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Newsletter Archive

2017 LHA Trust Funds Newsletters

Claims and Risk Newsletter


October 2017: Determining When to Go Up the Chain of Command: A 68-year-old female presented to the emergency room at 11:00 pm with complaints of pain in the lower abdomen. Symptoms had begun approximately six hours earlier; she also had constipation and nausea. Lab results indicated significant hypokalemia. A CT of the abdomen indicated sigmoid bowel perforation with adjacent abscess, possibly secondary to ischemic bowel. She was admitted to the floor at 2:45 am with planned percutaneous drainage of the abscess.


September 2017: What to Do When You Suspect Patient Neglect or Abuse : This month we will look at the duties of a facility when a patient presents for treatment and the facility suspects neglect or abuse of the patient. We recently had two claims from two different member facilities where a patient came into the ER and there was the possibility of neglect. In one instance the hospital took no action and a PCF complaint was subsequently filed. In the other case, the appropriate authorities were notified and no further action was taken against the facility. The claim in which a PCF complaint was filed is still ongoing.


August 2017: Improper Communication – A Life Threatening Result: Our claims study this month is related to the care of a six-year-old male child who presented to his pediatrician with viral symptoms. On his first visit to the pediatrician a urinalysis was run to rule out a urinary tract infection; that test revealed small levels of bilirubin.


July 2017: Patient Monitoring and Documentation: Patient monitoring and documentation are often an issue in medical malpractice claims. Documentation regarding postoperative care is especially vulnerable. Busy nurses may have difficulty prioritizing and are sometimes stretched to comply with their hospital’s own postoperative monitoring policy and procedures. In addition, documentation is often the last priority. 


June 2017: Timely Reporting of Critical Labs: As we all know, the timely reporting of “critical” lab values is of utmost importance. Unfortunately, there have been instances when the communication process fell through the cracks. This month, we will look at two claims related to this standard of care.


May 2017: IV’s and the Risk of Extravasation: The patient was an oncology patient being treated as an outpatient for non-Hodgkin’s lymphoma, a cancer of the lymphatic system. On a regular basis (every third Friday), she presented for treatments. Her chemotherapeutic regimen consisted of four different drugs, three of them given intravenously. The IV drugs were Cytotoxan, Oncovin, and Adriamycin. Click here to read more 


April 2017: Maintaining and Addressing Issues with Hospital Equipment: It is important that a hospital has a designated schedule for maintenance and cleaning of their equipment. These schedules should cover in-house testing as well as preventive maintenance. They should be easily accessible and readily available for the staff to see. This will also serve to potentially mitigate any legal claims against the facility if the facility can produce a written maintenance schedule.


March 2017: Medication Decisions for Chronic Pain Patients: Chronic pain patients can be problematic when trying to help them manage their pain with a course of care that will provide maximum benefit with the least amount of risk. Prescription medications, specifically steroid medications, come with significant risk when used for anything other than short-term treatment.


February 2017: Venipuncture and IV Liability: Retention of a Surgical Item: Professional liability claims are filed related to both venipuncture and IVs on a fairly regular basis. Allegations vary from phlebitis and site infection to nerve injury. We may look at evidence of technique and monitoring to determine potential liability related to this type of claim. Unfortunately, staff decision making, as well as documentation requirements across various ancillary departments, can sometimes hinder our defense. Click here to read more 


January 2017: What Things are Subject to Surgical “Count”?: We have two cases pending before Medical Review Panels that deal with the alleged failure of the surgical nursing staff to properly count material used during the procedure; therefore resulting in a retained foreign body that necessitated subsequent procedures to remove. Click here to read more


eNSIGHTS


September 2017: eNSIGHTS at a Glance: Increased Use of Antidepressants, New Thinking on Antibiotic Use, and Faster Door-to-Balloon Times


July 2017: eNSIGHTS at a Glance: Amazon at Healthcare’s Doorstep, Hospital Fined for Immigrant Disclosure, and Group Dangles Rewards for Whistleblowers.


May 2017: eNSIGHTS at a Glance: The GOP Healthcare Bill, Hospital Floors Pose Infection Risk, Payment Upfront, and Insurers Signal Mounting Troubles.


