12) Risk Management Flashcards
What is the key for successful risk management?
Thinking beyond the obvious
What should you do when you suspect a professional litigator?
- Keep them under your radar
- Keep meticulous documentation of their behaviors, subjective comments, etc
Malpractice
The liability of the PT for pt injury caused by professional negligence, breach of contratual promise regarding tx, or dangerously defective tx products/modalities
What does practicing defensive medicine do?
Incr your risk of malpractice
What is not good about non-disclosure?
It provides vague or deliberately misleading info
- Doing this is inconsistant w/the PT-pt relationship and the truth that pt’s expect as well as paternalistic
What skills should you demonstrate to avoid/decr litigations?
- Good communication skills
- Knowledge
- Technical (hands-on) abilities
- Attitudes that engender respect
What do pt’s typically use to make a decision to sue?
- Poor communication
- Poor PT-pt relationship
- Insensitive handling
Sorry Works Initiative
Truthfulness if something goes wrong
- Encompasses veracity
Why does the field of PT tend to have low malpractice rates?
- Good relationships/communication w/pt’s
- Direct supervision
- Truthfulness
- Deeper pockets to go after
When determining the best way to protect yourself from malpractice, what should you analyze?
- # of claims
- Cost of idemnity and fees
- Your geography
- Primary clinical reasons for litigations
- Primary/supervisory reasons
- Most severe claims
What setting gets the highest litigation payouts?
Nursing homes
What are the qualities of claims with the highest paid idemnity?
- Failure to report the pt’s condition to their PCP
- Failure to follow established policy
- Failure to complete a proper pt assessment
- Failure to refer out
- Working out of scope
- Improper positioning
- Injury
- Retained foreign body
What is included in risk management?
- Quality improvement
- Personnel effectiveness
- Infection control
- Pt and staff safety
Risk Management
The process of identifying liability risks and taking steps to decr potential risks
What does every malpractice case begin with?
A personal issue
What should you do to decr risk of a lawsuit?
- Do ongoing training programs
- Have knowledge of state practice act
- Staff orientation → Negligence if you don’t
- Documentation
- Professional Association Membership
- Follow policies and procedures
- Access to them
- Staff performance evals
- Plan for individual devo
- Remediate weaknesses
- Have organized systems for quality improvement
- Proficiencies and competancies
- Regular demonstration of basic essential skills
- CE
Application Process
Submitting a complete application regardless of the position
- References checked and documented
- Background check
- Verify that the person is qualified
What are some administrative challenges?
-
Demonstrating ongoing devo of staff and programs
- Infection control procedures
- Pt/Staff safety programs
- Encourage EBP
- Monitor quality of care
- Implement a quality improvement protocol
What is the acronym for dealing with administrative challenges?
FADE
- FOCUS ID what needs to be improved
- ANALYZE Analyze info and establish baselines/solutions
- DEVO Devo action plans
- EXECUTE Do the plan
What are some quality improvement models?
- Plan, Do, Study, ACT (PDSA)
- Define, Measure, Analyze, Improve, Control (DMAIC)
- Define, Measure, Analyze, Design, Verify (DMADV)
- Continuous Quality Improvement (CQI)
- Total Quality Management (TQM)
How can you ensure a safe environment for pt’s and staff?
- Make sure employees are qualified
- Have accessible space that is free of obstructions
- Eliminate infection
- Make sure equipment is safe and fxnl and do regular safety checks
What are some areas of clinical risk?
- Burns
- Fx
- Failure to supervise tx/procedures
- Perception of inappropriate behavior by PT
- Collaborative and Referral Relationships
What are the rules for informed consent?
- Comply w/state laws
- Ensure pt’s awareness of the PT dx and clinical findings as they relate to the POC
- Discuss risk/benefits to the proposed POC
- Discuss harm associated w/pt not following the POC
- Get pt’s signature after they’ve had their questions answered
- Adhere to standards when pt is involved w/research
- Maintain copies of all consent
What supports you in litigations?
Documentation
True or False: If you’re documenting w/a standardized form and you leave something blank, it looks shady?
True
What are some guidelines for pt communication?
- Use interview and listening skills to get info about pt
- Explain POC to pt and ensure their understanding
- Devo pt-stated goals and document them
- Document results of discussions
What are some guidelines for reimbursement?
- Discuss and document costs/fees of PT w/pt
- Make sure pt knows that insurance doesn’t always cover everything
- Make sure pt knows they’re responsible for things that insurance doesn’t cover
Alternate Dispute of Resolution
Govt entity that deals w/billing disputes
What are some guidelines for release of info?
- Release info only w/appropriate authorization
- Follow HIPPA, state regs, and FERPA
- Designate one individual to review records prior to release
- The day a pt turns 18, get their consent! (Otherwise tx is illegal)
Who should you notify if you’re anticipating a litigation?
Your Insurance Broker
How long should you hang on to copies of documentation?
At least the statute of limitations or 5yrs from d/c date
How long should you hang on to documentation for the tx of a minor?
Until 3yrs after they reach the age of majority
