sue
  • Medical Screening• Documentation of Actual Patient Screening (Medical & Psychological) often key to defending cases• Take extra care to document your decision making process and consultations whenever you “push the envelop” beyond published guidelines
  • Psychosocial Screening• Patient Screening – identify severe psychosocial problems that may disqualify• Difficult Patients – Need triage, better to discharge before surgery. Psychosocial problems may interfere with post-op care; may disrupt support group• Family & Support Systems – involve in assessment
  • It’s All About Aligning Expectations: Patient Education & Informed Consent
  • Education & Informed Consent• Mismatched expectations often leads to lawsuits: 78% lawsuits, no bariatric specific consent forms• Education begins with marketing materials & psychological screening• Well documented, team based training reduces the risk of lawsuit
  • Education & Informed Consent• Mismatched expectations often leads to lawsuits: 78% lawsuits, no bariatric specific consent forms• Education begins with marketing materials & psychological screening• Team based education that is well documented is effective risk management tool, basis for informed consent
  • Informed Consent• Bariatric informed consent process follows mandatory patient education sessions• Forms should have checkboxes that certain key points were reviewed• Recommend spouse & family attend classes & sign education form
  • On-line Education & Consent Tools Improve patient compliance Increase patient satisfaction Document informed consent process
  • Disclosure of Financial Relationships• The Patient’s Rights Issue: absence of bias in surgical decision making• The Relationships: –Consulting –Research –Education support –Investment• Organizations starting to require disclosure• Lawyers starting to use as tactic
  • Evolving Standard on PatientDisclosure• If a physician has a material financial relationship with company that manufactures permanently implantable medical devices, the physician must disclose to his/her patients this financial relationship before obtaining the patient’s consent. Such disclosure shall be documented in the patient’s medical record.
  • Care Coordination• Equal to Patient Education/Informed Consent as an Effective Risk Management Strategy• Making Teams of Experts into Expert Teams• Big Impact on Decreasing Dissatisfaction, Even When Outcome Less Than Expected
  • Managing Individual Patient Dissatisfaction & Complaints• Individual dissatisfaction should be managed by team, recommend use of patient advocate, follow through is critical• May include apology, written response and bill write offs when appropriate
  • Aggregate Complaint Tracking/Trending• Patterns of patient complaints may be predictors of suit• Facility should have a reliable complaint tracking system & regularly review aggregate complaint data to fix delivery systems• Complaint review committee
  • Conversations & Interventionswith Angry, Non-Compliant or Disruptive Patients
  • Crucial Conversations Training • Resolving “stuck” complaints through dialogue, active listening • Move to actionable solutions
  • Crucial Conversations• Often, dissatisfied patients feel like they are not being heard, personal issues not being addressed• Recommend selected team members receive conflict resolution or mediation training. Active listening (what does the patient/family really want)
  • Behavioral “Contracts”• Not true contract, a tool for aligning expectations/behavior when conversation fails• For disruptive or non-compliant patients• Lay out surgeon’s and team’s behavioral expectations• Sets up ground work for dismissal
  • Threats to Sue• When interventions, crucial conversations, patient advocate have failed• Damage physician/patient/team relationship enough that most programs will dismiss• May need to comply with insurer’s rules on dismissal• IF continue to treat, assure no disengagement
  • Dismissal From Practice• To avoid charge of patient abandonment, notify patient, in writing when surgeon wishes to discontinue care – Last day surgical care will be available – Provide at 15-30 days of emergency treatment & prescriptions – How to get copies of medical records• May need to comply with insurer’s rules on dismissal
  • Thank youQuestions?