Special Report: Lessons from Hurricane Katrina
Be voice of reason when sending help
(Editor's note: This month, Healthcare Risk Management continues its coverage of the risk management lessons from Hurricane Katrina with advice on how to send health care professionals to help without incurring unreasonable risks and how you can comply with federal privacy rules during a disaster. See the November HRM for coverage of the importance of planning before a disaster, the likely liability risks and lawsuits that will follow the hurricane experience, and what standards the courts may use as the "best-practice" model for disaster preparedness.)
Many hospitals outside the area directly affected by Hurricane Katrina had difficulty sending in teams of clinicians because of concerns about liability, says Lori-Ann Rickard, JD, a partner with of Rickard & Associates, a law practice in St. Clair Shores, MI, that specializes in health care. Their experience holds lessons for all risk managers, she says.
Good Samaritan laws can protect workers if they volunteer, but not if they will be paid by their regular employers, she says. State laws vary greatly and can be highly complex regarding who is covered by immunity clauses, Rickard adds.
"If I were a risk manager at a facility wanting to send physicians, I would want to be apprised of what federal and state laws apply," she says. "If there is a state of emergency in your own state, not just the state where you're sending doctors, that can help protect you a great deal. So does a federal state of emergency. And you need to know what your people are going to be asked to do."
There are plenty of other issues to consider before sending medical crews, she notes. Will your staff have death benefits if they die on the assignment? What are the health risks, and what is your liability for that? Risk managers must be the voice of reason sometimes when people are eager to respond quickly and join a humanitarian relief effort.
"It gets much more difficult than just saying you want to do the right thing and send your staff to help. You have a duty to watch out for them and consider what can happen to the organization," Rickard says. "Some of those people that go are going to die, especially if you're talking about a pandemic, and there will be a need for help 30 days out, 90 days, and 120 days out. You have to remind people that they still have a responsibility to help in their own communities."
She says those issues must be considered as more hospitals are being asked to sign agreements to respond when other communities need medical assistance, often as a requirement for receiving federal emergency equipment and funds. Risk managers should look beyond the paperwork and consider what the agreement actually means.
"You need to keep saying to people, 'Good idea, but what are the risks?'" she says. "You don't want to just do things with good intentions and then you don't exist as an organization because some plaintiff's attorney decided this would be a good thing to sue everyone across the country for."
All of those issues were serious concerns when hundreds of volunteers from Stanford (CA) Medical Center left for the Gulf Coast, says Pamela L. Popp, JD, MA, DFASHRM, CPHRM, senior director of claims and litigation at Stanford and immediate past president of the American Society for Health-care Risk Management in Chicago. Popp says that such situations can be career opportunities for risk managers because they are in a position to provide leadership.
"People will turn to you in these times and ask, 'What do we do now?'" she says. "And there is good reason for them to look to you for guidance, because there are some very serious risk management issues involved. In a way, this can be very positive, an opportunity for risk managers to showcase their knowledge and experience by becoming an internal resource for their organizations."
Of course, you can do that only if you're ready when the time comes. There may be little notice when a disaster strikes and people in your organization start mobilizing to respond. Plan now for the next disaster, and study the relevant issues calmly and thoroughly, she says.
The alternative, Popp says, is that you may find people coming to you with questions you can't answer during an emergency. If that happens, not only are unable to fulfill your obligation to the organization but you also have squandered an opportunity to shine as a risk manager.
"The limelight can be great, but there are pros and cons to it," she says. "If you have taken advantage of opportunities to learn about these issues ahead of time, you can break out as a real leader when people need that the most."
Sources
For more information, contact:
- Pamela L. Popp, Senior Director, Claims and Litigation, Stanford Medical Center, 300 Pasteur Drive, Stanford, CA 94305. E-mail: [email protected].
- Lori-Ann Rickard, Partner, Rickard & Associates, Grosse Pointe Plaza, 22725 Greater Mack Ave., Building B, St. Clair Shores, MI 48080. Telephone: (586) 498-0600.
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