Helpful Info for Medical Directors

Developing good rapport with patients

Developing Good Rapport With Patients

As a health care professional, it’s important for you to establish good communication and trust with your patients. Studies have shown that patient satisfaction and health outcomes are both affected by whether patients feel that the people caring for them are sensitive to their needs and empathize with them.

The surveys patients in hospitals and has found that the following items are top priority issues.

  • Response to concerns/complaints made during your stay
  • Staff sensitivity to the inconvenience that health problems and hospitalization can cause
  • Staff effort to include you in decisions about your treatment
  • Degree to which hospital staff addressed your emotional needs
  • How well the nurses kept you informed

Clearly, these will also be important to patients in any medical setting, not just hospitals.

So how can you help address these concerns as an individual health care provider?

  • Listen to what patients have to say. It can be easy to make assumptions, especially if you have a heavy workload and are pressed for time. However, it’s important to make sure you’re hearing and working to address each patient’s concerns or complaints. Patients want to know they’re being heard, even in cases where they know nothing can be done to change a situation.
  • Always explain what is happening. Medical experiences can be frightening and disorienting, so patients find it reassuring to be kept informed of what care is being given and planned for them. The more information you share, the more comfortable and safe patients tend to feel.
  • Put yourself in your patients’ shoes. Be aware that age gaps and cultural differences can make it more difficult for patients and health care professionals to relate to one another. Always be alert for any unsupported notions you might have about a patient and work to overcome those ideas to ensure that you are communicating as effectively as possible.
  • Have empathy and sympathy. There’s a chance that you’re seeing many patients at their worst simply because of the pain or emotional aspects of their health situation. Cultivate patience and work to smooth each patient’s way as much as possible.

In the rush of any given day’s work, many of these can be difficult to achieve consistently, but every health care professional should strive to keep improving in these areas. Patients who are satisfied with the people who provide their health care are likely to respond better to treatment. They are also less likely to complain or file a lawsuit, which means that their peace of mind is ultimately your peace of mind.

I'm sorry laws and lawsuit risk

“I’m Sorry” Laws and Lawsuit Risk

Miscommunication or poor communication between health care providers and patients or their families—particularly in the event of an adverse outcome or incident—is known to result in increased numbers of malpractice lawsuits. When health care providers have the opportunity to express condolences or apologies to patients and families without fear of having those words used against them in court, it can go a long way toward defusing many situations and can .

That’s the reasoning behind the increasing trend of “I’m Sorry” or “apology” legislation, which is currently on the books in 36 states. The state legislatures enacting these laws hope to change the previously prevailing culture in which health care providers , whether or not such denials were justified.

A simple apology can diffuse the anger a patient or their family feels when a mistake has occurred, and many health care institutions have found that their self-disclosure policies have resulted in fewer and less expensive malpractice lawsuits.

“I’m Sorry” laws vary from state to state, so it’s important for health care providers to be aware of what language is protected in what circumstances in the state(s) in which they practice. In some states, only statements of sympathy are protected. In other states, a health care provider can include an admission of fault or negligence in their apology and still be protected from having that admission used as proof of liability in court.

Even with “I’m Sorry” laws in place, health care workers need to be aware of their employer’s policies on admitting responsibility for medical errors. Some health care institutions are actually ahead of the curve with voluntary self-disclosure policies that pre-date their states’ legislation. Others still maintain a more guarded approach, so you should make sure you know the policies before an incident arises.

It’s also a good idea for health care providers to consult the terms of their liability insurance policies to see where the insurer stands on apologies that admit fault, regardless of the laws of their state. Many insurance companies still recommend against admitting mistakes or errors even if the state law offers some protection.

Organizational strategies to reduce work stress for health care professionals

Organizational Strategies to Reduce Work Stress for Health Care Professionals

Work stress is an unfortunate reality of much of the health care industry. The National Institute for Occupational Safety and Health (NIOSH) of the Centers for Disease Control has been for almost two decades, and many of their proposed solutions revolve around organizational changes.

