Hospitalists face unique liability risk due to their multifaceted role. The most common area of risk is communication around patient handoffs, which is compounded by the fact that there is often confusion about the hospitalist’s role. Even the most experienced, highest quality physicians face risk of litigation. Fortunately, there are key areas hospitalists can focus to not only deliver better patient experience, but also avoid lawsuits.
1. Communication. Communication. Communication.
Communication is far and away the most critically important way to reduce risk and improve patient experience. Ensure you always take the time to communicate effectively, clearly, and thoroughly with the patient, the patient’s family, your physician colleagues, and nursing staff.
2. Spend more time with the patient on admission/early in the hospitalization.
We are all busy as providers, but the smallest extra steps can go a long way. I recommend spending extra time with hospitalized patients as they are admitted and early on in their stay to build trust with the patient and their family. Once a facility knows they are in good hands, they are much more relaxed and ongoing exchanges become more relaxed and take less time.
3. Treat all staff with professionalism and courtesy.
Being kind to your colleagues and everyone you interface with pays dividends in all aspects of your practice. When you take time to do small things like say hello, smile, and treat everyone you interact with respectfully, you garner respect yourself. Nurses, physicians, and patients themselves are less likely to report anything negative if you are consistently professional and cordial. Arrogance and/or disregard for the concerns of colleagues or families is one of the fastest ways to find yourself named in a malpractice lawsuit or a complaint to the state medical board.
4. If you are asked to see a patient due to a change in clinical status, do it.
If anyone asks you to see a patient due to a real or perceived change in their clinical status, it is important that you do so. If that patient has a bad outcome and it is documented that you were asked to visit the patient, that is very difficult to explain/defend. When in doubt, make time to see the patient.
5. Never hurry.
Even if you feel too busy for questions or if you feel rushed, never let a patient or their family see that. Be upfront with patients about your availability. For example, if you are on call and know you may be interrupted, take time to let the patient know that at the beginning of the visit so they are not surprised when you are called away. Taking time to sit down in a patient’s room is a good way to establish that your undivided attention is on the patient and that you are not in a rush to see your next patient.
6. Own your mistakes.
First, ensure you know your facility and your physician group’s policies on reporting mistakes or omissions. They are not all created equal and dealing with each situation is unique. If you make a mistake or document something incorrectly, take time to place an addendum in the patient’s medical record. It is critical that you NEVER lie and NEVER change anything in a medical record.
Incorporating these best practices into your practice will have benefits far beyond reducing risk. They will also improve patient experience, your efficiency, and the quality of care you provide. In the event that you do face a complaint or litigation, the worst thing you can do is ignore it. Educate yourself on the resources you have available to you if you do face a suit or complaint, such as colleagues and legal representation.