Risk Management Tools & Resources


Inadequate Informed Consent Process for Orthopaedic Surgery Complicates Malpractice Defense



Residents performing surgeries and procedures under the supervision of experienced physicians is an integral component of the medical educational process. At the same time, disclosing to patients which providers will be involved in their care is an essential component of the informed consent process, which recognizes patients’ rights to make informed decisions about their care.

In this case, the patient was a 66-year-old male with a long history of arthritic and orthopaedic problems in his right knee. His medical history included one arthroscopy and one high tibial osteotomy. Continued evaluation of the knee resulted in the recommendation that he have a total knee replacement, to which he consented. The patient was aware that a resident would be assisting in his surgery. In actuality, though, an orthopaedic resident (Dr. A) performed the procedure with an attending surgeon (Dr. B) assisting.

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The Five Essential Elements of a Violence Prevention Program


Violence is a significant concern and an unfortunate reality in healthcare. Incidents of serious workplace violence (those requiring days off for the injured worker to recuperate) are about four times more common in healthcare than in private industry.1 Violence can occur in any geographic location and any type of facility, and it can come from a variety of sources, including patients, visitors, healthcare providers, and staff members.

Because violence represents such a serious concern for healthcare organizations, developing and implementing strategies to address hostile and aggressive incidents is imperative. To support these efforts, the Occupational Safety & Health Administration (OSHA) developed Guidelines for Preventing Workplace Violence for Health Care and Social Service Workers. The guidelines offer five major elements of an effective workplace violence prevention program, which are as follows:

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Accountability for Informed Consent in Healthcare: Considering Shinal v. Toms

Laura M. Cascella, MA, CPHRM


Issues related to informed consent are a persistent area of concern in healthcare and a source of liability exposure. MedPro Group malpractice claims data show that more than one-fourth (27 percent) of all communication-related malpractice claims involve allegations associated with informed consent.1 Of these allegations, the majority are related to inadequate consent processes and failure to manage patient expectations.

Because of these risks and the important role that informed consent plays in patient-centered care and shared decision-making, healthcare providers and organizations should assess their consent policies and protocols to identify improvement opportunities and monitor for adherence. An initial task during the assessment should focus on reviewing policies related to accountability for the consent process, including responsibility for having the consent discussion with the patient, responding to follow-up questions, and completing appropriate documentation.

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The Fundamental Elements of Informed Consent


Informed consent is a legal and ethical principle that supports disclosing important information to patients so they can understand proposed treatments and fully participate in their care. The basis of informed consent rests on the principle of autonomy, which recognizes an individual’s right to make decisions regarding his/her healthcare.

The thoroughness and complexity of the informed consent process will depend on the type of procedure or treatment involved. Minor procedures — such as the removal of a minor skin lesion or the filling of caries — may require only a simple discussion of risks. However, as procedures become more complex or have a greater degree of risk, the consent process should be more comprehensive.

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Opioid Prescribing: Navigating Through a Crisis

Marcy A. Metzgar and Laura M. Cascella, MA, CPHRM

Opioid Prescribing: Navigating Through a Crisis

Opioid addiction is arguably one of the most significant public health crises in the United States over the past few decades. Increases in opioid prescribing and consumption in the late 1990s and first decade of the 2000s fueled an epidemic of overdoses, a national heroin crisis, and a rise in deaths from synthetic opioids.1

Opioid prescribing has been declining since 2012; yet, these powerful analgesics still present serious concerns. Estimates suggest that more than 130 people die every day from opioid-related drug overdoses, and the amount of opioids prescribed per person is still around three times higher than it was in 1999. Additionally, opioids contribute to more than two-thirds of all drug overdose deaths.2

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15 Essential Risk Management Strategies for General Surgeons

General surgeons face various risks in day-to-day practice. Adverse outcomes related to surgical treatment, diagnosis, and medical treatment can result from a variety of factors, including issues with technical competency, clinical judgment, communication, documentation, and more. The following list offers 15 essential strategies to help general surgeons mitigate risks and enhance patient safety.

  1. Participate in ongoing performance improvement opportunities to enhance technical surgical skills and ensure competency (e.g., mentoring, continuing education, and ongoing practice performance evaluation).
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Lurking Beneath the Surface: Bias in Pain Management

Bias in healthcare is a persistent issue, both at an institutional level and among individuals. The downstream effect of this problem is evident in negative outcomes and health disparities for various populations. In particular, issues of bias have been noted in research focusing on variances in pain management. Studies have shown that:

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Feeling the Burn? 10 Ways Healthcare Providers Can Proactively Address Burnout

Burnout in healthcare is rampant, and it is not limited to one clinical setting or a particular type of provider. Rather, feelings of exhaustion, cynicism, pessimism, detachment, and ineffectiveness can take a grip on healthcare providers of various ages, backgrounds, and specialties and have far-reaching consequences.

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