Fluent Essays

I have 4 assignments 1 is a PowerPoint the others are papers. I have attached some PowerPoints of the chapters that the assignments are based on. Please read the documents carefully before I accept the bid.HAS-6505 Health Care Risk Management: Assignment Week 1 Page | 2 HAS-6505 Health Care Risk Management: Assignment Week 1 Critical Reflection Paper: Chapters 1, 2, 3 Objective: To critically reflect your understanding of the readings and your ability to apply them to your Health care Setting. ASSIGNMENT GUIDELINES (10\%): Students will critically analyze the readings from Chapter 1, 2 and 3 in your textbook. This assignment is designed to help you review, critique, and apply the readings to your Health Care setting as well as become the foundation for all of your remaining assignments. You need to read the chapters assigned for week 1 and develop a 2-3-page paper reflecting your understanding and ability to apply the readings to your Health Care Setting. Each paper must be typewritten with 12-point font and double-spaced with standard margins. Follow APA style 7th edition format when referring to the selected articles and include a reference page. EACH PAPER SHOULD INCLUDE THE FOLLOWING: 1. Introduction (25\%) Provide a brief synopsis of the meaning (not a description) of each Chapter and articles you read, in your own words. 2. Your Critique (50\%) What is your reaction to the content of the chapters? What did you learn about Risk Management Activities and Tools? What did you learn about Legal Standards and Risk Management related with OSHA and HIPAA? Did these Chapter change your thoughts about Risk Management in Employment? If so, how? If not, what remained the same? 3. Conclusion (15\%) Briefly summarize your thoughts & conclusion to your critique of the Chapter you read. How did these articles and Chapters impact your thoughts on Regulatory Environment, and Institutional Imperative? Evaluation will be based on how clearly you respond to the above, in particular: a) The clarity with which you critique the chapters. b) The depth, scope, and organization of your paper; and, c) Your conclusions, including a description of the impact of these articles and Chapters on any Health Care Setting ASSIGNMENT RUBRICS Assignments Guidelines 10 Points 10\% Introduction 25 Points 25\% Your Critique 50 Points 50\% Conclusion 15 Points 15\% Total 100 points 100\%HAS-6505 Health Care Risk Management: Assignment Week 2 Page | 3 HAS-6505 Health Care Risk Management: Assignment Week 2 Critical Reflection Paper: Chapters 4 & 5 Objective: To critically reflect your understanding of the most common policies and procedures of risk management, the role of the communications to reduce the risk and improve patient safety and your ability to apply them to your Healthcare Organizations. ASSIGNMENT GUIDELINES (10\%): Students will critically analyze the readings from Chapter 4 & 5 your textbook. This assignment is designed to help you review, critique, and apply the readings to your Healthcare Organization as well as become the foundation for all of your remaining assignments. You need to read the chapters assigned for week 2 and develop a 2-3-page paper reflecting your understanding and ability to apply the readings to your Healthcare Organization. Each paper must be typewritten with 12-point font and double-spaced with standard margins. Follow APA style 7th edition format when referring to the selected articles and include a reference page. EACH PAPER SHOULD INCLUDE THE FOLLOWING: 1. Introduction (25\%) Provide a brief synopsis of the meaning (not a description) of each Chapters you read, in your own words. 2. Your Critique (50\%) What is your feedback to the content of the chapters? What did you acquire about Communication and its impact on malpractice litigation? What did you absorb about Insurance Models and Risk Retention? Did these Chapters change your thoughts about Social Media Challenges and Clinician-Patient Online Interaction? If so, how? If not, what remained the same? 3. Conclusion (15\%) Briefly summarize your thoughts & conclusion to your critique of the Chapter you read. How did these articles and Chapters impact your thoughts on Inform Consent and Patient Education? Evaluation will be based on how clearly you respond to the above, in particular: a) The clarity with which you critique the articles; b) The depth, scope, and organization of your paper; and, c) Your conclusions, including a description of the impact of these articles and Chapters on any Healthcare Organization. ASSIGNMENT RUBRICS Assignments Guidelines 10 Points 10\% Introduction 25 Points 25\% Your Critique 50 Points 50\% Conclusion 15 Points 15\% Total 100 points 100\%HSA-6505 Health Care Risk Management: Assignment Week 3 Student PowerPoint Presentation: Chapter 6 & 7 Objectives: The presentation assignment has several goals. It requires students to apply concepts from Ethical Issues for Risk Managers and Assuring safety and Security in Healthcare Institutions. The process of Safety and security will allow students to practice close the Risk assessment and