Monday, October 25, 2010

HSA 6342 - Human Resources Management Role in Reducing Malpractice Risks.


The increasing cost of healthcare has many scholars, attorneys and politicians blaming the medical malpractice system as a major contributor to the ever increasing costs healthcare. The Office of Technology Assessment wrote in a 1994 extensive report that the “medical malpractice system adds to the costs of health care directly through increases in malpractice insurance premiums, which may be passed on to consumers and third–party payers in the form of higher fees.” However, Human Resource Management (HRM) can be an instrumental asset for healthcare organization in reducing such risks.

Examples of these high premiums are seen now in states such as California, Pennsylvania, Nevada, and Florida among others. In California, by 2009 OB/GYNs were expected to pay more than $55,000 per year for insurance coverage; and insurance for general surgeons were expected to cost between $22,000 per year and $34,000 per year. In Pennsylvania, one of the average paying states, was expected to pay in 2009 the average malpractice insurance cost rates for general surgery to be as low as $28,000 annually and as high as $50,000; and Obstetricians/gynecologists were finding themselves paying up to $64,000 or more for coverage. In other states such as Nevada and Florida, where malpractice insurance rates  are between middle to high found themselves in 2009 paying one of the highest rates of insurance. In Nevada is for OB/GYNs, who may pay between $85,000 for malpractice liability insurance per year up to $142,000 per year for a premium plan by a prominent insurance company. Although the average annual salary for such doctors is around $180,000 in 2009, malpractice insurance is still considered a huge financial burden. Moreover, in Florida, which has some of the highest rates of liability insurance, a doctor in internal medicine was expected to pay in excess of $56,000 per year for insurance; a General surgeons, between $90,000 per year and $175,000 per year or more; and an OB/GYNs once again could expect the highest rates, with liability coverage ranging from $100,000 to $200,000 per year (Alexis Writing, 2010).

The cost of medical malpractice is undeniably a tremendous burden that threatens to cripple financially any healthcare organization. Nevertheless, strategies exist to lessen the risk of malpractice law suits and increase the organizations bottom line. Some of these strategies are:

a.      Preventing Diagnostic Error: “The top medical conditions involved in malpractice cases for primary care physicians are acute myocardial infarction; breast, lung, and colon cancers; appendicitis; and medication problems. Diagnostic error -- that could cut across many conditions -- account for more than one third of the claims” (Mark Crane, 2010). HRM can use different way to low risk in diagnostic errors. One example is proper selection, development and training of personnel/staff members. To provide the best an organization should strive in acquiring the best. Providing training and development resources to employees about new medical techniques and advances in diagnosing can be instrumental to physicians, nurses and ultimately Human Resources (HR) and the organization as a whole.  
b.      Preventing Medication Error: “Medication errors, particularly involving warfarin, result in thousands of hospital admissions each year. Close monitoring of anticoagulants is essential, and the treating physician must communicate to the patient potential interactions with foods and other medications. Following established monitoring policies and procedures is crucial” (Mark Crane, 2010). HR must emphasize continuously, through policies that establishes accountability if staff members improperly medicaid patients or fail to address the necessary care that goes along with medication given. Here again we see the importance of selecting and hiring adequate and knowledgeable employees.
c.      Implementing Proper and Accurate Documentation and Follow-up: “documentation is the major defense against law suits and complaints.” Doctors and nurses should be accountable for documenting every detail of a patient’s visit, by using a couple of minutes extra with each patient. HR should establish questionnaires and note-sheets that push doctors to ask detail information about a patients visit, and to write details on patient’s comments. Because many doctors don’t have enough time to fully document each patient encounter, many lose malpractice suits because they lack evidence (Mark Crane, 2010).
d.     Implementing Continuous Communication: HR has the duty to set standards on physicians-patient follow up and proper communication strategies. HR should constantly reinforce the importance of adequate feedback in reducing law suits."When patients sue, it's often due to a breakdown in trust with the physician. Patients and families get frustrated when the physician isn't forthcoming with an explanation of what happened. They are looking for answers and get angry when they perceive physician indifference. All of that can be averted with better communication" (Mark Crane, 2010).
e.      And more importantly, Implementing Customer- Oriented/ Satisfaction Measures: “Pay for performance and other measures that tie reimbursement to quality have turned an even brighter spotlight on the need to ensure patient satisfaction” (Mark Crane, 2010). Healthcare organization can dramatically reduce lawsuits and positively impact the bottom line if they implement customer service focus as part of their running strategy. The must implement “five-star customer service principles into care giving, encourage patients to take responsibility for their care, taka few extra seconds to create legible, concise documentation, and provide pay for such performance” (James W. Saxton, 2010). With customer satisfaction comes loyalty, referrals, and more tolerance.


“Nearly 40% of general and family practice physicians have been sued in their careers, as have 34% of general internists. Even worse, 1 in 7 primary care doctors have been sued at least twice” (Mark Crane, 2010). It is imperative for HR to take measures that are necessary to assist healthcare organization in reducing malpractice risks. Communication is key, then implementing the proper standards, accountability, open door policy to communicate and compensate those that work hard to achieve this goal is essential for a health organization to thrive in such a competitive market that is constantly evolving.


References:

Bruce J. and Myron, Fottler D. (2008). Human Resources In Healthcare, Managing for Success. 3rd ed.

Crane, Mark. (2010). “Six Top Malpractice Risks in Primary Care”. Medscape Today. Retrieved from URL: http://www.medscape.com/viewarticle/728306

Office of Technology Assessment. (1994). “Defensive Medicine and Medical Malpractice.” Retrieved from URL: http://biotech.law.lsu.edu/policy/9405.pdf

Saxton, Esq., James, W. (2007). “The Satisfied Patient: A Guide to Preventing Malpractice Claims by Providing Excellent Customer Service.”  2nd ed.