March 2017: eNSIGHTS at a Glance: Colorectal Cancer Rise in Young Adults, Hospital Floors Pose Infection Risk, Retail Clinics Draw More Patients, and Designed for Comfort.


January 2017: eNSIGHTS at a Glance: Antibiotics: Wider Use of Statins Eyed, Ashtma Widely Misdiagnosed, Hospitals Reduce Readmission Rates, and Doctors Prescribing Stronger Antibiotics.


Physicians Quarterly


August 2017: Off-Label Use of a Medical Product/Device: A few years ago one of our Trust Fund Members was sued in state district court for failing to notify a patient that a “recall” had been ordered for a product that had been utilized for a surgery she had recently undergone. Investigation and legal discovery determined that the hospital had not followed its own policy for notifying its surgeons and patients about recalls. The case was eventually settled as to the hospital; however, in the course of that litigation, it was also determined that the surgeon who performed the procedure had used the product in question in an “off-label” manner, i.e. the product was not intended for the subject procedure. Although the hospital had settled, the case went to trial against the surgeon. The jury found in favor of the surgeon. As of this date we, are unaware if that case was subject to appellate review and a published opinion.


February 2017: The Credentialing Process: The Role of the Physician: In the 1970’s sitcom Chico and The Man, one of the standard gag lines was Chico’s response to almost any request with the phrase “Hey, that is not my job, man”.

While it is true that liability claims related to allegations of either “negligent credentialing” or negligent implementation/operation/use of electronic health records (EHR) would be directed at the hospital or healthcare facility, it would be foolish to disassociate the role played by the practitioner in both of these areas. It is most definitely the job of the practitioner to cooperate with the hospital in the credentialing process and in the use of the EHR. Damage to a hospital’s finances and/or reputation for injuries resulting from a credentialing or EHR related issue will also impact the medical staff to some degree.


General Liability Newsletter


July 2017: Injury Claims From Auto Accidents: Injury claims arising from auto accidents are typically handled and resolved by auto liability insurance carriers. However, auto accidents occurring on a hospital campus may present general liability exposure for the hospital. The LHA Trust Fund was recently presented with a claim made on behalf of a pedestrian who was struck by an automobile that was turning into the hospital’s parking garage. One vehicle was at a stop sign waiting to turn left into the parking garage. Another vehicle was in the process of exiting the parking garage. The exiting vehicle stopped to allow a pedestrian to cross. The other vehicle thought the exiting vehicle stopped to allow him to turn into the garage. He began his turn without noticing the pedestrian and struck the pedestrian causing serious injuries.


March 2017: Non-Medical Equipment Inspections: The Role of the Physician: It is not news to hospital administrators, risk managers, and compliance coordinators that the periodic inspection and maintenance of medical equipment is a high priority issue. In a November 2014 article in Becker’s Hospital Review, it was noted:

 “New regulations and standards for medical equipment maintenance were recently announced by The Joint Commission (TJC), aligning TJC’s accreditation with updated regulations from the Centers for Medicare and Medicaid Services (CMS) issued on December 20, 2013. The new regulations mandate substantial changes in the ways hospitals manage medical equipment – and these new requirements mean administrators will spend more time, money and staff to maintain their facility’s medical equipment.”

Workers' Compensation Newsletter


July 2017: Louisiana Supreme Court Decision Settles Choice of Pharmacy Issue: The Louisiana Supreme Court delivered a victory last week to employers in a decision released on June 29, 2017, in Burgess v. Sewerage and Water Board of New Orleans, a choice of pharmacy case. This is an important decision for those of us interested in pharmacy cost containment. The choice of pharmacy is an issue that circuit courts have been split on for some time. The Louisiana Supreme Court found that this choice belongs to the employer. This decision is not harmful to the injured worker.


May 2017: The Aging Workforce and the Impact on Workers’ Compensation:  Older workers make up a larger segment of our workforce than ever before. According to the U.S. Bureau of Labor Statistics, between 1977 and 2007 the segment of workers 65 and over increased 101 percent. This trend has continued to increase. The aging workforce significantly impacts workers’ compensation by driving up both medical and indemnity costs. The aging worker also often presents an increased recovery time subsequent to injury. This is not discriminatory, just the reality that we all eventually come to know.


