Risk Management Tools & Resources

 

How to Present a Patient With a Behavior Contract

How to Present a Patient With a Behavior Contract

A behavior contract is an agreement between a patient and healthcare practitioner or organization that defines expectations related to behavior, conduct, communication, and/or treatment. Practitioners or organizations might choose to use behavior contracts to address noncompliant or disruptive patient behaviors, as well as other issues (e.g., financial obligations or pain management expectations).

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Screening New Patients for Potentially Problematic Behavior

A number of risk management strategies can help healthcare practitioners manage difficult or noncompliant patients who are under their care. But what about new patients? Initial consultations with new patients present practitioners with a unique opportunity to identify potential signs of noncompliant or difficult behavior.

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CASE STUDY: Failure to Properly Manage Patient Noncompliance and Difficult Behavior Proves Costly

The patient was a 76-year-old male with uncontrolled hypertension and a complex medical and surgical history, including cardiovascular disease with myocardial infarction, hypertension, elevated cholesterol levels, diabetes, gastroesophageal reflux disease, stent procedures, and colon resection.

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Why Must You Be So Difficult?

Difficult patients represent one of the most challenging situations that doctors and other healthcare professionals encounter. Dealing with these patients can be emotionally and mentally draining — as well as increasingly frustrating — for practitioners and their staff members.

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Patients Who Don't Follow Their Treatment Plans: What's a Clinician to Do?

To a certain degree, healthcare providers have the right to choose which patients they want to treat, and a provider may choose to terminate a relationship with a patient who does not comply with treatment regimens or follow-up care recommendations.

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CASE STUDY: Improper Medication Management Leads to Patient Harm and Death

A patient in her late sixties presented to an emergency department (ED) with complaints of right flank pain and shortness of breath. She reported an allergy to Versed®. The initial working diagnosis was kidney stones. Lab work, an abdominal ultrasound, and an abdominal computed tomography (CT) scan were ordered, and the patient was given Demerol®/Phenergan® (50 mg/12.5 mg IV).

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CASE STUDY: Inadequate Patient Assessment and Improper Management of Treatment Lead to Patient Death

A patient in his mid-twenties with a history of asthma presented to an emergency department (ED) after a drug overdose. He was intubated after multiple difficult attempts. After a 48-hour stay in the intensive care unit (ICU) and consults with pulmonology and ENT, the patient was extubated and discharged.

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CASE STUDY: Narrow Diagnostic Focus and Inadequate Communication Lead to Delayed Diagnosis of Stroke

The patient, a women in her mid-forties, developed dizziness and vomiting during exercise. Upon presentation to an emergency department (ED), staff noted that the patient was unable to verbally communicate, but she could follow instructions. An examination revealed bilateral nystagmus, and a urine toxicology screen was positive for opiates.

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