Failure modes of techniques for managing, a skill they will be using as Healthcare Administrator. In addition, presenters learn as they teach others and contribute multiple critical perspectives to class discussion. Format and Guidelines: The student will create a Power Point Presentation from Chapter 6, Chapter 7 of the Textbook related to Week 3 (Choose your desire topic form these chapters). The Presentation should have a minimum of 12 slides, including Title Page, Introduction, Conclusion, and References. The student must use other textbooks, research papers, and articles as references (minimum 3). Due date: Sunday, March 21, 2021 at 11:30PM. EACH PAPER SHOULD INCLUDE THE FOLLOWING: 1. Title Page: Topic Name, Student Name 2. Introduction: Provide a brief synopsis of the meaning (not a description) of the topic you choose, in your own words 3. Content Body: Progress your theme, provide Material, illustrations and Diagram to explain, describe and clarify the Topic you choose. 4. Conclusion: Briefly summarize your thoughts & conclusion to your critique of the articles and Chapter you read. 5. References: The student must use other textbooks, research papers, and articles as references (minimum 3). Florida National University Student PowerPoint Presentation: Chapter 7 & 8 Grading Sheet Student Name __________________________________ Date_____________________ Category Possible Points Actual Points Presentation style and content. 3 Distributed bibliography w/ 3 additional readings 2 Inclusion of diversity content Pictures, Graphic, etc. 2 Length: Minimum 12 slides 1 Required Format 2 TOTAL 10HAS-6505 Health Care Risk Management: Assignment Week 4 Case Study: Chapters 8 & 9 Objective: To judgmentally reveal your knowledge of the most common Patient Safety Tools integrating quality and Managing risk, the role of the communication on Medical malpractice and your ability to apply them to your Healthcare Organizations. . The analytical exercises will improve students’ understanding and ability to think critically about the public relations process, and their problem-solving skills. As a result of this assignment, students will be better able to understand, analyze and diagnose Risk Management issues and strategies to prevent them. ASSIGNMENT GUIDELINES (10\%): The students will complete A Case study assignments that give the opportunity to synthesize and apply the concepts learned in this and previous coursework to analyze a real-world scenario. This scenario will illustrate through example the practical importance and implications of various roles and functions of a Health Care Administrator and Risk Management. The assignment will be 3-4 pages long reflecting your understanding and ability to apply the readings to your Healthcare Organization. Each paper must be typewritten with 12-point font and double-spaced with standard margins. Follow APA style 7th edition format when referring to the selected articles and include a reference page. EACH PAPER SHOULD INCLUDE THE FOLLOWING: 1. Introduction (25\%) Provide a brief synopsis of the meaning (not a description) of each Chapter you read, in your own words. 2. Your Critique (50\%) Case Study: Surgical mistakes can result in serious medical complications for patients. Errors by surgeons can run the gamut from performing unnecessary surgery on a patient, to negligent technique in carrying out the procedure -- even leaving medical instruments inside a patient. Many (though not all) common surgical mistakes rise to the level of medical negligence and can form the basis of a medical malpractice lawsuit against the surgeon and any other responsible party. To give you an idea of what these cases might look like, this article provides a snapshot of three real-life surgical mistake medical malpractice cases. Sophia Savage Case In 2018, Sophia Savage underwent a hysterectomy at the Three Rivers Medical Center in Louisa, Kentucky. During the surgery, a surgical sponge was left inside her abdomen, but the presence of the sponge wasnt revealed until 2020, when Savage had an x-ray after she reported pain in her stomach. She had to undergo additional surgery to remove the sponge. During this procedure it was discovered that the sponge was lodged in her lower intestine. The doctors had to remove a 49 centimeter section of her small intestine in order to remove the sponge. Due to this she suffered from lingering abdominal pain, diarrhea, and constipation as well as bouts of anxiety and depression. She and her husband Darrell file a surgical mistake lawsuit against the ThreChapter 5: Financing Risk Financing Risk Risk exists for a healthcare organization is there is an event or action that can have impact on its financial or operational performance. Healthcare organizations work to balance this by covering the financial risk or transferring it. Financing risk means to ensure that adequate funds are available to cover costs related to unexpected events Transferring risk is accomplished by purchasing insurance. To Finance or Transfer Risk Management of risk is paramount to the healthcare organization and should be