April 2017: The Importance of Post-Accident Drug Testing:  Intoxication is defined as a state in which a person’s normal capacity to act or reason is inhibited by alcohol or drugs. Drugs can include prescription medication, over the counter medication or illegal narcotics. Similar to “buzzed driving,” there is even a phrase that has been coined…”buzzed working.”

 The statistics surrounding drug use are staggering. 75% of illegal drug users are employed, and drug and alcohol users are 3.5 times more likely to have workplace accidents. Some studies have shown that up to 20% of all occupational injuries involve drugs and/or alcohol.

March 2017: Considering Medicare Set-Asides in WC Claims: Workers’ Compensation Medicare Set­-Aside Allocations (WCMSA) play a significant role in how workers’ compensation claims are evaluated when considering the settlement of a claim.

As per Federal law, Medicare is always a “secondary payer”, meaning if there is any other available insurance, in this case from a workers’ compensation or personal injury settlement, Medicare will not pay bills for injury unless that insurance becomes unavailable. Because the injured worker received settlement money from an insurance company to cover future medical treatments, Medicare wants to make sure that the injured workers spend the portion of the settlement money on the injuries designated in the settlement before taxpayers start paying for injuries through Medicare.

 

Workers' Compensation Claims and Conclusions


June 2017: Carefully Worded Judgment Documents: Our injured worker (a 63-year-old Certified Nursing Assistant), strained her lower back while helping a resident to a sitting position in order to make a transfer to a lift. Simple claim, right? Obviously, compensability isn’t an issue, as this injured worker is clearly within the course and scope of employment when the injury occurred.

The CNA immediately chose her orthopedist, whom she had generate a work status slip to remove her from the workforce. Interestingly enough, her physician indicates, “… (she) is permanently disabled from work,” (only four (4) days post incident).

 

March 2017: Ingenious Strategy: Several newsletters ago, we reviewed the importance of investigation and utilizing social media to thwart bogus claims. Our injured worker thought she had outsmarted the system.

The claim began innocently enough with a strain/sprain injury to the lower back. The initial red flag was the choice of physician the injured worker demanded. Efforts to divert her to a physician less liberal were unsuccessful. Knowing the reputation of the medical provider, a Second Medical Opinion (SMO) was secured quickly, then followed by a state Independent Medical Exam (IME).

 

2016 LHA Trust Funds Newsletters

Claims and Risk Newsletter

November 2016: Informed Consent and Adequacy of Disclosure: The process of informed consent involves a relationship and communication between the patient and the physician in which a discussion ensues regarding a particular treatment or procedure. The signed informed consent document should serve to support that the discussion took place and the appropriate disclosures were made. Although, oral consent can be acceptable, it is recommended that the document be obtained to help prove the process was completed.


October 2016: Hospital Acquired Infections and Medical Malpractice Litigation: Alleged hospital acquired infections are becoming increasingly more a subject of medical malpractice litigation. In this month’s claim, our patient had a history of MRSA when she presented for an abdominal hysterectomy and lysis of adhesions. MRSA is a prevalent illness that requires priority in assessing, identifying, preventing and treating diagnosed patients with evidenced based practices.


September 2016: Consequences of Poor Communication in a Clinical Setting: Poor communication is cited as a root cause in a majority of sentinel events. This month we present three situations where ineffective communication could facilitate a negative outcome. Click here to read more 


August 2016: Communication Between Contracted ED Physicians and Specialty Department Consultations: Our claim this month is related to physician practice/physician decisions and an emergency room physician who did not follow medical staff policies related to consultant requests. It is important to recognize the role and responsibilities of the clinical staff whose sound critical thinking could have affected the outcome of this event. Click here to read more 


July 2016: Preventing Infection and Exposure in the Ambulatory Surgery Setting: The facility is responsible for incorporating a process to prevent errors related to sterilization of equipment due to the sequence of events. It is incumbent upon the facility to ensure that there is a clear distinction between the clean and the sterile room and associated carts to prevent a clean package being placed on a sterile cart.Click here to read more 


