Steps for ensuring compliance with reporting
An incident such as the Plaxico Burress gunshot injury should prompt risk managers to review all relevant contracts, bylaws, and related policies related to the legal obligation to report gunshot wounds, says Martin Kalish, MD, JD, a partner with the law firm of Arnstein & Lehr in Miami.
Kalish says if the emergency department was outsourced, for instance, then the contract between the hospital and the provider of services would need to be reviewed and addressed, as well as any written employment agreement between the physician and the employer. If the physician were an independent contractor, any applicable agreement would need to be reviewed.
"In addition to reviewing any agreements, the medical staff bylaws should be reviewed to insure appropriate compliance when subjecting any applicable physician to corrective action including suspension," he says. "Failure to follow these procedures carefully can subject the hospital to legal difficulties [brought about] by the practitioner. Consequently, the hospital would want to insure that it was properly following all of its contractual obligations and its medical staff bylaws in suspending or terminating a physician."
Charles H. Cole, JD, chairman of the Public Policy Committee of DRI the Voice of the Defense Bar, based in Chicago, cautions that it is not enough to have proper policies in place. You must make sure physicians and staff understand them.
"Policies and procedures may not be worth the paper on which they are written. Implementation and compliance can be difficult," he says. "Mere publication in writing of policy changes that affect the public may not be adequate. Use of video or web-based education seems more suitable to a modern-day work force. When issues of harassment came to the forefront many years ago, many in the workplace implemented sensitivity training to address these new liability exposures. The Burress case may bring such a need to light in matters involving the need to report."
Kalish offers these steps for helping avoid the same sort of problem encountered with the Burress case:
1. The risk manager should ensure that policies and procedures exist for all legal reporting requirements and determine which require input from the medical staff.
2. The risk manager should confirm that the responsible departments are aware of the policies and procedures that are applicable to them, and arrange for the appropriate inservice to be performed. Similarly, with regard to those policies and procedures that affect physician involvement, administration and the medical staff office should be advised so that the medical staff can be properly advised and updated.
3. Since EDs have many more requirements, specific attention should be paid to educating the hospital personnel and medical staff members who work in that environment and may have reporting obligations.
4. The risk manager should consider working with administration to develop a policy for dealing with the celebrity patient to ensure that things operate smoothly in the event such an individual should seek care at the facility.
5. Use the Plaxico Burress incident as a teaching opportunity. The risk manager should use news articles involving those incidents as an opportunity to insure that people at their facility know how to handle a similar situation.
An incident such as the Plaxico Burress gunshot injury should prompt risk managers to review all relevant contracts, bylaws, and related policies related to the legal obligation to report gunshot wounds, says Martin Kalish, MD, JD, a partner with the law firm of Arnstein & Lehr in Miami.You have reached your article limit for the month. Subscribe now to access this article plus other member-only content.
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