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Preventing Medical Malpractice

Fairfax Injury Lawyer Brien Roche Addresses Preventing Medical Malpractice

Brien Roche

Team Approach

The team approach in medicine may have arrived.  In a December 2, 2012 article in The Washington Post a young doctor reported on the team approach. The team approach involves a team leader. This is the primary person who oversees care.

One of the examples given was an Iraq veteran who had multiple problems. He was dealing with chronic pain. He was drug dependent.  In addition, he had gained a great deal of weight. Also he had become a diabetic.

The primary care doctor upon seeing him had him meet with a social worker and a psychologist.  He was booked for appointments with the pain management clinic and the mental health clinic. The goal was to deal with the post traumatic stress disorder. Also he needed PT to help him get more mobile.  In addition, the primary care doctor began treating the diabetes.

Coordinated Care

If this patient had gone to a private clinic, he might have received one of those treatments. However it is not likely he would have been referred on to all of the above.

The VA, of course, is a bit different. It is able to refer patients to many doctors under one roof.  A private doctor does not have these multiple specialists within one building.

One Stop Shopping

The article cites another incident. A patient with diabetes came in to see the primary care doctor.  He was given times to see a nutritionist, weight loss specialist and optometrist. The latter to deal with sight problems down the road.  In addition, the patient was brought back a week later to learn how to control his diabetes.

This type of team approach has received lip service over the years. However now it may have arrived. In addition to the benefit of one stop shopping it enhances continuity of care.  That is needed. Where people have many problems they are best served with one doctor overseeing all care. As a result that person has the big picture over time. Call, or contact us for a free consult.

Preventing Medical Malpractice Through Better Communication

Good “chatter” among doctors is needed in any hospital stay. In a Washington Post article of April 30, 2013 a failure to talk is reported. A GI doctor reported a patient had an blocked kidney. An internist came in thereafter and reported that “We don’t know what’s wrong.” Thereafter a social worker told the patient “You are good to go home.”

If these people had talked to each other the patient would have been admitted. This lack of talking is a huge danger because  when the “shit hits the fan” the doctors close ranks. They convey only limited info to the patient. Their fear is that of pointing the finger at another doctor. Even more so the finger may be pointed at them.

As a result the Joint Commission has attempted to develop some guidelines to assist communicating well.

Safety Goals

Many hospitals use the “National Patient Safety Goals” published by the Joint Commission. These goals state how certain things should be communicated and recorded. They are called NPSG standards. They address telephone orders, abbreviations to be avoided and proper hand off. Also they address how to convey info about test results.

One model for communication is what is called SBAR (Situation, Background, Assessment, Recommendation).  This requires the provider who is communicating info to another to state the current situation. In addition they state the background leading to where the patient is. They state what is the assessment and what is the course forward.  This is all written in the chart.

In promoting good chatter it is important to look at the issue of bad conduct by doctors. Does the doctor have a history of abuse of nurses or doctors? If so that impedes communication.  As a result the past of that doctor becomes important.  Many hospitals have a policy of zero tolerance of any such conduct. Call, or contact us for a free consult.

Having An Advocate

A patient’s best means of obtaining info is to have his own advocate. This person can interact with the doctors.  This person should be some one with some medical knowledge who can ask the right questions. This may include inquiry as to fall safety, what medicines are being used and their interaction. Is there any planned surgery and the need for such?  With such an advocate the level of chatter goes up. That is good.

Records Technology and Chain of Command

You need to know the technology aspects of recording info. You need to review the chain of command within the system.  Nurses are to report concerns about a patient to the attending doctor first.  If that doctor fails to take action then the nurse notifies the next up in the chain of command.  The failure of the nurse to do so may make the nurse liable. All of this needs to be looked at in a failure to communicate case.

Hospitalists May Help With Communication Flow

Many hospitals have attempted to improve the info flow by the hiring hospitalists.  A hospitalist typically is a internal medicine doctor.  These doctors oversee the care of the patient. Also they guide the movement from hospital to home or other place.

The problem with the use of these doctors is that many of them are overworked.  Most of them report a safe workload as being up to 15 patients. According to a survey from Johns Hopkins University School of Medicine 4 in 10 reported excess workloads. In many hospitals they work 7-15 days in a row. They work shifts of 10-12 hours.

