A plan to convert Jewish Hospital's outpatient medical center in Bullitt County, KY, into an inpatient hospital with as many as 60 beds has been approved by the state Certificate of Need office. The $55.8 million project was made possible when Gov. Steve Beshear signed an emergency regulation to allow it. Prior to that, state regulations ruled out hospital beds in Bullitt because of the number of unused beds in adjacent Jefferson County.
Five months after the project was rejected by the courts, Miami-based Mercy Hospital has officially given up plans to turn a portion of its campus into a three-tower condo project serving the uber-rich. Though approved by Miami City Hall, the condos had been struck down by two court decisions earlier this year. The condos were touted by Mercy as a way to raise millions toward Mercy's capital-improvements plans, and both court decisions were being appealed. "We felt that the most appropriate step for Mercy Hospital was to reengage the land as part of the hospital's long-term strategic plan," said a statement released by Mercy President and CEO John Johnson.
More than 50% of chief information officers who participated in a recent poll are "extremely concerned" about security breaches of personal health information affecting their facility. And they should be, especially as more practices are moving toward utilizing electronic mediums to communicate with their patients, colleagues, and healthcare leaders.
Various ways to keep patient and other personal health information secure from those inside or outside the practice are being more widely used. Security breaches can be averted by enacting and following these simple steps.
Limit the number of staff members authorized to view personal health information
Require unauthorized personnel to apply for disclosure if they need access
Require patients to complete a release form to access their records
Require release forms between providers except in the case of a referral
Notify any patient older than 12 years of any request to access his or her information
Deny any provider request if the patient objects to disclosure
Encrypt data
A policy should be in place that outlines what information should be encrypted and how to do it.
This article was adapted from one that originally appeared in the October 2008 issue ofThe Doctor's Office, a HealthLeaders Media publication.
If a police officer pulls you over—and you both know full well you were speeding—he or she typically asks, "Do you know why I stopped you?" The officer is trying to elicit an admission of guilt from you, such as, "But officer, I was only going eight miles over the limit." That is self-incrimination, and as Miranda makes clear, you have the right to remain silent because what you say can and will be used against you.
Although medical malpractice lawsuits are civil and not criminal proceedings, sometimes admitting what you did wrong may prevent a medical malpractice claim.
But other times, such an admission could result in a slam-dunk malpractice case against you. So it's best to know what to say and how to say it.
The medical apology
Although some providers disagree with offering a medical apology after an adverse incident, hospitals, medical centers, risk managers, and malpractice insurers increasingly recommend it.
A study published in the Journal of the American Medical Association concluded that subsequent to committing medical mistakes that harmed patients, providers were not providing the information and emotional support those patients needed, and that failure resulted in an increased likelihood of a malpractice claim.
After any questionable event, try to be open, honest, communicative, and understanding while making yourself fully available to the patient and/or his or her family.
The medical apology has four components:
The acknowledgment includes details of the event, the persons involved, and the unacceptable nature of the behavior.
The explanation is the exact reasons for the event. (Stating there is no explanation yet is acceptable.)
Remorse is the genuine expression of contrition; if the expression is false or simply a pretense, the listener will sense it, and the apology will do more harm than good.
Reparation is an attempt to make things right, even in a small way.
In some states, such an apology is perfectly acceptable; in others, it's an admission against interest and evidence of malpractice. Your malpractice insurer or risk management department can provide guidance on your state's laws.
Real-world case study
An elderly patient presented to the hospital for major abdominal surgery performed by an attending surgeon. The procedure was successful. After seeing the patient on the first post-op day and noting recovery was progressing normally, the attending surgeon proceeded with a planned vacation.
On the second and third post-op days, the nurses observed a gradual deterioration of the patient's condition, which they recorded in their notes and verbally alerted the covering attending surgeon. On the fourth post-op day, the patient continued to deteriorate, and the covering attending surgeon finally called the vacationing attending surgeon, who made some general inquiries but did not further contribute to the patient's care. On the sixth day, the patient crashed and died the next day.
The attending surgeon returned home, met with the family, apologized, and said, "This never should have happened. It's my fault for not returning early to take care of her and for not ensuring she was in good hands when I left. This was a mistake that could have and should have been avoided."
The attending surgeon later told me he said these things to appease and comfort the family, although he did not believe he or any other healthcare provider committed malpractice. But in the resulting lawsuit, the attending surgeon, covering attending surgeon, nurses, and hospital were all forced to settle.
The attending surgeon's statements implicated the entire medical team caring for the patient; each healthcare provider involved in the patient's care was held legally responsible in some way. (This incident took place in Florida, where a physician's apologetic statements are considered an admission against interest and can be used as evidence of malpractice.)
Alan G. Williams, JD, is the author of Physician, Protect Thyself: 7 Simple Ways NOT to Get Sued for Medical Malpractice and an attorney with Physicians MedicaLegal Prevention in Orange Park, FL. This article originally ran in the September issue of Private Practice Success, a HealthLeader's Media publication.
Medical officials, researchers, and policymakers all debated how best to boost the number of physicians in Idaho during the last legislative session. As part of lawmakers' efforts to boost the state's doctor to patient ratio, they're digging into research that could help remedy the state's physician shortage. That research points toward a number of educational options that could help attract doctors to the state and push some to consider the feasibility of an Idaho medical school.
A New York Times reporter says she found out how unreliable MRIs can be after a scan missed a serious stress fracture in her foot. MRIs use powerful magnets and radio waves to manipulate protons in the body's hydrogen atoms. The idea is that protons in different types of tissue respond in distinctive ways to this pushing and prodding, and the differing responses reveal the characteristics of the tissue. Magnetic resonance machines, though, vary enormously. Even more important, radiologists say, is the quality of the imaging coils they put around the body part being scanned and the computer programs they use to control the imaging and to analyze the images. And there is a huge variability in skill among the technicians doing the scans, the reporter writes.