Medical_Malpractice-1

Medical_Malpractice-1 - Medical Malpractice Vithal...

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Unformatted text preview: Medical Malpractice Vithal Vernenkar, D.O St. Barnabas Hospital Department of Surgery Goals Goals To understand medical error and appreciate the causes of malpractice claims To learn ways to reduce medical error and avoid claims To view Risk Management as a resource when questions involving medical error arise MEDICAL ERROR MEDICAL ERROR A “preventable adverse medical event” “adverse event” “an injury that was caused by or is associated with medical management and that results in death or measurable disability” ELEMENTS OF A ELEMENTS OF A MALPRACTICE CLAIM Physician owes duty to patient Deviation from “standard of care” Patient must sustain injury Physician’s actions are proximate cause of injury WHY PATIENTS SUE WHY PATIENTS SUE Dissatisfied with quality or cost of care Feel they’ve been wrong Sustain injury or imperfect result Perceived MDs as rude, unsympathetic Culture of a litigious society PHYSICIAN­PATIENT PHYSICIAN­PATIENT RELATIONSHIP Cornerstone of good medical practice and risk management Often more crucial than outcome Negative perceptions based on health care providers’ attitudes Establish good rapport, concern, and trust Establish open communication and effective listening skills Be aware of limitations MEDICAL RECORD MEDICAL RECORD Records clinical information Provides means to communicate among providers Documents medical necessity of treatment Supports billing and reimbursement Helps evaluate cost­effectiveness of care Serves as a legal document GOOD RECORD­KEEPING GOOD RECORD­KEEPING Use common sense Make them complete, timely, and accurate Write legibly, use correct grammar & spelling Use ink Abbreviate correctly Include date, time, and signature GOOD RECORD­KEEPING GOOD RECORD­KEEPING PRACTICES (cont’d) Document factually and contemporaneously Write entries chronologically Make entries continuous Be specific Be consistent Be thorough Be clear No underlining or starring DOUMENTING/CHANGING THE DOUMENTING/CHANGING THE RECORD DO Know the facility procedure for making corrections Standard approach: Draw single thin pen line through entry Record change in chronological order Date and initial change Note reason entry is being replaced Have notation witnessed if possible DOCUMENTING/CHANGING DOCUMENTING/CHANGING THE RECORD (cont’d) DON’T Delete material or destroy record Use correction take or fluid Make self­serving statements Be flip, cavalier, sarcastic or inappropriate Use the record to “vent” even to defend yourself DISCLOSURE OF MEDICAL DISCLOSURE OF MEDICAL ERROR Preserves patient trust Requires balancing of multiple concerns Respects patient's right to self­ determination May cause harm Difficult area REPORT TO RISK REPORT TO RISK MANAGEMENT REPORT: Any significant complaint or complication Any attorney inquiry Any threat of legal action Any subpoena Any doubt whether or not to report BENEFITS OF REPORTING BENEFITS OF REPORTING R/M can assist you with What to disclose How to make a disclosure What and how to appropriately document record Billing adjustment, when appropriate Flagging and securing medical record OTHER INTERNAL OTHER INTERNAL MECHANISMS Patient advocate/patient relations dept. Social work Hospital ethics/infant care committees Psych consult re capacity ...
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