Legalities in Healthcare 1 Reviewed December 2012

MANAGING EXPECTATIONS Expectations are individually – based concerns. They evolve from past experiences and are unique to the person. Expectations that are set too low may not allow the patient to get the full benefit of their hospital experience. Expectations that are set too high may set everyone up for failure as they may be unrealistic. One must balance reality with giving the patient hope and assurance when managing expectations. Managing the expectations of the patients and their families and friends regarding their care and their outcomes is often the first step in avoiding a legal battle. 1

Legalities in Providing Care We live in a very litigious society today. In our own society, we must all be aware of the impact negligence cases have had in the way we provide care and how we document the care we provide. When we don’t function in the same manner that an average, reasonable, and prudent professional would, negligence can occur. Negligence can result from omission or commission of an act based on standards of care like policies and procedures. A breech can result in harm to the patient. Some common causes of negligence and the resulting law suits are: 1.Human Error: Medication errors, assessment errors, and documentation errors fall into this category. 2

Legalities in Providing Care 2.Equipment Failure or Misuse: Always check equipment before you attach it to a patient. Always make sure you are thoroughly inserviced on equipment before you use it. 3. Patient Falls: The issue is often not that the patient fell but whether or not the care provider evaluated the patient’s needs and implemented safety precautions. 4. Patients Teaching Issues: Make sure teaching is complete and done in a language the patient and their family / significant others understands. Start early. Check for understanding and comprehension. 5.Remember the patient defines what quality care is for them. Use your communication skills to find out what quality means to them, then set that as part of your patient care goals. 3

Prevention of Legal Trouble Checking for patient and family understanding lessens the likelihood of mistakes and unrealistic expectations from the patient. Resolution is a vital component in providing closure to an incident both for you and the patient. Deal with both the facts and feelings of everyone involved. Also, learn from it. Ask yourself what valuable lesson can be learned and how you can either improve your care or the systems and processes that impact patients and patient care. Extend compassion to the patient and their family / significant others. Understand that they are scared, angry, frustrated, and just don’t feel well. Reach beyond yourself and understand that we, too, have, at one time or another, been scared, angry, frustrated, and just not felt well. How would we want to be treated? 4

Prevention of Legal Trouble Know your policies and procedures regarding equipment safety and how to appropriately remove equipment from service. When in doubt- ask! The only “dumb” question is the unasked question. The dangerous practitioner is the one who thinks they know it all. Healthcare is changing everyday. Ask questions. Ask for clarification. Ask for help. Know your limitations and the limitations of those around you. Anger is a breeder of law suit behavior. When a patient feels he has been done “wrong,” “ignored,” “done things to,” and attacked with hostility, there is a likelihood that the patient may follow a legal avenue which may or may not be legitimate. When expectations are not managed, it effects everyone negatively. 5

Prevention of Legal Trouble Make sure to greet patients and their families. Be warm and friendly. Anticipate their needs and don’t make them wait. Be attentive and upbeat. Make sure to introduce yourself by giving your name and title. Use good communication skills. Always thank the patient. Be sincere. Follow-up as needed. Keep your promises. Keep the patients informed regarding the length of time a request or procedure will take. Be realistic and check for understanding. Adhere to the time frames you set. Answer questions that are within your domain to answer and refer other questions to the proper person. You can facilitate future conversations through referral and follow-up. 6

Prevention of Legal Trouble The Joint Commission standards now mandate that patients be told of mistakes that are made. If you make an error, please notify your instructor and person in charge in your area for assistance. Use terms that are easy to understands. Clarify and check for understanding. Be honest, direct, and respectful in all interactions with patients and their families. 7