Urgent Care Facilities

A September 18, 2012 Washington Post article estimated 3 million patients visit urgent care facilities each week.  Most consumers find these offices to be user friendly. They do not involve the long waits of a doctor’s office or ER.  In addition, an ER visit could cost several hundred dollars. However urgent care may be $100.

The downside of these places is a lack of continuity of care. People with any chronic problem need to be followed by one doctor who can plot their course. That lack of continuity allows patients to fall into a black hole. Hence no one doctor understands the full picture of what is going on. That can be a danger. Call, or contact us for a free consult.

Prompt Apologies As A Way Of Preventing Medical Malpractice Claims

At Tufts Medical Center in Boston a neurosurgeon apologized to a patient’s family after a rare medical error took the life of a mother.  

In November of 2013 the 74 year-old mother awoke following surgery with seizures and extreme pain.  The surgery was to install a pain pump.  The mother’s neurosurgeon, Steven Hwang, MD, admitted to her sons the dye used to test the location of tubing into the mother’s spine was incorrect.  Dr. Hwang ordered Omnipaque. The pharmacist told the nurse that they don’t carry that and gave the nurse MD-76.  However MD-76 comes with a warning label. It says “not for intrathecal use.”

Even though Dr. Hwang acknowledged the medical error Tufts’ malpractice attorneys denied any fault.

Since this case there have been some developments:

  • Legislation has been passed in Massachusetts that requires a cooling-off period of 6 months before patients can sue.  This was intended to encourage settlement discussion during that 6-month period. In addition it allows for providers to apologize without the apology being used against the provider in court.
  • Six other hospitals in Mass. began pilot programs that offer patients injured by medical errors a timely apology. Also it offers prompt financial settlements.  The thinking is that a program such as this could boost patient safety and prevent lawsuits.

Call, or contact us for a free consult. Also for more information on preventing medical malpractice see the pages on Wikipedia and the other pages on this site.

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Contact Us For A Free Consultation

Preventing Medical Malpractice

Fairfax Injury Lawyer Brien Roche Addresses Preventing Medical Malpractice

Brien Roche

Team Approach

The team approach in medicine may have arrived.  In a December 2, 2012 article in The Washington Post a young doctor reported on the team approach. The team approach involves a team leader. This is the primary person who oversees care.

One of the examples given was an Iraq veteran who had multiple problems. He was dealing with chronic pain. He was drug dependent.  In addition, he had gained a great deal of weight. Also he had become a diabetic.

The primary care doctor upon seeing him had him meet with a social worker and a psychologist.  He was booked for appointments with the pain management clinic and the mental health clinic. The goal was to deal with the post traumatic stress disorder. Also he needed PT to help him get more mobile.  In addition, the primary care doctor began treating the diabetes.

Coordinated Care

If this patient had gone to a private clinic, he might have received one of those treatments. However it is not likely he would have been referred on to all of the above.

The VA, of course, is a bit different. It is able to refer patients to many doctors under one roof.  A private doctor does not have these multiple specialists within one building.

One Stop Shopping

The article cites another incident. A patient with diabetes came in to see the primary care doctor.  He was given times to see a nutritionist, weight loss specialist and optometrist. The latter to deal with sight problems down the road.  In addition, the patient was brought back a week later to learn how to control his diabetes.

This type of team approach has received lip service over the years. However now it may have arrived. In addition to the benefit of one stop shopping it enhances continuity of care.  That is needed. Where people have many problems they are best served with one doctor overseeing all care. As a result that person has the big picture over time. Call, or contact us for a free consult.

Preventing Medical Malpractice Through Better Communication

Good “chatter” among doctors is needed in any hospital stay. In a Washington Post article of April 30, 2013 a failure to talk is reported. A GI doctor reported a patient had an blocked kidney. An internist came in thereafter and reported that “We don’t know what’s wrong.” Thereafter a social worker told the patient “You are good to go home.”

If these people had talked to each other the patient would have been admitted. This lack of talking is a huge danger because  when the “shit hits the fan” the doctors close ranks. They convey only limited info to the patient. Their fear is that of pointing the finger at another doctor. Even more so the finger may be pointed at them.

