Risk Management Tools & Resources

 


CASE STUDY: Failure to Provide Explicit Instructions Results in Poor Outcome for Pediatric Patient

CASE STUDY: Failure to Provide Explicit Instructions Results in Poor Outcome for Pediatric Patient

Laura M. Cascella, MA

Details

The patient in this case was a 2-year-old female. A physician assistant (PA) at a pediatric practice performed a finger stick test on the patient for anemia and lead poisoning. Following the test, the PA applied gauze and a bandage to the patient’s finger, and the family returned home. Three days later, the patient’s family brought the patient to an urgent care clinic because she was in pain. The child’s finger was still bandaged, and it had turned necrotic, requiring a partial amputation.

The patient’s parents filed a malpractice lawsuit against the PA and the pediatric practice alleging communication failures and improper performance of a treatment/procedure. The case ultimately was settled with a payment in the mid-range.

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Understanding Informed Consent for Pediatric Patients

Understanding Informed Consent for Pediatric Patients

Laura M. Cascella, MA

Informed consent is a pillar of patient engagement and patient-centered care. It helps patients gain a full understanding of the benefits and risks of proposed procedures and treatments, thus allowing them to make informed decisions. But what happens when patients are infants, children, or adolescents?

The right to consent to treatment or refuse treatment generally applies to competent adults. Thus, healthcare providers who treat pediatric patients — such as pediatricians, family medicine physicians, physician assistants, nurse practitioners, and pediatric dentists — should be well-versed in how to address informed consent with patients who are minors. Doing so requires understanding specific state laws related to informed consent and developing thorough organizational policies to guide the consent process.

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Risk Perspectives in Telehealth: Privacy & Security

Risk Perspectives in Telehealth: Privacy & Security

Laura M. Cascella, MA

The rapid expansion of technology in healthcare has significant implications for privacy and security of patients' protected health information (PHI). Confidential or sensitive data that are stored or sent electronically create a host of security issues that healthcare organizations must consider. For example, mobile devices can be easily lost or stolen, unintentional data breaches can occur, and cyberattacks can cripple information technology systems.

When healthcare delivered through telecommunications (telehealth) is thrown into the mix, the issues of privacy and security become even more complex. The transmission of data to and from various locations using a variety of technologies increases risk exposure and the possibility that data will be disclosed in inappropriate ways.

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Risk Perspectives in Telehealth: Online Prescribing

Risk Perspectives in Telehealth: Online Prescribing

Laura M. Cascella, MA

An important aspect in the provision of telehealth is abiding by appropriate standards of care and scopes of practice, which are defined by federal and state laws, professional boards, accrediting agencies, specialty associations, payers, and so forth. Prescribing medications to patients as part of telehealth services — online prescribing — falls into the parameters of "standards and scope," and healthcare providers must take precautions to ensure they are prescribing within legal and professional boundaries.

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Risk Perspectives in Telehealth: Credentialing & Privileging

Risk Perspectives in Telehealth: Credentialing & Privileging

Laura M. Cascella, MA

Credentialing and privileging — the processes by which a healthcare organization assesses and confirms the qualifications of a healthcare provider and authorizes the provision of specific services — play an important role in patient safety and high-quality care. These processes are essential for traditional, in-person care as well as for healthcare delivered through telecommunication technology (telehealth).

Although a telehealth provider at a remote location (distant site) will not have the same relationship with a healthcare facility (originating site) as its onsite providers do, the facility still must exercise the same level of due diligence in its screening and selection processes. Individuals accountable for credentialing and privileging must ensure that the distant site practitioner is legally allowed to provide care to the specified patient population, and that he/she is qualified for the scope of services requested.1

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Risk Perspectives in Telehealth: Licensing

Technology has created opportunities for physicians, surgeons, dentists, and other healthcare practitioners to extend the reach of their professional practice beyond the physical limitations of geography. Through the use of telehealth technologies, providers can evaluate, diagnose, and treat patients in other localities, which can increase access to, convenience of, and choices in care.

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CASE STUDY: Delayed Cancer Diagnosis Results in Malpractice Liability for Physician Assistant and Supervising Physician

The patient was a 53-year-old male who presented to an internal medicine practice because he had a lump in his right groin. The patient had been going to the practice for years and typically saw one physician assistant (PA) for most appointments. Over the years, he had seen the PA for various conditions, such as allergies, abdominal pain, cardiac issues, respiratory infections, and hypertension, among others.

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Data Insight: Triage Pitfalls in the Emergency Department

Communication issues, particularly among healthcare providers, are not unusual in malpractice cases; in fact, they are noted in approximately one-third of all cases. Various scenarios across care settings illustrate the importance of thorough communication among providers — yet few highlight it as well as cases occurring in the emergency department (ED), where decisions are made quickly and little time is available to correct miscommunication.

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