Risk Management Tools & Resources

 

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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CASE STUDY: Failure to Diagnose Heart Attack Leads to Tragic Outcome

A 47-year-old female presented to her local emergency department (ED) on a Saturday evening with complaints of shoulder and back pain, nausea, dizziness, and chest discomfort. Earlier in the day, the patient reported working in her garden and attending a family picnic. An ECG was ordered, and the results were negative. The patient was not referred for further cardiac testing because the emergency physician determined that muscle strain and acid reflux were the cause of the patient's symptoms.

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CASE STUDY: Physician's Tweets Prove Costly

A state medical board received a complaint that an internal medicine physician in a small town was tweeting about specific patients without their knowledge or consent over a 12-month period. The medical board initiated an investigation into whether the physician's actions constituted (a) a breach of doctor–patient confidentiality (b) a violation of laws connected with practice, and/or (c) unprofessional conduct.

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CASE STUDY: Online Dispute Becomes Problematic for General Dentist

Dr. Miller, a general dentist, treated a male patient in his fifties for various dental issues. Although the treatments were successful, the patient was unhappy with Dr. Miller's office staff and the amount for which he was billed. The patient joined an online forum and began posting negative comments about Dr. Miller's billing policies, office staff, and efficacy of care.

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Social Media Might Be Informal, but Your Healthcare Practice's Policies Shouldn't Be

Without doubt, the ease, flexibility, and convenience of social media offer various opportunities to enhance the dissemination of health information and communication between patients and healthcare providers.

However, like any type of technology, social media can create safety and risk issues if it is not used responsibly. Additionally, because social media changes rapidly, standards and best practices are not always well-defined.

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