Legalities in Healthcare Reviewed 10/2016

MANAGING EXPECTATIONS Expectations are individually–based concerns. They evolve from past experiences and are unique to the person. Low expectations may not allow the patient to get the full benefit of their hospital experience. High Expectations may set everyone up for failure as they may be unrealistic. One must balance reality with giving the patient hope & assurance when managing expectations. Managing the patients’ & their family expectations regarding their care & 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. We must all be aware of the impact negligence cases have had in the way we provide care & how we document the care we provide. When we don’t function in the same manner that an average, reasonable, & prudent professional would, negligence can occur. Negligence can result from omission or commission of an act based on standards of care regarding policies & 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, & 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 educated on equipment before you use it. Patient Falls: Often the issue is not that the patient fell but whether or not the care provider evaluated the patient’s needs & implemented safety precautions. 4. Patient Teaching Issues: Make sure teaching is complete & in the language the patient & their family & significant others understand. Start early. Check for understanding & comprehension. 5. Remember the patient defines what quality care is for them. Use your communication skills to find this out. Set it as part of your patient care goals. 3

Prevention of Legal Trouble Checking the patient’s & family’s level of understanding lessens the likelihood of mistakes & unrealistic expectations from the patient. Resolution is a vital component in providing closure to an incident for you & the patient. Deal with the facts & feelings of everyone involved. Also, ask yourself what valuable lesson can be learned? How can you either improve your care or the systems & processes that impact patients and patient care? Extend compassion to the patient & their family/significant others. Understand that they are scared, angry, frustrated, & just don’t feel well. Reach beyond yourself & understand that we have also encountered these emotions as well. How would we want to be treated? 4

Prevention of Legal Trouble Know your policies & procedures regarding equipment safety. Know 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 & the limitations of those around you. Anger is a breeder of law suit behavior. When a patient feels he has been “wronged,” “ignored,” “done things to,” & attacked with hostility, there is a greater likelihood that the patient may take legal action which may or may not be legitimate. Unmanaged expectations affect everyone negatively. 5

Prevention of Legal Trouble Greet patients & their families. Be warm & friendly. Anticipate their needs & don’t make them wait. Be attentive & upbeat. Make sure to introduce yourself by giving your name & 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; check for level of understanding. Adhere to the time frames you set. Answer questions that are within your domain to answer. Refer other questions to the proper person. You can facilitate future conversations through referral & 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 & the person in charge of your area for assistance. Use terms that are easy to understand. Clarify & check for understanding. Be honest, direct & respectful in all interactions with patients & their families. By following these guidelines, you will meet or exceed your patients’ expectations. You will also decrease the risk of legal action throughout your career. 7