June 2016: Equipment Failure in Surgery: When reporting a medical malpractice claim that involved equipment failure, hospitals are advised to sequester any/all equipment that is either directly involved or considered to be a possible factor in patient injuries. Click here to read more 


May 2016: Medical Staff and Hospital By-Laws: Every hospital has a set of by-laws that are approved by the Governing Body that its medical staff must operate under. But what happens when an on-call physician doesn’t follow one of these by-laws. Hospitals act through their staff physicians (even if they are not direct employees) and regulate those physician’s behavior relative to emergency services. Therefore, the hospital is responsible for any dereliction by the physician. Click here to read more 


April 2016: Communications with Injured Patients: Patients who experience an adverse outcome during their hospitalization often expect the organization to acknowledge the event with honesty, and sometimes an apology, even if the patient does not submit an actual grievance (by definition. While supporting a culture of safety and the obligation to uphold a patient’s right to be included and informed regarding their care, disclosure can improve the patient/provider relationship as well as enhance patient care through the identification of process errors.Click here to read more 


March 2016: When Medical Equipment Fails: Advances in medical devices and equipment improve the care of patients dramatically. Often, it is so integrated into providing routine care that we forget that these are pieces of equipment that while not often; they can fail. In recent months, we have handled cases involving such incidents. When it comes to medical equipment and device incidents, early response and intervention is key. this practice help us to preserve any evidence for possible defense and allows us to develop strategy to minimize claim settlement value and provide direction regarding appropriate response and prevention of similar incidents in the future. Click here to read more  


February 2016: Retention of a Surgical Item: Retention of a surgical item (RSI) is a preventable event that can result in patient injury. In this case, it is apparent that the hospital policy related to RSIs was followed. It is crucial that changes in behavior and organizational culture occur to reduce risks related to retained surgical items because the entire surgical team can be held legally responsible for RSIs. Click here to read more 


January 2016: Lack of Informed Consent: Despite all the work that has been done to improve the informed consent process over the years, the lack of informed consent continues to be a frequent focus of professional liability claims. The importance of documentation of the informed consent process cannot be underestimated. It is a process that contains a huge component of communication between the healthcare provider and the patients. The documentation serves as a way of memorializing the substance of the informed consent process. Click here to read more

eNSIGHTS

November 2016: eNSIGHTS at a Glance: How to Communicate Health Risks, ICD-10: Not Out of the Woods, AHA 2017 Environmental Scan, and Warning on Defibrillators.


September 2016: eNSIGHTS at a Glance: Cardiac Care, Orthopedics: More Bundled Payments in 2017, New Ratings for Hospitals, Johns Hopkins Redesigning ICU, Good News Surprises Medical Experts.


July 2016: eNSIGHTS at a Glance: Antibiotics: One in Three Prescriptions Unnecessary, AMA Calls Digital Apps Snake Oil, Online Tools Broadening Healthcare, ER Death Rates Drops 50%.


May 2016: eNSIGHTS at a Glance: Ransomware: Hackers Hit Several Hospitals, New Warnings About Opioids, Expanding Definition of Healthcare, EEOC Sues Hospital Over Vaccination Policy.


March 2016: eNSIGHTS at a Glance: Sued Physicians: Just 1% Account for 33% of Claims, Surge in CT Scans for Minor Injuries, Drug Shortages: Prices Bedevil Hospitals, Hospitals Should Be Wary of Calling Cell Phones.


January 2016: eNSIGHTS at a Glance: Gaps in Data Affect Hospital Payments, ICD-10: Much Ado Over Nothing, Jump in Prescription Drug Use, Cybersecurity Task Force for Healthcare.

Physicians Quarterly

October 2016: Medical Review Panel Opinion vs. Court Judgment: One of the important things to remember in regard to the difference between a Medical Review Panel opinion and a court judgment is that only the medical treatment rendered by the defendant healthcare providers is considered by the panel members. Whether or not the patient’s or patient family’s comparative negligence played a role in the outcome or whether some other third-party such as a product manufacturer contributed to the damages cannot be part of the opinion.  