As a result the Joint Commission has attempted to develop some guidelines to assist communicating well.

Safety Goals

Many hospitals use the “National Patient Safety Goals” published by the Joint Commission. These goals state how certain things should be communicated and recorded. They are called NPSG standards. They address telephone orders, abbreviations to be avoided and proper hand off. Also they address how to convey info about test results.

One model for communication is what is called SBAR (Situation, Background, Assessment, Recommendation).  This requires the provider who is communicating info to another to state the current situation. In addition they state the background leading to where the patient is. They state what is the assessment and what is the course forward.  This is all written in the chart.

In promoting good chatter it is important to look at the issue of bad conduct by doctors. Does the doctor have a history of abuse of nurses or doctors? If so that impedes communication.  As a result the past of that doctor becomes important.  Many hospitals have a policy of zero tolerance of any such conduct. Call, or contact us for a free consult.

Having An Advocate

A patient’s best means of obtaining info is to have his own advocate. This person can interact with the doctors.  This person should be some one with some medical knowledge who can ask the right questions. This may include inquiry as to fall safety, what medicines are being used and their interaction. Is there any planned surgery and the need for such?  With such an advocate the level of chatter goes up. That is good.

Records Technology and Chain of Command

You need to know the technology aspects of recording info. You need to review the chain of command within the system.  Nurses are to report concerns about a patient to the attending doctor first.  If that doctor fails to take action then the nurse notifies the next up in the chain of command.  The failure of the nurse to do so may make the nurse liable. All of this needs to be looked at in a failure to communicate case.

Hospitalists May Help With Communication Flow

Many hospitals have attempted to improve the info flow by the hiring hospitalists.  A hospitalist typically is a internal medicine doctor.  These doctors oversee the care of the patient. Also they guide the movement from hospital to home or other place.

The problem with the use of these doctors is that many of them are overworked.  Most of them report a safe workload as being up to 15 patients. According to a survey from Johns Hopkins University School of Medicine 4 in 10 reported excess workloads. In many hospitals they work 7-15 days in a row. They work shifts of 10-12 hours.

Urgent Care Facilities

A September 18, 2012 Washington Post article estimated 3 million patients visit urgent care facilities each week.  Most consumers find these offices to be user friendly. They do not involve the long waits of a doctor’s office or ER.  In addition, an ER visit could cost several hundred dollars. However urgent care may be $100.

The downside of these places is a lack of continuity of care. People with any chronic problem need to be followed by one doctor who can plot their course. That lack of continuity allows patients to fall into a black hole. Hence no one doctor understands the full picture of what is going on. That can be a danger. Call, or contact us for a free consult.

Prompt Apologies As A Way Of Preventing Medical Malpractice Claims

At Tufts Medical Center in Boston a neurosurgeon apologized to a patient’s family after a rare medical error took the life of a mother.  

In November of 2013 the 74 year-old mother awoke following surgery with seizures and extreme pain.  The surgery was to install a pain pump.  The mother’s neurosurgeon, Steven Hwang, MD, admitted to her sons the dye used to test the location of tubing into the mother’s spine was incorrect.  Dr. Hwang ordered Omnipaque. The pharmacist told the nurse that they don’t carry that and gave the nurse MD-76.  However MD-76 comes with a warning label. It says “not for intrathecal use.”

Even though Dr. Hwang acknowledged the medical error Tufts’ malpractice attorneys denied any fault.

Since this case there have been some developments:

  • Legislation has been passed in Massachusetts that requires a cooling-off period of 6 months before patients can sue.  This was intended to encourage settlement discussion during that 6-month period. In addition it allows for providers to apologize without the apology being used against the provider in court.
  • Six other hospitals in Mass. began pilot programs that offer patients injured by medical errors a timely apology. Also it offers prompt financial settlements.  The thinking is that a program such as this could boost patient safety and prevent lawsuits.

Call, or contact us for a free consult. Also for more information on preventing medical malpractice see the pages on Wikipedia and the other pages on this site.

Contact Us For A Free Consultation

Contact Us For A Free Consultation