- Spring/Summer 2021 Healthcare Market Update
- Adverse Outcomes in Medicine: Acknowledgement and Sympathy in the Disclosure Process
- Infection Control Risk Assessment and Mold
- HR & Benefits Highlights
- Additional Resources
Spring/Summer 2021 Healthcare Market Update
As we reach the midpoint of 2021, the market remains very challenging but there are small signals of change and, perhaps, optimism toward some moderation. Across the healthcare industry, renewal premium increases for many organizations have been upwards of 20 percent or more, which was unsettling for many after an already difficult year. In this update we will analyze the market conditions within each major line of coverage and offer guidance to help you ensure a successful renewal outcome.
Adverse Outcomes in Medicine: Acknowledgement and Sympathy in the Disclosure Process
Author: Mary Stoll, BSN, RN
In a Risk Watch from 2020, we discussed the importance of good communication as a vital element in the patient-physician relationship, often helping to prevent or mitigate malpractice claims.
According to many studies, patients and family members expect open communication from their physician about their healthcare. This is especially true in the event of a negative outcome, also known as an adverse event, from medical treatment. Disclosure about what happened and plans to prevent similar adverse events from recurring are important.
This raises the questions: "How can I best disclose these unanticipated outcomes in conversations with my patients?" and "Should I say 'I'm sorry'?"
Before delving into any disclosure conversation, it is recommended to review your situation as it relates to your state's "apology law". It is important to keep in mind "apology laws" that exist in many states. Illinois has such apology laws in place. These laws prevent a plaintiff from using an apologetic or conciliatory statement made by a defendant as evidence of the defendant's liability. In Illinois, neither the provision of nor the offer to provide medical care, rehabilitation, facilities or equipment, may be construed as evidence of liability.1
Disclosure conversations are challenging due to their complexity, so it is also important to consider the following:
- First and foremost, seek assistance before you have any difficult conversations with your patients.
- We recommend contacting the risk management and/or claims division of your medical professional liability carrier. They can help guide you through the steps for handling the disclosure conversation with the patient. The resources and guidance will be beneficial.
- Check with the risk manager at the hospital/clinic about the proper procedure to follow in the disclosure process.
- When the time comes to have the conversation, remember to keep the focus on your patient and express sympathy to patient and family as appropriate. Discuss facts of what happened in a way that is understood by your patient.
Gallagher Healthcare will put you in contact with the risk management consultant of your individual medical malpractice insurance carrier in preparation for having these types of conversations with your patients. Please contact us with any questions.
The following are the most common medical errors (AHRQ, 2020):2
- Adverse drug events
- Catheter-associated urinary tract infections
- Central line-associated bloodstream infection
- Injury from falls and immobility
- Obstetrical adverse events
- Pressure ulcers (bed sores)
- Surgical site infections
- Venous thrombosis (blood clots)
- Ventilator-associated pneumonia
Infection Control Risk Assessment and Mold
Author: Gallagher National Risk Control
The healthcare industry has been challenged by widespread media attention to mold, aspergillus, legionella and other environmental threats that severely impacted immuno compromised patients and resulted in the closure of surgical suites and hospitals around the country.
In response, healthcare organizations have worked to diligently implement infection control practices and measures to better identify and mitigate potential exposures.
A common practice in new healthcare construction involved the establishment of an Infection Control Risk Assessment (ICRA). This process, typically falls under the oversight of an Infection Control Committee. The Committee oversees the program objectives to ensure the new, remodeled or problematic areas are effectively controlling potential contaminants and opportunistic infections, molds and bacteria.
The Committee is also tasked with preventing opportunistic pathogens which often occur naturally in the environment from spreading to internal patient care areas.
Establishing a Committee
The Committee membership is impacted by the nature of the project, new construction, remodeling or event response. A typical committee includes:
- Leadership representative (Chief Operating Officer, Administrator)
- Director, Design and Construction
- General Contractor
- Architect
- Director of Facilities
- Infection Control Physician
- Infection Control Practitioner
- Safety Officer
Initial Considerations
The Committee and initial ICRA, will consider the planned environmental and facilities impact of new work. The impact of disrupted soils, dust and material exposure from demolition and potential mold or pathogen exposure from released moisture sources. The initial planning for mold and spore management is crucial as evidenced by the severe impact Aspergillus spores are known to have on the immune-compromised patient.
Initial Planning
Initial planning objectives include:
- Communication: Developing and implementing a communication network in an exposure event.
- Initial Dirt/Dust/Soil Control Plan: Mitigating soil exposure from wind, foot traffic etc.
Establish Exposure Plans and Algorithms
The initial planning, should include the development of detailed action plans or algorithms that define the immediate response in the event of an exposure. The algorithms should include:
- Water damage (ceiling)
- Water damage (dry wall)
- Water damage (flooring/carpets)
- Mold discovery
Note: The emergency response algorithms should also include immediate contact information to industrial hygienist or environmental monitoring resource.
Construction Management
As most organizations are continually under construction or renovation, the ICRA should be a standard function in the construction planning process:
- ICRA should be included in monthly construction planning meetings.
- Minutes should be made available to Infection Control, Facilities and Safety.
- The Environment of Care (EOC) Committee should be provided a Construction/Infection Control educational session. All construction and renovation areas should then be included in all environmental rounds/hazard surveys.
- EOC and Facilities should actively monitor the organization's Interim Life Safety Program.
HR & Benefits Highlights
Virtual Onboarding: Keys for Successfully Integrating Leaders
Gallagher's HR and Compensation Consulting team provides guidance on how to assess your onboarding program for a virtual environment.
Does Your Leadership Manage a Crisis and Lead Through it?
Are you an exceptional leader? It is important to balance leadership traits around the executive table as an unbalanced team of operators can become mired with their heads down, solving today's problems without thoughtful regard to life after the crisis resolves.
GBS 2021 Workforce Trends Report Series – People & Organizational Wellbeing Strategy
This report will discuss the findings and insights from the 2021 Benefits Strategy Benchmarking Survey.
Additional Resources
Gallagher Safety Training Education Platform (STEP), our web-based learning management system, provides human resources and safety-related training topics in English and Spanish.
Gallaghers CORE360® is our unique, comprehensive approach of evaluating your risk management program that leverages our analytical tools and diverse resources for customized, maximum impact on six cost drivers of your total cost of risk.
Sources:
1 Illinois Medical Malpractice Law | ExpertLaw
2 Medical Error Reduction and Prevention - StatPearls - NCBI Bookshelf (nih.gov)