tailored to the specific needs and structure. The healthcare organization must determine what risk can and should be internally financed versus what risk should be transferred The goal of risk management is to add value to the organization by appropriately and wisely managing risk Costs of Adverse Risk Defense Costs Settlement or Judgment Loss Reduction Employee Morale Opportunity Costs Identifying Risk Risk managers work to identify areas of risk exposures in order to minimize the likelihood of adverse events as well as how to cover costs if they should occur by monitoring: Adverse incident reports Patient safety data Quality indicators Insurance company claims Employee satisfaction/complaints Patient satisfaction/complaints Accreditation survey results Financial reports Professional literature Financing the Risk The fiscal well-being of the organization is the determinant of how best to managing the financing of risk. Internal financing is not prudent if the organization does not have available funding to cover risk. External financing of risk is less costly yet still is a financial expense to the organization and must be weighed as to how much coverage is needed. Analyzing How to Finance Risk Healthcare organizations evaluate cost-effectiveness of available risk financing alternatives through: Quantitative analysis measures an event’s risk variables Qualitative analysis measures the event’s impact on the organization Insurance Options Traditional Insurance Companies Fairly common Standard coverage Cost is relative predictable Events not covered by insurance remain the responsibility of the healthcare organization Self-Insurance or Self-Funding Requires a significant amount of capital and financial reserves Choosing an Insurance Plan Make sure the plan meets your needs in terms of: Portability Flexibility Services provided Choose a company based on: Experience -- Staffing Technology -- Procedures Costs -- Protection Total Cost of Risk In order to balance the need for risk financing with the cost, healthcare organizations need to estimate the total cost of risk by analyzing: Cost of risk transfer Cost of risk retention Administrative costs associated with managing both the exposure to risk and claims if adverse events occur Areas of Exposure Automobile Liability Aircraft Liability Business Interruption and Income Crime Cyber Liability Directors/Officers Liability EmergChapter 6: Ethical Issues for Risk Managers Why is Ethics Important to Risk Management? For many issues, there are laws to guide how facilities need to deal with ethical situations Abortion -- EMTALA HIPAA -- Civil Rights Act For other issues, no legal guidelines are available. The Risk Manager needs to assist the facility to develop appropriate procedures for dealing with ethical issues Ethical Issues Ethical Issues have become increasingly important to risk management. Some issues are bound by law while others are not, leaving the risk manager to confront and solve them to the best of their ability. Many healthcare organizations establish ethics committees to assist with managing ethical situations History of the Ethics Committee The forerunners of Ethics Committees: Dialysis committees of the 1960s Abortion and Sterilization committees Impetus for establishing today’s Ethics Committees sprang from high profile cases Karen Ann Quinlan Baby Doe Growth in the field of Bioethics has also provided support for Ethics Committees Growth of Ethics Committee The healthcare industry has witnessed a growth in use of ethics committees due, in part, to the focus of accrediting bodies on patients’ rights and ethical issues during the survey process. Organizations with ethics processes and oversight in place may see better outcomes for patients Role of the Ethics Committee Education Policy Development Consultation Composition of the Ethics Committee Generally interdisciplinary (the committee’s most important aspect) May also include a member of the clergy, the healthcare organization’s attorney, a risk manager, and/or administrative personnel. Ethical Guidelines for Risk Managers Autonomy (Self-determination) Patients have the right to make their own healthcare decisions. Beneficence Obligation to do good for the patients Justice Obligation to treat all in an equitable fashion Ethical Standards for Decision Making Decisional Capacity An individual’s ability to weight the relative benefits, risks or burdens of treatments plans and make an informed decision Substituted Judgment Applies when an individual who previously had decisional capacity has either temporarily or permanently lost that capacity. Seeks to find what that person would have decided in the circumstance Ethical Standards for Decision Making Best Interest Applies when an individual never had decisional capacity or when there is no way of knowing the individual’s wishes Makes use of the ‘reasonable person’ standard Informed Consent In keeping with the concept of autonomy, clinicians are obligated to provide patients with information regarding their condition and possible treatments in order for them to make an informed