Risk management and Healthcare responsibility. How to guarantee legal protection in Medicine.

Having regard to the increasing attention to the issue of safety and health of patients and workers by low, the hypothesis that this topic will be the growing trend in the next years does not seem to be manifestly unfounded. For this reason, it is wise for healthcare professionals to already be aware that any violation of the interests underlying the legislation in question entails a ruling on civil and/or criminal liability. It is therefore necessary to identify the most suitable means to prevent undue harm occurring, partly to exempt healthcare professionals and hospitals from compensation costs, thereby providing them with recourse to insurance coverage. Healthcare facility organisations must adopt Risk Management techniques as a tool to simultaneously guarantee the effectiveness of health services (in this case), the efficiency of the management economy, and finally compliance with all legally required precautions. This will relegate the occurrence of an adverse event to remote and unpredictable hypotheses, thus guaranteeing useful recourse to insurance coverage to compensate any harm that does occur.

[Delegation of medical responsibilities to non-medical personnel. Options and limits from a legal viewpoint]. / Delegation ärztlicher Aufgaben auf nichtärztliche Berufsgruppen. Möglichkeiten und Grenzen aus rechtlicher Sicht.

Increasing specialization and growing mechanization in medicine have strongly supported the transfer of originally medical responsibilities to non-medical personnel. The enormous pressure of costs as a result of limited financial resources in the health system make the delegation of previously medical functions to cheaper non-medical ancillary staff expedient and the sometimes obvious lack of physicians also gains importance by the delegation of many activities away from medical staff. In the German health system there is no legal norm which clearly and definitively describes the field of activity of a medical doctor. Fundamental for a reform of the areas of responsibility between physicians and non-medical personnel is a terminological differentiation between instruction-dependent, subordinate, non-independent assistance and the delegation of medical responsibilities which are transferred to non-medical personnel for independent and self-determined completion under the supervision and control of a physician. The inclination towards risk of medical activities, the need of protection of the patient and the intellectual prerequisites required for carrying out the necessary measures define the limitations for the delegation of medical responsibilities to non-medical ancillary staff. These criteria demarcate by expert assessment the exclusively medical field of activity in a sufficiently exact and convincing manner.

Perspectives on Patient Safety and Medical Malpractice: A Comparison of Medical and Legal Systems in Italy and the United States.

OBJECTIVES: Italy is experiencing a crisis of malpractice litigation with important repercussions on the insurance industry (e.g., lower profits), physicians (e.g., defensive medicine), and the courts (e.g., work backlog, lengthy proceedings). We searched for common ground between legal systems in Italy and the United States and considered the implications for international collaborations in patient safety. METHODS: We examined the judicial frameworks of medical malpractice litigation in two countries with different legal foundations: the United States (a public-private system governed by common law) and Italy (a publicly financed healthcare system governed by civil law). RESULTS: We found important differences and similarities across the two systems that suggest a high compatibility for future comparisons and collaborations. Although many Italian hospitals maintain risk management programs, the U.S. emphasis on patient safety and quality has not yet been integrated into Italian healthcare systems. CONCLUSIONS: Based on our findings, we propose that the Italian system might benefit from assertively adopting some concepts from the U.S. system. In particular, we consider the role of the law and Italian medicolegal experts as key facilitators for the integration of patient safety and risk management units within Italian healthcare facilities.

What to know about duty to report.

Recognize what conduct needs to be reported to meet ethical and legal duties and to avoid ramifications.

Inside the Nurse Practice Act.

: Nursing practice statutes provide patient care guidelines for each state.

Protection from negligence lawsuits.

Learn the four elements necessary to prove professional negligence, what actually happens in this type of lawsuit, and how nurse managers can protect themselves from claims based on vicarious liability.

Minimizing employee benefits litigation through effective claims administration procedures.

With the marked increase in employee benefits litigation, employers and benefit plan sponsors are searching for ways to avoid such lawsuits, minimize their exposure in such lawsuits, and maximize their ability of prevailing in such lawsuits. Benefit claim processing and administration have become fertile areas for lawsuits. Consequently, improving benefit claim processing and administration obviously becomes important, and an area where affirmative actions by the employer and plan sponsor will produce many litigation-related benefits. This article will discuss, in a very simple and straightforward manner, various actions an employer or plan sponsor can take which will decrease the number of lawsuits, minimize the potential exposure if a lawsuit is filed, and maximize the ability of prevailing if a lawsuit is filed.

Firing without fear. Heading off litigation in employee terminations.

Under most state laws, employee handbooks carry the status of employment contracts, or such contracts are implied through various employment conversations. Unlike in the past, when a management decision to discharge an employee could be challenged only for statutory or public policy reasons, today's employer may have to prove that he or she did not violate an employee's contractual right to employment. Employers can reduce the risk of employment liability through practical steps such as careful monitoring and documenting of the hiring, performance appraisal, and disciplinary processes, and a credible grievance procedure. Many employers have found, however, that taking these steps does not always prevent litigation. Certain legal precautions, such as written disclaimers and other handbook revisions, can result in the dismissal of such actions before trial and will deter many plaintiffs' attorneys from taking the case. The strongest legal protection in termination situations is a release of all claims executed by the employee and supported by severance pay or other valuable consideration to which the employee would not be otherwise entitled.

Independent contractors, overtime wages, and negligent hiring. Assessing an agency's risks.

Independent contractors, the payment of overtime wages, and negligent hiring practices present legal risks to home care agencies. Conducting an internal review now could save having to defend an agency on a government audit later.