| The Bedside Lawyer
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| | meaning in a survey of physicians in one
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| 17th August 2006
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| | teaching hospital they had the most
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| Author: Richard Hall
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| | patient complaints on file. Complaints
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| Today's hospital administrator faces a
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| | fell into categories of communication,
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| number of challenges including rising
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| | care and treatment, humaneness, access,
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| costs, labor shortages, increased
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| | environment, and billing. Physicians who
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| regulatory requirements and the potential
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| | have a bad rapport with their patients
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| for costly, credibility damaging
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| | had a higher incidence of every other
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| lawsuits. We live in a litigious time.
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| | type of complaint listed. In other
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| Disputes are played out in the court
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| | words, patients were more likely to
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| system and in the realm of health care,
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| | report adverse outcomes or diagnosis
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| lawsuits can take millions of dollars and
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| | problems when the physician was
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| years before they are concluded. It is
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| | considered rude or communicated poorly.
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| in the best interest of hospitals to do
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| | Quality management. Quality programs
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| all that is possible to mitigate the risk
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| | must be more than the program du jour.
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| of litigation. Every hospital will face
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| | Just as risk management must be embedded
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| litigation but there are ways to reduce
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| | in the hospital culture, there must be a
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| the opportunity and /or reduce the
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| | bottom up commitment to quality
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| damages if sued. While in no way a
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| | procedures. Quality when viewed through
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| comprehensive list, the following
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| | the lens of "must do" policies and
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| guidelines can help.
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| | procedures becomes devalued as "one more
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| Risk management must be facility wide.
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| | management program." However, an
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| All Hospitals have Risk Management
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| | organization that involves everyone in
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| Departments but risk management cannot be
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| | the quest for quality and the pride that
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| confined to a department to be truly
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| | accompanies providing an excellent
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| effective. It is not enough to satisfy
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| | product or service will be far more
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| the requirements of the various governing
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| | effective.
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| bodies during times of accreditation. An
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| | Infection Control. In the United States
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| effective risk management program is
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| | more than 1.7 million people will get a
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| embedded into the culture of the
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| | drug resistant infection from a hospital.
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| hospital. Every employee at every level
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| | More people die from hospital infections
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| is in effect a risk manager. Risk
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| | than AIDS and breast cancer combined.
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| management is sometimes viewed as a
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| | Hospital acquired infections is a well
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| necessary evil. Hospitals must move
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| | documented problem and disturbingly most
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| beyond doing what is required to adopting
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| | can be prevented through the
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| a risk adverse culture. This requires
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| | implementation of rigorous sanitary and
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| active involvement of staff at all
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| | bacterial testing procedures. Infection
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| levels, continuous monitoring and
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| | control needs to be vigorously monitored
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| communication.
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| | and should be a vital piece of the
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| Internal Service. Employees that do not
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| | overall risk management strategy.
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| feel valued by the organization will not
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| | Any risk mitigation strategy will require
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| invest in its policies. Studies have
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| | an organized, rigorous surveillance and
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| shown that employee satisfaction leads to
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| | management to be effective. Physicians,
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| greater productivity and loyalty.
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| | and hospital staff all play a part in
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| Hospitals must make everyone feel like
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| | risk management activities but hospital
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| part of the team, physicians, nurses,
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| | management must make decisions and
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| clerical, every person that works in the
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| | provide sufficient resources for risk
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| hospital must feel like an integral part
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| | management activities. Staff and
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| of the healthcare team. In no other
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| | physicians should have an active voice in
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| environment is teamwork a life and death
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| | policy and risk events need to be clearly
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| matter. More importantly, happy
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| | communicated to all. As risk is
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| employees treat patients well. Patients
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| | identified there also needs to be a clear
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| that have a positive hospital experience
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| | mechanism for correcting or eliminating
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| even in the event of a problem are more
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| | the risk. The absence of
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| willing to resolve the dispute without
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| | problem-resolution mechanisms in
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| litigation. It is human nature to not
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| | hospitals is a major cause of poor
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| wage a hostile battle with someone who
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| | quality and unnecessary risk.
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| has treated you well. Treat your staff
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| | Managing risk will not only reduce the
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| well and make them feel valued and
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| | potential for litigation but will provide
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| patients will receive better care and you
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| | hospitals with a clear competitive
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| will lower your risk of litigation.
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| | advantage. A hospital that adopts a risk
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| Doctor-Patient Relationship. There is a
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| | adverse culture will provide better
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| great deal of evidence to support the
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| | patient care and that translates to
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| importance of the impact of the
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| | success in the highly competitive
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| doctor-patient relationship on
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| | marketplace of healthcare.
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| litigation. This relationship is a
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| | ________________________________________
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| significant determinant of the
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| | _____
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| physician's claims experience (Hickson
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| | Reference:
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| et al., 1997; Levinson et al., 1997;
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| | Hickson, GB, JW Pichert, Federspiel,
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| Pontes and Pontes, 1997; Beckman et al.,
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| | Clayton (1997), "Development of an Early
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| 1994) Hickson et al. found that
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| | Identification and Response Model of
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| "high-malpractice" physicians were also
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| | Malpractice Prevention", Law and
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| likely to be "high-complaint" physicians;
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| | Contemporary Problems, 60/1-2, pp.
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