decision as to their choice of healthcare services. Code of Ethics Almost every profession of healthcare providers provides its members with a set of standards detailing the values, duties and ethical responsibilities of the profession. Chapter 3: Risk Management in Employment Employment Relationship carries Risk Risk to an organization is not limited to provider-patient relationships As in any business, the healthcare organization has responsibilities to its employees. Many of which, if not properly implemented/enforced, can lead to negative and litigious results Employment-at-Will An employer may dismiss an employee hired for an indefinite period of time for any reason or no reason at all without incurring liability to the employee Caveat: cannot discharge for an unlawful reason, such as racial discrimination Implicit Employment Contracts Though most states follow the employment-at-will doctrine, many organizations may unknowingly negate their ability to apply this principle through Employer policies (i.e. progressive disciplinary policy) Oral assurances (i.e. looks like you have a bright future ahead of you here) Industry customs (i.e. after so many years in one position, employees are promoted to the next level) Employer conduct (i.e. allowing some employees more chances to correct errors than others) Burden of Proof In civil litigation of discrimination, the burden of proof is usually on the plaintiff -they must show: Membership in a protected group Satisfactory job performance or appropriate qualifications for the job being sought Receipt of discipline, termination or rejection despite having the qualifications Employees of another protected class were disciplined less severely or the employer continued to accept application of people who were no better qualified Sexual Harassment Unwelcome sexual advances, request for sexual favors or other verbal or physical conduct of a sexual nature when it is one of the following: is a condition of employment is the basis of employment decisions interferes with work performance creates a hostile work environment The employer must be made aware there is an issue and then take action. The employee cannot sue unless he/she has told someone and nothing was done. 6 Minimizing Risk of Sexual Harassment Organization must exercise reasonable care to prevent and correct any sexually harassing behavior Written policies/procedures Documented staff training on policies/procedures Consistently adhere to and enforce policies Immediately investigate allegations of sexual harassment Responsibility of the Employee Employee must report occurrences of sexual harassment to employer Employer must be given the opportunity to investigate and take corrective action Though it is important that an employer investigate all reports of sexual harassment, proactively addressing situations or behavior that may be perceived as sexual harassment is imperative. If management is aware of a potential situation and does nothing, the risk of litigation and penalty is increased People with HIV or AIDS are protected by the ADA Persons with HIV disease, both symptomatic and asymptomatic, have physical impairments that substantially limitChapter 2: Regulatory Environment Most Regulated Industry Health Care is one of the most regulated industries in the US. It is vital to be aware of and understand what regulations may affect the facility. Standards Statements concerning proper procedures taken in a given situation: Explicit or implicit National or local Validated or Consensual Used or ignored Periodically updated or static 3 Legal Standards Judicial system (court decisions) provides initiative for implementing standards public health rules Disease reporting requirements Immunizations Worker’s comp Licensing of professionals Federal Mandatory Regulations CMS OSHA HIPAA EMTALA Mammography Quality Standards Act Safe Medical Devices Act MedWatch MWTA EPA Medical Waste Tracking Act 5 State Mandatory Regulations Professional Licensure of Providers Smoke-free Workplaces Smoke-free Environment Violence Prevention Medical Waste Tracking Act 6 State Mandated Risk Management Legislation Risk Management Responsibility Governing Body Involvement Risk Identification Risk Analysis Risk Management Education State Mandated Risk Management Legislation Sharing Information Patient Grievance Procedures Immunity and Confidentiality for Providers Risk Management Follow-up Procedures Reimbursement Standards Payers set their own standards for reimbursement Fee for service Negotiated fees Capitation Prospective payment RBRVS Medicare - is a federal program so the standards are the same across the US Medicaid - is a state run program so each state sets its standards for reimbursement 9 Medicare Incentives to Improve Quality Evidence based medicine in now generally accepted as essential to effective and safe medical practice. This link was presented in 2 seminal works from IOM: Crossing the Quality Chasm To Err Is Human Deficit Reduction Act 2003 and Beyond Pay for Posting Pay for Performance Value Based Purchasing Scores and Withhold Determination False