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Failure to De-escalate Disruptive Patient Behavior

June 12, 2023

In the following case, the patient and his wife were removed from the ED for using profanity and issuing threats. The patient may not have become disruptive if de-escalation strategies had been used. Consider what could have been done differently.

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Filed under: Practice Manager, Physician, Patient Care, advanced practice professional, Documentation

Failure to Document Disruptive Patient Behavior

June 12, 2023

When a malpractice lawsuit is filed, lack of documentation can significantly complicate the process of proving the patient’s treatment met the standard of care and did not cause the patient’s injury. In the following case, the emergency department (ED) physician failed to adequately document three different aspects of the patient’s care: her disruptive behavior, her departure from the ED against medical advice (AMA), and her follow-up telephone conversation. Each failure complicated the defense of the ED physician’s case.

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Filed under: Practice Manager, Physician, Patient Care, advanced practice professional, Documentation

Patient Safety and Liability Risks Associated with Texting in Healthcare: Case Studies and Best Practices

May 19, 2023

Text messaging has changed the way we communicate with each other. Like most people, healthcare team members use their mobile devices at work,1,2,3 and texting about patients is common.4 Texting with patients and other members of the healthcare team has risks and benefits.

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Filed under: Digital Health, Patient Communication, Article, Practice Manager, Physician, Patient Care, Documentation, culture of safety

HIPAA, HITECH, and Confidentiality Risks When Texting in Healthcare

May 19, 2023

Texting protected health information (PHI) without proper safety and encryption processes in place could result in HIPAA/HITECH violations, and noncompliance with CMS and accreditation requirements for secure text messaging, and violation of state medical information confidentiality laws. Because PHI goes where the phone goes, ensuring the privacy and security of PHI sent by text messaging can be challenging.

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Filed under: Digital Health, Best Practices, Practice Manager, Physician

Unprofessional Text Messages Complicated Defensibility of a Malpractice Claim

May 19, 2023

The medical record is not the forum for blame, personal attacks, or finger pointing.1 Text messages relating to patient care should be considered part of the medical record (whether they are transferred to it or not), and the same rule about appropriateness of forum should apply. If something about patient care is important enough to be texted, it should be included in the medical record. If it is something that does not belong in the medical record, then it should not be texted. It seems clear that the members of the healthcare team texting each other in the following case study did not expect their text messages to be used against them in the malpractice lawsuit.

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Filed under: Digital Health, Case Study, Practice Manager, Physician, Patient Care, Documentation, culture of safety

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