Although there are steps that health care workers can take as individuals to and , it takes medical directors or other health care administrators who are responsible for institutional and organizational changes to truly benefit workers and patients alike.

NIOSH has found that health care workers’ stress results from the following factors:

  • The demands of the jobs or task, particularly when there is work overload, a lack of control over a task, or ambiguity about a person’s role.
  • Organizational factors, including unfair management practices or poor interpersonal relationships.
  • Financial and economic factors, which can mean inadequate pay for workers or insufficient funding for supplies, staffing or other aspects of patient care, among other things.
  • Poor work-life balance leading to conflicts between work and family roles and responsibilities.
  • Stalled training and career development, including a lack of opportunity for growth or promotion.
  • Poor organizational climate, with management lacking a commitment to core values and demonstrating a lack of communication or transparency with workers.
  • The health care setting itself, with potential exposure to hazardous or infectious substances or other risks.

Organizations can work to reduce occupational stress in their workers by making policy changes and redefining jobs and roles. Some of the changes may seem relatively minor but still have a noticeable positive impact on worker stress. They include:

  • Evaluating the workload to ensure that it matches workers’ capabilities and resources.
  • Making sure workers’ roles and responsibilities are clearly defined and understood.
  • Allowing workers the opportunity to have a voice in decisions and actions that directly affect their jobs.
  • Maintaining open communications.
  • Developing career development paths that reduce uncertainty about future employment prospects.
  • Giving workers opportunities for social interaction amongst themselves.
  • Organizing teams to work together and support one another in handling their cumulative workload.

Focusing on workers and their needs is key to successfully managing workplace stress. Be sure to listen to their concerns and involve all staffers in organizational change from the planning stage onward.

Reducing laboratory errors

Reducing Laboratory Errors

Lab testing forms the basis for many aspects of diagnosis and treatment. This means that test-related errors can have serious repercussions.

found that the majority of errors related to lab testing took place outside the laboratory itself. Common errors included:

  • Mislabeled specimens
  • Specimens with an incomplete or missing label
  • Missing or delayed results
  • Wrong tests ordered
  • Misinterpretation of results

ECRI Institute PSO listed the different people who bear the responsibility for the accuracy of the testing process, including:

  • The health care professional who orders the lab test and makes decisions based on the findings.
  • The person who collects the specimen to be tested.
  • The transporter who delivers the specimen to the lab.
  • The lab technician who processes the test order and records the test results.
  • The person who makes the test results available to the health care team that initially ordered the testing.

It’s easy to see how important it is for all of these people to do their jobs effectively to ensure the integrity, accuracy and availability of the test results. An article for suggests that teamwork is the key. The author recommends increased communication between clinicians and health care professionals to help reduce errors and establish protocols and processes that help eliminate mistakes.

A article analyzing the same study offered five strategies for implementing the study recommendations, including:

  • Using bar-code identification for patients and specimens.
  • Automatic digital transmission of reports.
  • Error-reporting protocols to analyze mistakes and near misses.
  • Standardizing results reporting and identification protocols.
  • Creating facility-wide protocols for team communication, including setting reporting time frames, establishing testing priorities and outlining notification processes to report results.

As an individual, you can contribute to reducing laboratory errors by carefully following the established protocols of your employer, making sure to ask questions when there’s any doubt about the identity of a patient or specimen, and helping to facilitate the movement of information between your office and the lab. Just slowing down and taking extra care can make all the difference.

Medical liability terminology for health care professionals

Medical Liability Terminology That Health Care Professionals Should Know

You probably learned basic legal terminology while you were getting your degree and other training, but if you are ever involved in a malpractice lawsuit or claim, you may find yourself overwhelmed by unfamiliar words and phrases.

Here is a glossary that covers many of the legal and insurance terms you might hear in relation to a malpractice case.

Affidavit – A sworn written statement or declaration of facts.

Allegation – In a legal proceeding, this is a statement of the claim against the defendant that the person making the complaint intends to prove.

Answer – The written reply by the defendant to an allegation, which denies or admits to it.

