Managing risk in healthcare facilities is a multi-faceted, ever-changing challenge. Identifying areas of vulnerability is the first step in any risk management program. In this blog post, we’ve identified five scenarios that can put healthcare entities and professionals at the greatest risk of a lawsuit and we’ve added some best practices that can be put into place to keep patients safe and less likely to sue.
#1 Poor communication – Several elements of poor communication can leave healthcare providers vulnerable to a lawsuit. Poor communication with the patient regarding their disease process and appropriate education on managing disease can lead to a claim. In addition, poor communication between primary care and consultant physicians or specialists can drive a delay in diagnosis claim and leave both the consultant and the primary care physician vulnerable to a lawsuit.
#2 Lack of informed consent – Informed consent is not just a document – it is a process – a process that should be well documented in the medical record. Patients should be informed of the risks, benefits and alternatives to significant procedures – as well as given the opportunity to sign a document for informed refusal should they elect not to follow the providers advice.
#3 Patient dissatisfaction – It has been said that “happy patients don’t sue” and there is some validity to that statement. Patients who have open communication and a solid relationship with their healthcare provider generally report higher satisfaction scores. The feeling of trust and open communication fosters a relationship that can dissuade a patient from filing a suit even in light of an adverse event. It is important to measure patient satisfaction in a systematic way to identify opportunities to improve the patient experience.
#4 Missed or delay in diagnosis – Frequently this stems from insufficient communication between primary care providers and consultants in the outpatient setting or from a delay in recognition and attention to a post-surgical complication. It is critical to have formal tracking mechanisms to follow up on diagnostic tests and referrals to specialists. In the post-operative setting it is important that nurses can validate their competency in being able to quickly recognize the signs and symptoms of a post-operative complication.
#5 Inadequate medication reconciliation – Complex patients are often seen by multiple specialists, and without integration of one electronic medical record – which is often the case – it is critical to do comprehensive medication reconciliation at each visit to verify that the medication regimen is compatible and that there are no duplicative medications (trade vs. generic names) or contraindications between medications prescribed which could lead to a significant adverse event.