Healthcare Risk Management – May 1, 2005
May 1, 2005
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lesson of the Terri Schiavo case: Living wills no panacea for end of life
Risk managers know better than most people that, while living wills can be useful in some circumstances, they do not guarantee that end-of-life decisions will be simple or uncontested. The Schiavo case proves that point well, says the Chauncey Stillman Professor of Law at the University of Michigan Law School and professor of internal medicine at UM in Ann Arbor. -
Brace for more living wills, encourage deeper thought
Many agencies and nonprofit organizations that tout living wills are reporting a sharp increase in people seeking the documents because of the Schiavo case, so you can expect more patients to show up with questions about them or clutching a living will that they downloaded off the Internet. -
Research questions living wills and sees a better way
Living wills just arent worth the paper theyre printed on, say two experts who have looked at how the documents are really used. -
MN hospital creates a culture of full disclosure
To make full disclosure work, you first have to remember that it is not a program or an effort, or a policy, says a leader at one hospital that has undergone a major change in way adverse events are discussed with patients and families. Full disclosure is more of a philosophy and an overall way of working with people, says the chief operating officer and vice president of care delivery at Childrens Hospitals and Clinics of Minnesota in Minneapolis. -
Disclosure process starts with an apology, then info
Disclosure is a complex process, not simply an opportunity to sit at the patients bed side and say youre sorry, says the chief operating officer and vice president of care delivery at Childrens Hospitals and Clinics of Minnesota in Minneapolis. -
CPOE leads to other errors if implemented improperly
While computerized physician order entry (CPOE) is expected to significantly reduce medication errors, systems must be implemented thoughtfully to avoid facilitating certain types of errors, according to a recent study. -
Mandatory error reporting worries hospital leaders
A survey of hospital leaders indicates that many have serious reservations about a mandatory error reporting system, including that it would discourage event reporting and increase the risk of lawsuits, according to a recent study. -
Coordinating care doesn’t have to increase liability
Conventional wisdom is wrong: Primary care doctors who coordinate the care of their patients by specialists may actually have lower liability risk than primary care doctors who do not attempt care coordination. -
Reader Question: When alerting to urgent care copay, beware of risk
Any statement by staff that is construed as discouraging a patient from staying for treatment could be seen as an EMTALA violation. -
Legal Review & Commentary: Failure to diagnose perforated bowel results in a $670,000 settlement
A woman presented to the ED of a hospital. When told there would be a two-hour wait to be seen, she tried to drive to another hospital but had to stop and call for emergency medical assistance. She was taken by ambulance back to the first hospital where, several hours she later, she was diagnosed with a perforated bowel. Rather than immediately undergo the required emergency surgery, she agreed to be transferred to another hospital. She died shortly after arriving at the receiving facility. -
Legal Review & Commentary: Perforation found during surgery causes settlement
A woman underwent surgery to remove her gallbladder. During the procedure, the surgeon noticed a hole in the patients intestine, which he immediately repaired. However, he completed the surgery without examining the rest of the intestine. After the procedure, the woman exhibited symptoms of an abdominal infection. Doctors reopened the womans abdomen and discovered a second perforation that had caused intestinal contents to leak into her abdominal cavity. Although they attempted to repair the hole, the delay had irreversibly exacerbated the womans condition and she died. -
HIPAA Regulatory Alert: Privacy and security rules affect development of care management and outcomes improvement programs
To effectively manage patients care, providers need the most information possible. The question becomes, under HIPAA, whether managed care organizations can disclose patient information to all providers for any reason -
HIPAA Regulatory Alert: Process for administrative simplification complaints
In the March 25 Federal Register, the Centers for Medicare & Medicaid Services published procedures for nonprivacy administrative simplification complaints under HIPAA, along with a description of the procedures the Department of Health and Human Services will follow in reviewing such complaints. -
HIPAA Regulatory Alert: Many are unprepared for April 20 security deadline
Many small physician practices had gaps in three key areas as they attempted to meet the April 20 deadline for HIPAA security standards, according to Dallas-based MedSynergies. -
HIPAA Regulatory Alert: HHS publishes paper on HIPAA physical safeguards
The Department of Health and Human Services (HHS) has published the third in a series of seven papers designed to provide guidance on the HIPAA security standards. -
HIPAA Regulatory Alert: Group wants changes to privacy rule requirement
The Confidentiality Coalition, a group of hospitals, health plans, drug companies, medical device manufacturers, biotech firms, health product distributors, pharmacies, employers, medical teaching colleges, and others, is asking Health and Human Services Secretary Mike Leavitt to use his authority to change the HIPAA privacy rules accounting of disclosures requirement. -
HIPAA Regulatory Alert: HIPAA’s ‘chilling effect’ on biomedical research
An editorial in the February Annals of Epidemiology expresses concern that HIPAAs efforts to enhance patient confidentiality by restricting access to medical records is slowing the progress of critical biomedical research.