A few pearls from a session on legal risks and mitigation strategies from an HM ‘11 session by Harvard’s Allen Kachalia, MD, JD:
–A relatively small number of injured patients actually file claims and get compensation.
–Many filed claims do no have actual errors in them, but the majority do.
–Poor outcomes are correlated with claims, and so is patient satisfaction. Satisfied patients are less likely to file.
–There is no evidence that hospitalists’ risk of having claims filed against them is higher than primary care internists.
To protect yourself against claims, document well. Don’t go back and change a record (you can addend, but don’t alter). Document as contemporaneously as possible. Also, “as simple as it sounds, don’t abandon your patient, and don’t stop providing necessary care,” he said.
When an error occurs and it comes time to have the disclosure talk with the patient, don’t go it alone. Call Risk and/or Safety to help, “just like you’d call cardiology for ST elevations, even though you pretty much know what to do.”
In the disclosure conversation, be sincere and honest; state the facts; do not lay blame; assure all facts will be gathered. You can say you are sorry for the bad outcome, and that the hospital will find out what happened. Assure the patient and family that steps will be taken in the future to prevent this from happening again. And finally, document the family discussions.
*This blog post was originally published at ACP Hospitalist*