Claims Act Anti-fraud activities Lawsuits Revocation of Medicare participation Practice Guidelines Accreditation Programs develop standards and facilities can voluntarily apply for review Joint Commission on the Accreditation of Healthcare Organizations (Joint Commission) National Committee for Quality Assurance (NCQA) Many equate facility accreditation with quality Medicare accepts a JCAHO accreditation as evidence that a hospital meets Medicare conditions of participation Summary IGNORANCE of the Law is no excuse Know the regulations Identify which ones are pertinent to the facility Ensure that appropriate policies are in place Document complianceChapter 1: Risk Management Dynamics Healthcare can hurt… In the 1970’s, the fact that receiving healthcare services can actually cause harm was brought to the forefront with the Institute of Medicine report “To Err is Human: Building a Safer Health Care System”: In 2 studies, adverse events occurred in 2.9\% and 3.7\% of hospitalizations More than half of these adverse events were the result of preventable medical errors Extrapolation: > 1 million medical errors may occur each year resulting in 140,000 deaths More data about medical errors Studies indicate the following: Hospital employees recognize and report only 1 in 7 medical errors that harm Medicare patients Even after medical errors are reported and investigated, many hospitals do not change their practices to prevent repetition of the event >50\% of patients treated for side effects and other medication related injuries were 65+ years old Continued reporting of wrong-site surgeries What can be done? The Joint Commission recommended safety standards in 2001 that relate to: Providing leadership Improving organizational performance Information management Patient’s rights It is imperative to monitor adverse events from 2 standpoints: Quality of care Legal responsibility to do no harm How do we monitor adverse events and ensure patient safety? Recognize and minimize instances where a medical error can occur This is the function of Risk Management What is Risk? Uncertainty about future events that may threaten the safety of patients and the assets and reputations of providers. What do we mean by assets? People – patients, clinicians, volunteers, and employees Property – buildings, facilities, equipment, and materials Financial – revenue, reserves, grants, and reimbursement Goodwill – health and well-being, reputation, and stature in the community What is Risk Management? Discipline for dealing with the possibility that some future event will cause harm. An organized effort to identify, assess and reduce risks to patients, visitors and staff Objective of Risk Management To reduce the risk of preventable accidents and injuries and minimize the financial loss if one occurs It provides strategies, techniques and an approach to recognizing and confronting any threat faced by an organization. In other words… What can go wrong? What will we do to prevent harm and in the aftermath of an incident? If something happens, how will we pay for it? What are the risks we are trying to protect against? Antitrust violations Breach of contract Casualty exposure Defamation Embezzlement Environmental damage Fraud and abuse General liability Hazardous substance exposure Professional malpractice Securities violations Transportation liability Worker’s compensation So, what will be done? In the Risk Management Process we will: Identify Risk Perform Risk Analysis Implement Risk Control/Treatment Finance Risk Risk Identification Continuous collection of informationChapter 7: Assuring Safety and Security in Healthcare Institutions Safety and Security – Risk? Health facilities that experience adverse events due to safety or security issues can incur penalties ranging from large fines to loss of accreditation. An aggressive and well-organized safety and security management program can help minimize risk of and adverse event. Regulation and Accreditation Medicare and Medicaid require a participating healthcare organization to satisfy the Conditions of Participation (CoP) relevant to the management of safety and security. Accreditation by the Joint Commission, DNV Healthcare Inc. or HFAP ensures that the facility meets the CoP requirements State Departments of Health also regulate safety and security in healthcare organizations Safety vs. Security Safety can be a broad category with standard policies and procedures throughout a facility or system. Hand-washing policy Use of Personal protective gear Hazardous waste disposal Security must be more site specific. Safety and security policies sometimes conflict. High Risk Events A facility may incur major penalties if a “never” adverse event occurs (an event that should not occur if appropriate safety/security measures were in place) CMS may not reimburse costs of a never event and many third party payers have a non-reimbursement program as well. Techniques for Managing Safety and Security Risk Assessment Estimate Failure Modes and Effects Analysis (FMEA) Root-cause Analysis (RCA) Technological Redundancy Crew Resource