Arbitration – A process for resolving a legal dispute without involving the court system.

Assumption of risk – This is an allegation that the defendant was aware of the danger of the actions they were taking but chose to take the risk anyway.

Case law – The body of previous decisions of appellate courts which forms the basis for law.

Civil lawsuit – A lawsuit that does not seek to prove criminal liability. Many medical malpractice and personal injury cases fall under the umbrella of civil suits.

Comparative negligence – In cases where there is more than one defendant, this refers to the degree of fault of each accused party.

Compensation – Money awarded by the court to be paid to the plaintiff by the defendant to make up for an injury, damage or wrong inflicted by the defendant’s actions or negligence.

Complainant – Another word for plaintiff.

Cross-examination – At a deposition, hearing or trial, this is the questioning of one party’s witness by the opposing party.

Damages – Money awarded to a plaintiff by the court for injuries or losses suffered by them due to the wrongdoing of the defendant. Where compensation is designed to right an injustice, damages can vary significantly and take the form of non-compensatory damages including punitive damages.

Default – Failure to file documents or appear in a civil case during a specified time period.

Defendant – The person sued in a civil case or accused in a criminal case.

Deposition – Pre-trial testimony from a witness.

Disciplinary hearing – A hearing or licensing review by a professional regulating authority, government agency or licensing board.

Discovery – The process that allows one party the pre-trial opportunity to review the evidence being presented at a trial by the opposing party.

Dismissal – The order to dismiss a case. In a dismissal with prejudice, the court is saying that the plaintiff cannot sue again. In a dismissal without prejudice, the court leaves open the possibility that the plaintiff can sue again for the same cause.

Established customary standard of care – This refers to the level of skill and care that the average medical professional would provide to a patient in a similar situation.

Evidence – Any fact presented to the court, including objects, documents and written or spoken testimony by witnesses.

Exhibit – Items offered into evidence at a trial, including documents or physical objects.

Incompetence – Being unfit or legally unqualified to perform a necessary duty.

Liability – Legal responsibility.

Litigation – Using the court system to settle a dispute.

Medical incident – Any error, omission or act that takes place in the course of providing professional services.

Medical negligence – The failure of a medical professional to conform to standards of conduct for their job duties, based on how a reasonable person with the required knowledge and skills would act in the same situation.

Misdiagnosis – A failure by a health care professional to correctly identify and diagnose a patient’s medical condition.

Negligence – An act or omission by a health care professional that causes an unacceptable level of treatment based on accepted practice standards within the medical community, leading to injury or death to the patient.

Prescription error – A variety of malpractice where a patient is harmed by medication, which may include being given the wrong medication, being provided the wrong dosage or being given medication at the wrong time.

Plaintiff – The party who alleges that they have suffered harm due to the defendant’s negligence or actions.

Pleadings – Written statements of the allegations and claims of each party in a legal dispute.

Professional services – The services someone performs as a health care professional, for which they are trained, licensed and qualified.

Subpoena – A court-issued document ordering a person to appear and provide testimony or evidence.

Wrongful death – A death caused by the malice, recklessness or negligence of another person.

Communication is vital to good patient care

Communication is Key for Patient Care

According to the , “Extensive research has shown that no matter how knowledgeable a clinician might be, if he or she is not able to open good communication with the patient, he or she may be of no help.”

That’s a strong statement, but it speaks to how incredibly important it is for health care professionals to learn and practice effective communications skills to ensure their patients get the benefits of the treatment they seek.

Patients who have not effectively communicated with their health care team miss out on vital information about their own conditions, including the purpose and importance of their medications and other prescribed treatments.

Communication skills encompass a whole range of , as well as everything that goes into being an effective listener. Think about each one of the following skills and consider whether you may need to work on improving some of them.

