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Eric Hess, vice president of Children's Hospital of Pittsburgh of the University of Pittsburgh Medical Center (UPMC), provides these examples of how risk management concerns were incorporated into the hospital's recently completed $625 million redesign:
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A man presented at an emergency department (ED) complaining of shortness of breath and chest pain. He was seen by an ED physician who ordered blood studies and an EKG.
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When patients leave the ED early, what your staff do afterward can make the difference between insulating yourself against a lawsuit and encouraging one, says Robert A. Bitterman, MD, JD, FACEP, a lawyer and emergency physician who is president of Bitterman Health Law Consulting Group in Harbor Springs, MI, and also vice president of Emergency Physicians Insurance Company (EPIC) in Auburn, CA.
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Most hospitals already have against-medical-advice (AMA) forms they use when the patient gives the staff a chance, but Helenemarie Blake, JD, a shareholder with the law firm of Fowler White Burnett in Miami, says risk managers should remember that merely having an AMA form and procedure does not guarantee they will be used correctly.
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The recent settlement by the University of Medicine and Dentistry of New Jersey (UMDNJ) in Newark has some legal experts concluding that the hospital ended up with a relatively light punishment considering the extent of the alleged billing fraud and the long, contentious litigation that was prompted by a whistle-blower lawsuit.
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A pregnant woman contacted her doctor with complaints of decreased fetal movement. He advised her to go to the triage outpatient obstetrical department, where she was placed on a fetal heart monitor and underwent a biophysical profile. The monitor showed a nonreactive fetal heart rate pattern, and the profile confirmed that the fetus was in distress.
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As U.S. deaths from the H1N1 virus have mounted in recent months, media reports began to include the inevitable comments from hospital spokespeople that the patients who died had "pre-existing conditions," with no specifics given.
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The role of intensive antiplatelet therapy for prevention of vascular events in patients with atrial fibrillation remains controversial. The Atrial Fibrillation Clopidogrel Trial with Irbesartan for Prevention of Vascular Events (ACTIVE) trio of studies is an attempt to clarify this issue.