Management Red Rules Potential Environmental Hazards OSHA has a list of the types of hospital-wide hazards and provides information on how to prevent and respond to them Three categories of hazardous materials Biological Chemical Radioactive Security: Unwanted Intruders Use of high-tech solutions to manage visitor and employee access Automated turnstiles with card swipe readers for employee entrances Visitor areas/desk where all visitors enter and sign-in. Employee ID badges Secured areas Potential Security Hazards Theft of Patient Valuables/Employee theft Infant abduction Workplace Violence Gangs Patient Valuables Provide a safe in the building to house valuables Provide receipts for any valuable stored by facility Encourage patients to leave valuables at home or give to family to take home Violence in the Workplace Patients have a right to treatment but staff have a legal right to a safe workplace Watch for signs that may lead to violence (in patients, visitors and staff) Anger Stress Under the influence of drugs/alcohol Gangs Many health facilities treat victims of gang violence and occasionally the dispute continues upon arrival at the facility. Use of metal detectors is increasing to prevent entrance of weapons into the health facility Information Security With increasing use of information management systems, healthcare facilities must insure that the system itself is secure from unauthorized access orChapter 8: Patient Safety Tools: Integrating Quality and Managing Risk Why do we talk about Quality in the Risk Management setting? Risk management makes contributions to quality by assuring that hazards and injuries are less likely to occur for both patients and employees. Risk management works to prevent malpractice claims by identifying, analyzing and treating risks which quality assessment tries to eliminate Predicting Hazards and Malpractice Prediction is not specific in risk management – can say an event is likely to occur, but not when or to what extent Confounding factor: increased patient satisfaction tends to correlate to lower likelihood of legal action by a patient Incident Reporting: can assist the risk manager in identifying causes Healthcare Acquired Conditions Conditions for which, when acquired during admission in the health facility, CMS will not reimburse. Examples include: Foreign object retained after surgery Air embolism Blood incompatibility Pressure ulcer stage III and IV Falls and trauma Catheter-associated infection Manifestations of poor glycemic control Importance of Communication Effective communication is a factor in the likelihood of a patient deciding not to sue a provider as it has impact on patient satisfaction Informed Consent is the result of effective communication between the provider and patient. The patient needs to know the possible outcomes of treatment, both good and bad, so as to have proper understanding and expectations. What if Unanticipated Outcomes Occur? Disclosure of unanticipated outcomes is mandatory. The ethical question is NOT should it be disclosed, but how and by whom. Risk managers need to plan, prepare and educate staff to avoid inappropriate disclosure Enterprise Risk Management (ERM) An approach to assessing and addressing risks from all sources that either threaten the organization’s objectives or represent opportunities to exploit competitive advantage. Categories of Risk Operational/Clinical Risks Financial Risks Human Capital Risks Strategic Risks Legal/regulatory Risks Technological Risks Natural Disaster/Hazard Risks Difference from Traditional Risk Management Traditional Risk Management took a more clinically focused approach and examined risks individually. With ERM, the Risk Manager has a larger focus and more strategic position. It begins with risk identification and determination of the relative importance of the risk ERM Process ERM utilizes the steps in the traditional risk management process Identify and analyze the exposures to loss Examine the feasibility of alternative techniques Select the best technique Implement the technique Monitor and improve the risk management program Quality and Risk Management Historically Risk Management and Quality initiatives were seen as separate. Today, organizations utilize a more integrated approach, recognizing that many risk management errors are breakdowns in process (quality) rather than Chapter 4: Communications to Reduce Risk Communication is a risk? Lack of communication between physicians and their patients can be a critical factor leading to malpractice lawsuits Lack of communication can lead to patient dissatisfaction Dissatisfied patients are more likely to pursue malpractice litigation Barriers to Communication Lack of or poor listening skills Physical barriers Personal distractions Communication depends on… Personality Age Environmental factors Income Education Social situation Intelligence Fluid intelligence Crystallized intelligence Communication and Risk Management Understanding patients within their societal environment and culture is important to managing risk This will assist with communicating to the