Effects of Litigation and Adverse Events on the Psychological and Physical Health of Providers
Adverse events and litigation have a profound effect upon patients and families.  That is clear.  However, there is always a second, often silent, sufferer in every event and suit – the provider.  The effects of participation in an adverse event, or being sued are profound and long lasting.  There are permanent psychological reactions that increase the likelihood of future suits.  There are changes in attitude and career satisfaction.  There are physical effects that can be devastating on both the provider and their family.  This program examines the range of effects and how to recognize when a provider is experiencing any of those effects.  Finally, pragmatic methods for handling the stress of adverse events or litigation are discussed.  This program is applicable in any care setting and is geared for physicians and the people who work or live them.

Blame and Accountability

 

Communication in the Office Setting for Risk Reduction
While we know that communication break-down is the root cause for most sentinel events and stimulates lawsuits, most people think about communication problems in the inpatient setting.  However, “hand-off” of information occurs just as frequently, if not more, in the office setting.  What makes communication even more difficult is the use of outside providers, laboratory services, and radiological services, as well as the intermittent and diverse nature of outpatient care visits.  It is a system fraught with opportunities for communication breakdown!  With the growing number of claims for missed diagnosis and misdiagnosis, the concerns about patient adherence to a care plan, and the increased cultural heterogeneity of our society, an understanding of the process for ensuring effective communication is essential.  This program will provide office providers and staff with the tools for creating effective systems and improving interpersonal communication in the office setting.  This program is appropriate for any out-patient setting and can be customized for any provider and/or staff mix audience.

Conflict Resolution – A Requisite Communication Skill in Healthcare
Conflict is inherent in any situation where two or more parties have competing interests.  In healthcare that is demonstrated daily….how do we see as many patients as we are told and yet provide each patient with the time and individual attention they deserve?  How do we work with colleagues, providers, and staff who are stressed and behave in ways that we see as unreasonable or worse yet, dangerous?  How do we deal with patients who have expectations of care that we cannot meet?

In each of these situations, we have two perspectives on the situation, two sets of needs with competing interests, and a basic belief that in order for one person to get their needs met; one party will have to give up their needs. Using basic conflict resolution skills, each of these situations and more can be addressed in a way that allows both parties to retain their respect and come more closely together to address their common goals, as well as their differing goals. This program is applicable in any care setting and can be customized for any provider and/or staff mix audience.

Conflict Resolution - The Next Step in Disclosure
We’ve had the initial disclosure discussion with the patient/family.  We’ve revealed the unanticipated outcome.  Now we’ve done our evaluation and understand what has happened.  Maybe an error has occurred.  Maybe no error has occurred.  However, it’s time for the discussion in which we tell the patient/family.  How can we expect them to not be angry?  Conflict occurs anytime there are competing interests, differing perspectives, a feeling of distrust, and/or a feeling that the situation is unfair.  The place where conflict would be most obvious and threatening is when we realize that a medical error has led to patient injury, or when the family believes there has been an error that we are not sharing.  Beyond saying “I’m sorry”, how do we manage the conversation that is based on fear, anxiety, anger, and potential litigation? This presentation looks at the various sources and aspects of conflict in the disclosure process.  A primary focus of this talk is to introduce methods to resolve conflict with patients and families.  An approach to conflict resolution that allows both parties to retain their self-respect, yet address the underlying needs of each is introduced and examined. This program is applicable in any setting and can be customized for any provider and/or staff mix audience.

 

Service Excellence in Healthcare
Customer loyalty and retention are essential to success in today's health care market. In a competitive marketplace, you stand out through excellence in customer service.  Dissatisfaction is one of the many reasons patients become litigious, so it is important to have a risk reduction strategy to assess patient satisfaction and respond to complaints. Patients who believe their questions or concerns are being addressed generally do not feel compelled to consult a malpractice attorney. This presentation is designed to provide participants with an understanding of customer service principles as well as tools and techniques to apply on a daily basis. This program is applicable to all settings and is geared towards staff.  It can be customized specifically to meet the needs of physicians and other direct care providers.

Creating the Healing Relationship through Effective Communication
The relationship between the patient and the healthcare giver is more than simply an exchange of treatments for symptomatic data.  When effective, it is a connection that embraces the physical and the human aspects of health and healing.  In a world of quotas and financial pressures, how do we create the healing relationship?  The key is effective communication which starts at the inception of the relationship, and continues throughout.  How do we establish communication in the initial meeting?  How do we ensure communication throughout the relationship?  And how do we build upon that relationship to create an effective partnership that retains trust even in the event of poor outcomes or even medical error?  This program exams the components of effective communication and applies these concepts to every step of the patient-provider interaction. This program is applicable in any care setting and can be customized for any provider and/or staff mix audience.

