Share




Physician Healthcare Law

6 Communication Tips to Reduce Medical Malpractice Risk


May 24, 2020

Harsha Moole, M.D., MBBS


6 Communication Tips to Reduce Medical Malpractice Risk | Doctor Malpractice

 

Disclaimer: This is not legal advice, I am not a financial advisor or an attorney. You have to reach out to your attorney for legal advice. The information presented here is purely for educational and entertainment purposes. These are my personal opinions and do not represent the opinions of my employer. 

 

6 Communication Tips to Reduce Medical Malpractice Risk (Doctor Malpractice). Hospitalist’s job is integrated into a mesh of multi-modal communications between healthcare professionals. There is barely anything we do that doesn’t involve constant communication. This part of the eBook is an attempt to identify high-risk or grey zone communication areas that could negatively impact a patient’s health and might land you your first malpractice claim. Getting on top of these topics is mandatory, to help bridge communication gaps, thereby avoiding fatal outcomes, and medical malpractice claims (doctor malpractice). 

 

This is one of the 5 blog posts on how to avoid having a medical malpractice lawsuit or claim (doctor malpractice). In this series, the next blog posts discuss the 10 best risk mitigation strategies for physicians to avoid having a medical malpractice lawsuit, top 6 circumstances contributing to patient injury, medical malpractice lawsuit – 6 most common medical malpractice claims (doctor malpractice), along with the patient injury severity scale.

 

6 Communication Tips

Communication  Teams

 

High Risk – Grey Zone Communication Areas – Develop Definitive Protocols for These Topics

 

(1) Hospitalist & ER Team

Boarding Patients: While the patient is boarding in the ER, waiting for their hospital bed – Who is the attending physician? Who takes care of a decompensating boarding patient? – Hospitalist or ER doc? Pending workup–ER doctors calling for an admission while workup is still pending. Pending labs or images might determine the need for another service/consultant to be involved.

Calling Consults: ER doctor says “I spoke to cardiology.” Was cardiology officially consulted?, was it a curbside?, was an EHR order placed? Does the hospitalist need to call the consultant again?

Patient Transfers: Confusion regarding services that may not be available at the hospital (Ex. Liver Transplant services not available at the hospital. Transfer patient to a tertiary care center vs. Keeping patient in house. What if a particular sub-specialty is not available at the hospital? Does the ER doctor push an admit to hospitalist, or will they transfer the patient?

Attending Physician: If patient needs multiple specialists, who assumes the attending role?

ER Team Shift Changes: ER hand-offs are important to eventually improve the quality of hand-offs to the admitting physicians. 

 

(2) Physicians & Nursing Staff

Who Call Consults? The RN or the Attending physician.

Phone Orders: Does the RN place orders in the computer after receiving verbal orders or text orders? Read back protocols when verbal orders are placed. 

Communication Platform Standards: Lay out the rules of communication–pager vs. call vs. overhead announcement vs. text, etc. When do you use a particular form of communication?

Communication Structure: SBAR (Situation, Background, Assessment, Recommendation) is a proven and effective system. Do you use this structure while communicating with other healthcare team members? 

 

(3) Physician & Physician

Hand-offs Are Mandatory: Do you have a standardized written form of hand-offs when you leave your shift? (e.g. Pending labs, Pending consults)

Pending Test Follow-Ups: Who follow-ups on a test ordered by a physician that is about to go off-service. There is a traditional medical saying – “if you ordered it, you own it.” So make sure you appropriately hand-off these pending labs or tests to the incoming physicians, so you don’t land in legal trouble. 

Documentation Cannot be More Important: Make sure to document everything you do. It is probably the most extensively used mode of communication among physicians. Another famous saying–“if it is not in the chart, it did not occur.” Documentation can your best asset or worst enemy when it comes to legal issues.  Do a thorough job documenting all you do, and this will be become the basis of claims defense.

Inpatient and Outpatient Physicians: A well-established communication portal must be developed to enable clear communications between inpatient and outpatient physicians. Inpatient physicians can inform outpatient physicians about pending labs, consults, and the next steps of follow-up and medical management after a complicated hospital stay. 

 

(4) Physician & Patient/POA

Importance of Setting Expectations: Letting patients and their families know regarding roles of various treatment teams and/or consultants, sharing practical expectations of recovery and time frame.

Keeping Patients’ Family/POA (Power of Attorney) in the Loop: For patients who are unable to communicate effectively, their respective POAs must be given regular updates, either by you, or an RN or someone who knows the current treatment plan. Have an established process for this.   