patient at their level of understanding Misunderstandings due to cultural or societal differences may be avoided with attention to proper communication Why do Patients Sue? Patients tend to sue when the Provider has caused them harm but also when they feel the Provider has: Deserted them Didn’t listen or devalued their view Didn’t give them necessary information or didn’t explain it Didn’t understand or acknowledge their perspective Why is this important? Patients do not have the skills to accurately identify ‘quality’ healthcare, therefore they tend to view how they are treated (customer service) as an indicator of quality of care Poor customer service = Poor quality What are Patients looking for with litigation? Altruism Rationalization Recompense Accountability Do unto others… Respect and civility can play a major role in risk management. Providers need to civil and respectful of their patients’ concerns by offering: Empathy Compassion Care Cultural Awareness Providers need to have an understanding (sensitivity) of their patients’ backgrounds as cultural differences can lead to misunderstandings or non-compliance if not properly attended to. Cultural destructiveness Cultural incapacity Cultural blindness Patient Empowerment Studies show that much patient dissatisfaction comes from deficient communication Empowering the patient to be an active participant in the provision of healthcare may lead to improved communication Programs are available to assist the patient in learning their role in provision of health TJC: Speak Up program AHA: Patient’s Bill of Rights Facility specific: Complaint/Grievance Process Health Literacy Degree to which individuals have the capacity to obtain, process and understand basic health information. Approximately 1/3 of adults have basic or below basic skills for dealing with health material Health facilities must follow federal regulation to provide language services for those patients with limited English proficiency (LEP) Informed Consent Informed Consent implies that the patient understands the service to be rendered, the risks involved and potential outcomes. Valid consent is given when the patient: Has been informed Is competent HasChapter 9: A Primer on Medical Malpractice Malpractice – What is it? Error - behavioral matter Misperception Mistake Omission Substitution Accident - unplanned event Malpractice - negligence 2 Negligence An act that a prudent person would not have done or the omission of a duty that a prudent person would have fulfilled, resulting in injury or harm to another person. A civil wrong and part of the law of torts. Founded on the relationship between the actor and the victim Requirements of an Act of Negligence Legally recognized relationship between the health care worker and patient Health care worker has a duty of care to the patient Health care worker breached the duty of care by failing to conform to the required standards of care The breach of duty was the direct cause of harm, resulting in the patient suffering damages as a result of the harm Malpractice Negligence that is the proximate cause of injury or harm to a patient resulting from A lack of professional knowledge, experience or skill that can be expected in others in the profession. OR From failure to exercise reasonable care or judgment in the application of professional knowledge, experience or skill. Medical Malpractice The commission or omission of an action causing an injury is shown to arise from the exercise of professional medical judgment There must be: A Physician-Patient Relationship A Duty to Perform Professionally 6 Sources of Professional Standards Government statutes and regulations Professional society standards Voluntary accrediting agency standards Administrative policies and rule of the facility Theories of Liability Informed consent Strict liability Vicarious liability Res ipsa loquitur Re ipsa loquitur The thing speaks for itself Injury would not ordinarily occur in the absence of negligence Injury was caused by the actions was within the control of the defendant Injury is not due to any action on the part of the plaintiff Evidence surrounding the circumstances is mostly within the control of the defendant Hospital Liability for Malpractice Respondeat superior Ostensible agency Staff Privileges Corporate Negligence Contributory Negligence 10 Other Liability Theories Intentional tort Assault and battery Libel Slander Invasion of Privacy Types of Damages Compensatory damage Awards for pain and suffering Punitive damages Statute of Limitations The maximum period of time after the patient’s injury during which a lawsuit may be commenced. Most state have a statutory period between one and three years. Typically the statutory period is deferred (tolled) during infancy and starts to run only on the patient’s 18th birthday. Common Malpractice Allegations Surgery/post-op complications Failure to diagnose cancer Surgery/inadvertent act Improper treatment (birth related) Failure to diagnose fracture or dislocation 14 Most Expensive Settlements Improper treatment (birth related) Failure to diagnose hemor