PT Role As Employee — Legal And Malpractice Flashcards
What is administrative law
- Health service providers must be licensed to provide reimbursable clinical services
- License is evidence that individual has met requirements of the state practice and act and are qualified to practice
- After a license is issued in the licensee must meet his/her responsibilities as stated in the practice act.
What is purpose of Illinois practice act
Enacted for the purpose of protecting the public health, safety, and welfare, and for providing the state administrative control, supervision, licensure, and regulation of the practice of physical therapy.
more on practice acts
- State laws enacted to protect residents
- Administrative law is determined by a hearing panel consisting of health professionals and public representatives
- Responsibility of the licensee - be aware of the practice act and the associated rules and regulations
- State boards can regulate professional conduct outside of patient interaction
What is torts
our biggest thing - negligence and malpractice falls here
- 2 general types of tort: negligent and intentional
Negligence tort
Omission or commission of an act that is reasonable and prudent person would or would not do under given circumstances
- professional negligence: occurs when the alleged wrongdoer is a licensed professional and the requisite action is within the scope of practice, thus requiring the knowledge, and skills of a professional.
Intentional tort
An act that is intentionally committed knowing harm is a likely result
- assault — threat to touch another without consent
- battery — intentional touching of another without his or her consent. Plaintiff does NOT need to prove injury.
Usually comes with not telling someone that is cog intact that you are gonna touch them or someone says stop and you don’t stop.
False imprisonment
Confinement of a person to the extent that there is no reasonable exit and physical restraint was not necessary
Defamation
Communication to a third party or parties that is unfounded and negative to their character
- slander — oral communication
- libel — written communication
Fraud
Intentional misrepresentation in a manner that could cause harm
Invasion of privacy
Intentional deprivation of one’s right to be left alone — (disclosure of personal facts)
Infliction of emotional distress
Intentional actions or omission that would cause a reasonable person to suffer emotional trauma
Main example here is ROM post op — its gonna hurt but we have to do it so we HAVE to educate
Negligence
Both ordinary negligence and malpractice plaintiff must prove that all four elements below exist:
1. Duty
2. Breach
3. Damages
4. Causation
What is duty
There was a duty owed to a person…
1. Legal duty exists whenever a healthcare facility or provider undertakes care or treatment of a patient
2. Corporate liability — the company has a duty to hire qualified staff, supervise, employees, and monitor employee performance
In healthcare - the legal duty starts as soon as we undertake their care so eval
What is breach
Demonstration that the duty was not met, either by failure to act (omission) or by failing to meet the standard of care for the circumstance at the time (what a reasonable professional would have done under similar circumstances)
Expert witness has to establish a minimum standard of care.
What are damages
Party who has owed a duty incurred damages
1. Direct — lost wages, current and future medical expenses
2. Indirect — value for pain, emotional distress, and loss of consortium
3. Punitive — may be added with conduct was intentionally harmful or so negligent that it demonstrates a willful disregard for standard of care.
What is causation
Causal relation between the breach of duty and damages that occurred
Have to prove there is an exact relationship between the two
What is malpractice
Negligence case must meet all of the above examples and IN ADDITION… expert witness has to be involved
They have testimony required to demonstrate ordinary professional’s standard of care
What is malfeasance
An act that is legally unjustified, harmful, or contrary to law
What is misfeasance
Performance of a lawful action but in an illegal or improper manner
What is nonfeasance
Failure or omission to do something that should be done
What is an example of something that can establish standard of care
Documentation
What is an event
This is what triggers the case — misunderstanding, accident, clearly defined injury
As soon as event occurs if you are aware it has occurred:
1. Attempt to remedy the situation
2. Alert appropriate health professional if you need additional professional assistance
3. Document thoroughly, accurately, and objectively
4. Likely facility has a report to fill out for risk management
when in doubt - fill out incident report
What is summons and complaints
Lawsuit is formally initiated when 2 documents are filed
1. Summons = written legal document given to defendant in a lawsuit which names the defendant, plaintiff, jurisdiction, and when/where the defendant should appear
2. Complaint = gives detail about the case against the defendant and outlines the basis of the suit,
What should defendant do should they receive a summons and complaints
- Notify liability insurance carrier
- Notify employer
- Review all records
- Preserve all records
What should NOT happen if you get a summons and complaints
- Distribute original records without advice from legal counsel
- Make changes to the records
- Converse about case with colleagues, family, friends, or emails
What is retrial discovery
- Where both parties research relevant facts to be presented to court
- Oral depositions, written depositions, and requests for production of records — medical records, office calendars, correspondence, and personal notes
- Oral depositions are taken under oath
What/when/how are depositions
- You can be a part of a deposition as both a fact witness and as a defendant
- Review your records prior to deposition
- Ask the attorney to repeat or rephrase question if you do not understand
- Give answers to the questions but do not give additional info
- Listen to your attorney’s advise
- Act professional and confident
- Avoid use of words: always and never!!!!
The trial…
If judgement is in favor for the plaintiff in a malpractice case…
1. Financial consequences
2. Employment consequences
3. Licensure consequences — censure, suspension, revocation
4. National practionaer data bank — not good
Settlement
An option up until the case goes to trial
A settlement is not an admission of fault
Two advantages
1. Less expensive than paying for attorneys, expert witnesses, court costs
2. Amount may be significant;y less than what jury would aware
Two types of fraud
- Civil — claiming a certain care plan will cure patient while knowing that it will not
- Criminal — billing for services that were never rendered
Workplace harassment provisions
U.S Equal Employment Opportunity commission — harassment is a form of employment discrimination that violates Title VII of the civil rights act of 1964, adage of discrimination in employment act of 1967, and Americans with disabilities act of 1990.
When does harassment become unlawful
- Offensive conduct becomes enduring and a condition of continued employment OR
- Conduct is severe or pervasive enough to create a work environment that a reasonable person would consider intimidating, hostile, or abusive.
What is OSHA
Assures the safety and health of American workers by setting and enforcing standards, providing training, outreach, and education
Impacts PT — safe environment like cords covered and out of walkway, equipment well maintained, training of all new equipment with therapists
Look at strategies to minimize risk
Slides 37-40
External vs. Internal workplace audits
External — assessment of specified data points to determine compliance with previously identified standard
Internal — assessment to determine compliance performed by, or initiated by, the organization or facility itself to look for inproprieties, errors, or other wrong doing
Sampling vs. Comprehensive audits
Sampling — assessment conducted on a statistically valid portion of the entire body of data
Comprehensive — assessment of the entire body of data to determine compliance with previously identified standards
What are types of problems
- OVERT — non compliant event that is obvious or easily seen
- COVERT — noncompliant event that is not obvious or easily seen
- TREND ANALYSIS — a review and assessment of data taken over a period of time with the intention of identifying patterns in the organization
- OCCULT PROBLEMS — noncompliant event that is deeply hidden and cannot be identified without an in-depth investigation
Who does internal audits
Companies can have staff complete, staff positions solely for the purpose of compliance, or hire companies to audit internally
What are some organizations that perform external audits
- Recovery Audit Contractors
- Occupational Safety and Health Administration
- Department of Justice
- Office of the Inspector General
- The Joint Commission
- Health and Human Services
Responding to patient complaints
- In house complaints — acknowledge the patient concern -> attempt to immediate remedy situation -> manager or patient relations -> grievance policy
- Patient complaints to accrediting agencies — report filed and company is required to respond