The skills you need for good communication with patients include:

  • Speaking clearly and making sure the other person understands what you are saying.
  • Choosing words and phrases that are appropriate to the subject matter and audience.
  • Clarifying and repeating information in different ways as needed.
  • Projecting empathy and support for patients and their families through tone of voice, word choice and non-verbal cues.
  • Organizing and structuring conversations to help set patient expectations and give patients the information they need to make decisions.
  • Listening closely to what patients are saying to make sure you are gathering all relevant information.
  • Learning to watch for cues from patients that you need to ask follow-up questions to get more detailed information.
  • Strategies for overcoming communication style differences between you and a patient due to cultural factors, language, age, or other reasons.
  • The (both verbal and non-verbal) needed to advocate for patients and ensure proper interpersonal boundaries between you and your patients.

Polishing your skills in all of these areas will help you care for patients more effectively, which in turn should improve both their satisfaction levels and their treatment outcomes.

Liability concerns for health and safety educators

Liability Concerns for Health and Safety Educators

As an educator specializing in health and safety education, you have the satisfaction of knowing that you’re sending people out into the world to potentially save lives. Whether you provide first aid, CPR, AED or other related training, your professional advice and expertise is unquestionably valuable.

The flip side is that the life-or-death nature of your field can expose you to malpractice liability claims if a former student injures someone while using a technique you taught. No matter how experienced you are as an instructor, there’s always a chance that someone could claim that you were negligent in the way you provided training.

Other liability concerns can also come into play during your training sessions. If someone trips and falls on their way into a class or gets injured using a piece of training equipment, you could find yourself facing a lawsuit.

Your professional authority may have some ramifications when it comes to actions you personally take as an emergency first aid provider. The Cardiac Arrest Survival Act (CASA) provides some AED users with Good Samaritan legal liability immunity from harm resulting from the use or attempted use of the device; however, this immunity does not apply to AED trainers.

These are some of the reasons that many companies hiring health and safety educators will require you to carry Professional Liability Insurance.

Fortunately, from Lockton Health is quite affordable and easy to purchase online in minutes. It’s comprehensive personal coverage that applies to you wherever you work or volunteer, and you may be eligible for discounts and special benefits if you belong to an eligible group or association.

The impact of nursing workloads on patients

The Impact of Nursing Workloads on Patients

Study after study has shown that nurses around the world are burdened with heavy workloads. This is largely a result of under-staffing, which is caused by a , including an increase in demand for nurses as the population ages, an inadequate supply of available nurses, deliberately reduced staffing and increased overtime intended to reduce costs, and more acute patient needs due to shorter hospital stays.

A report from the Canadian Federation of Nurses Unions (CFNU), Nursing Workload and Patient Care: Understanding the value of nurses, the effects of excessive workload and how nurse-patient ratios and dynamic staffing models can help, cited the statistic that for every surgical patient added to a nurse’s workload, the odds of a patient dying under that nurse’s care .

High nurse workloads also correlated to higher infection rates, increased incidences of readmission, more patient falls, longer patient stays, diminished ability of nurses to assess and observe potentially fatal medical complications in their patients, and lower patient satisfaction.

The nurses also experience adverse effects from excessive workloads. A found that each additional patient assigned to a nurse led to a 23% increase in the risk of nurse-reported burnout and a 15% increase in job dissatisfaction, in part due to frustration that they could not adequately care for their patients.

What can be done to fix this problem? The Agency for Healthcare Research and Quality suggests that are a possible answer. California’s minimum nurse-to-patient staffing ratios have resulted in fewer patient deaths and higher levels of nurse job satisfaction.

Becker’s Hospital Review suggests to help skilled nurses remain engaged. Lest that sound like an inadequate adjustment, the article goes on to recommend outsourcing various tasks such as post-discharge follow-up to lighten nursing workloads.

The New England Journal of Medicine and concluded, “…providing sufficient resources to ensure that staffing is adequate and paying close attention to patient transfers and other factors that have a major effect on workload should become an active part of daily conversations among nurses, physicians, and hospital leaders in planning for the care of their patients.”

Until there is significant overhaul of the system that causes nurse overwork to be such a common problem, nurses are best advised to do what they can to , work to , and make sure they’re covered with a .

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