 

(5) Physician & Discharge Process

Communication: Communicate with patient regarding new medication at discharge, changes to prior medication, follow-ups with physicians.

Follow-Ups: Who sets up the follow up appointment? Do the patients have to call a phone number to make an appointment? Does the physician’s office call the patient? Having a clarity in this topic is vital.

Written Instructions: A detailed print out of instructions must be given to patients regarding final medical reconciliation, and all other discharge recommendations–wound care, activity status, and dietary recommendations. If you are recommending a low sodium diet and extensive education, written instructions must be provided to patients regarding what this means. 

 

(6) Physician & Hospital Admin or Leadership

Being a Liaison: Physicians are on the front line on healthcare delivery. We are usually the first ones to notice any inefficiencies. It is our responsibility to liaison with the hospital administrator or leadership to take up these issues.

Protocols and Processes: At the end of the day, process changes must be made to improve outcomes, and hospital leadership plays a vital role in establishing a ‘Swiss Cheese Model’.

Swiss Cheese Model: When an unfavorable patient care event occurs, it can be noted that the event could potentially be avoided or nullified at several checkpoints. A well-known example of the Swiss Cheese Model is still valid in this topic. When these multiple checkpoints fail to capture the error, all the holes in the Swiss Cheese lineup, leads to unfavorable outcomes. This topic highlights the need for system based approach to mitigate unwanted outcomes. A comprehensive approach must be followed, involving a multi-disciplinary approach to lay out all the possible error-prone areas, hold discussions in a non-judgmental environment, and come out with changes that have the efficiency to prevent errors, and detect errors at an early stage, much before they can influence an outcome. 

(ex. If the patient received the wrong medication in the hospital, resulting in an adverse effect, there are several potential checkpoints that should be evaluated–physician knowledge deficit, negligence, fatigue from overwork, communication error, EMR technological issues, documentation errors, pharmacy review, telephone order inefficiency, and etc.)

 

 

Although most of the content presented in this blog post (6 Communication Tips to Reduce Medical Malpractice Risk | Doctor Malpractice) seems pretty basic, the goal of this blog post is to highlight the importance of topics that often fall through the cracks, and eventually get physicians and patients in trouble. I hope that you picked up at least a few key points from this article, to include them in your practice. Practice thoroughly, keep your patient safe, and you stay safe!

 

Please also read the rest of the blog articles in the same series: the 10 Best Risk Mitigation Strategies for Physicians to Avoid Having a Medical Malpractice Lawsuit, Top 6 Circumstances Contributing to Patient Injury, Medical Malpractice Lawsuit – 6 Most Common Medical Malpractice Claims, along with the Patient Injury Severity Scale.

 

Follow us on social media – Facebook, and Instagram to get the latest information and news on this topic. 

Here at PhysicianEstate, we welcome all physician entrepreneurs to learn about commercial real estate investments, rental property investments, and wealth generation. We encourage all physicians to eventually become real estate physician investors. We know a great deal about Who – What – Why – How. 

Stay in touch with us by signing up for our newsletter. The newsletter will keep you up to speed on the current real estate investments we are looking at, provide physicians with investment opportunities, and much more.  

Doctor Malpractice

Legal Disclaimer: This is not investment advice. I am not a legal and/or investment advisor. This is my personal blog, and all information found here, including any ideas, opinions, views, predictions, forecasts, commentaries, suggestions, or stock picks, expressed or implied herein, are for informational, entertainment or educational purposes only and should not be construed as personal investment advice. These are my views, it is not a production of my employer, nor is it affiliated with any broker/dealer or registered investment advisor. While the information provided is believed to be accurate, it may include errors or inaccuracies. To the maximum extent permitted by law, PhysicianEstate disclaims any and all liability in the event any information, commentary, analysis, opinions, advice and/or recommendations prove to be inaccurate, incomplete or unreliable, or result in any investment or other losses. You should consult with an attorney or other professional to determine what may be best for your individual needs. Your use of the information on the website or materials linked from the Web is at your own risk. 

Don't forget to share this post! Sharing is caring.


Authored by Harsha Moole, M.D., MBBS

Hey there! I hope you enjoyed reading this blog. PhysicianEstate is my brain child and passion project. I run this platform to empower entrepreneurially motivated physicians to make financially educated investment decisions and discuss asset protection strategies. Lots of important but free content here and here! If you have any questions or if you are interested in partnering with me, let’s connect! hmoole@physicianestate.com

No Comments

Comment

Comment as guest

Subscribe to Our Newsletter