Dealing with the Dangerous or Disruptive Patient
Why is it that people who appear functional in most parts of their lives become demanding, disruptive, or even dangerous in the healthcare setting?  In many instances, the sense of helplessness and fear that accompanies encounters with healthcare professionals and the healthcare situation can trigger behaviors that otherwise appear under control.  So how do we identify potentially dangerous patients/families and deal with them before the situation gets out of control? In this program, we will discuss the signs of potentially disruptive patients and provide techniques for managing them. This program is appropriate for any setting and can be customized for any provider and/or staff mix audience.

Dealing with the Disruptive Physician
Where did this physician come from?  How did they make it through medical school?  What makes them believe they can behave this way? The disruptive physician is not a “creature”, but a person who is expressing deep emotions in a way that is destructive in our healthcare environment.  This program will provide guidelines for understanding the basis of disruptive behavior, and strategies for hard-wiring processes into the system that address disruptive behavior. This program is appropriate for any setting and can be customized for any provider and/or staff mix audience.

Engaging the Patient and Family to Improve Patient Safety
The terms patient-centered care and patient-focused care are frequently used in our current healthcare environment.  What do they mean?  Are they the same as involving patients to improve safety?  Is it surprising that a patient centered environment may not be the most inclusive of patients when it comes to improving the quality of care.  How do we educate, facilitate and include patients/families in the patient safety effort?  This program will provide pragmatic approaches for identifying which patients are best equipped to help improve patient safety organizationally as well as tools for engaging all patients in ensuring their care is safe. This program is most applicable to in-patient settings, but can be customized to outpatient settings and to any physician and/or staff mix audience.

The Basics of Risk Management for Non-Risk Managers: How to Teach Your Staff to Think Like a Risk Manager
Why do physicians and staff often believe that Risk Managers are “picky” when they point out risk management concerns?  Risk Managers often wonder: how physicians and staff can see clinical exposures and not say anything, go into dangerous situations and not think about it, or document so poorly?

The easy and wrong answer is that people might not care….the real answer is that most people haven’t learned the WIIFM (What’s In It for Me?) of thinking like a risk manager.  In this presentation, we will define risk management and teach about the risk management process.  Everyday examples will be used to demonstrate how the process can be applied. This program is appropriate for all care settings and can be customized to any provider/staff mix audience.

Transparency in Health Care
"Transparency" is a word often heard in health care forums today.  It is used in conjunction with patient communication, billing information, and even with information previously considered proprietary to the organization.  This presentation will define transparency and discuss its potential application to 21st century health care.  It will also examine the legal ramifications of transparency and develop strategies for preparing for a transparent health care society.  This program is applicable to any care setting and is customizable to any provider/staff mix audience.

Medical Literacy: What it is and How to Address It
Almost 50% of adult Americans function at health literacy levels that jeopardize care to themselves and their families.  This finding of a 2004 IOM report supports studies showing that diminished medical literacy affects patients’ ability to make informed decisions about their care and may reveal itself through non-cooperation with treatment, poor disease self-management, refusal of urgent, appropriate treatment, and post-treatment disputes about agreed upon care.  Health literacy is an issue for functionally illiterate Americans, those with special communication needs, and those we may not suspect.  Many affected people may be educated and employed, thereby passing under our literacy radar.  Medical literacy is a patient safety, quality of care, and risk management concern.  This presentation will provide approaches to improve communication with patients through strategies designed to address literacy issues. This program is applicable in all care settings and can be customized to any provider/staff mix audience.

Medication Safety with the Elderly
The elderly take more medications on average than younger adults; are more likely to have medical literacy issues; and more likely to have social isolation in conjunction with multiple significant health concerns.  This is a recipe for medication problems. Focusing on the communication aspects of medication safety with the elderly, this program examines the aspects of medication error with the elderly and provides pragmatic techniques for increasing the likelihood of medication safety and reducing error. This program is suitable for all settings, but particularly for out-patient settings.  It is customizable to any provider/staff mix audience.

SBAR
Initially used in the military, the SBAR communication approach has been successfully applied in healthcare clinically, and for administrative communications.  How can this hard-wired approach to transmission of important information be used by clinicians and administrators?  This program will describe the barriers, the latent problems, and the methods for ensuring that SBAR communication can be used effectively by the organization to improve patient care and administrative function. This session is suitable for all settings, with the most applicability to inpatient settings or physician practice groups.  It is customizable to any provider/staff mix audience

 

Membership on the Board of Directors was once a position of relative peace. In times of financial security, the Board's role was primarily one of broad oversight. It ensured health care facility was meeting the needs of the community, was trustworthy, adn financially solvent. In this turbulent era, the Board's role has shifted to one of far greater legal and fiduciary implications. While still responsible for ensuring the facility meets the needs of the community it services, Boards today are being held accountable for the health care organization's efforts to ensure that safe care of the highest quality that meets all governmental and regulatory standards is being delivered. This obligation carries the need for enhanced skills and expanded knowledge. This presentation will discuss the role of the Board with regard to risk management, quality and compliance.