July 2016: Five Areas of Concern for Malpractice Claims: Recent statistics from The Physicians Insurers Association of America (PIAA) indicates that a “loss” or “indemnity” payment is only made in about 30% of medical malpractice claims. This means a significant percentage of money paid out on professional liability claims goes to legal defense costs only. Medical Economics recently looked into the primary causes for both claims in general and loss payment in particular: faulty communication, lack of informed consent, failure to stay up-to-date on standards and training, inadequate follow-up of diagnostic tests and specialist referral, and variations in policies and procedures. Physicians Quarterly – Five Areas of Concern for Malpractice Claims


March 2016:Physicians Liability in Louisiana 2015: Three Cases – The Good, The Bad and The Ugly. We take a look at three liability cases in Louisiana from the past year and analyze each case. Physicians Quarterly – Physicians Liability in Louisiana

General Liability Newsletter

September 2016: Environmental Risks and Hazards – Let’s face it. Environmental risks are all around us. Unknowingly, we traverse these potential pitfalls several times daily without incident; on public sidewalks, in parks, supermarkets, hotels…and hospitals. When someone does sustain an injury from one of these hazards is some person or entity always financially responsible? The answer from both state and federal courts is a resounding “NO.” Click here to read more


July 2016: Third-Party GL Claims Resulting From Direct Patient Care – We know that a failure of a healthcare provider to exercise the appropriate standard of care in treatment of a patient that results in injury or death to the patient clearly falls within the realm of medical malpractice. But what happens when a failure to provide proper care to a patient results in the patient injuring a third-party? In Louisiana, would that claim be subject to the terms of the medical malpractice statute; a “cap” on damages and review by a medical review panel. Click here to read more


June 2016: Statewide Hurricane Drill – Since Hurricane Katrina in 2005, Louisiana hospitals have worked to prepare for hurricanes and other emergency events in order to better serve and support our communities. This year, Thibodaux Regional Medical Center enhanced its annual hurricane preparedness routine by testing its evacuation procedures as a part of the statewide 2016 Vigilant Guard Exercise. Click here to read more


May 2016: Sexual Assaults in Hospitals – Unfortunately, a much more common occurrence we have been seeing nationwide the past several years goes beyond merely physical assault to the much more traumatic sexual assault. Generally, in order to show that a hospital is liable, a plaintiff will need to show that the employee, healthcare provider or patient posed a risk of danger to others, and the hospital knew about the employee’s dangerous proclivities. Click here to read more


March 2016: Vicarious Liability on GL Claims – Non-“slip and fall” general liability claims occur less frequently, but many times can involve serious damages. One concept that needs to understood is that hospitals may be held vicariously liable (liable for the act of an agent) for the intentional acts of employees if the incident/harm is deemed to be so closely related to employment duties in time and place that it cannot be reasonably viewed as a purely separate and personal act. Click here to read more


February 2016: Data Breaches – Data breaches continue to be on the forefront of risk awareness in the healthcare community. The cyberattack on Indianapolis-based Anthem, reported in February 2015, was the biggest healthcare data breach to date, affecting 78.8 million individuals. The information services group Experian reports the number of data breaches it has serviced has increased between 15 and 18 percent each year over the last three years. Forty-six percent of incidences Experian has serviced are in the healthcare industry. Click here to read more


January 2016: Welcome to the New General Liability Newsletter – For the past 24 months, this newsletter has been exclusively focused on slip, trip, and fall prevention. Over the years, we have investigated claims resulting from lawnmowers throwing rocks, doors falling on visitors, elevator doors closing too quickly, falling light fixtures, malfunctioning automatic doors, cabinets falling from wall-hangers, and chairs collapsing. The future editions of our General Liability Newsletter will address many of these risk and exposure factors. Click here to read more

Workers' Compensation Newsletter

September 2016: Workers’ Compensation Symposium – We invite and encourage you to join us for our annual Workers’ Compensation Symposium. The event will consist of six educational sessions beginning with a keynote-style address entitled “Claimants are People Too” presented by Mark Pew, national speaker and Senior Vice President of PRIUM. Christi Kingsley, VP of Human Resources and Organizational Development at West Calcasieu Cameron Hospital will give a presentation entitled “One Facility’s Story of a Safety Transformation,” where she will discuss the evolution and success of their hospital safety program. Ending the symposium will be a presentation on “Active Shooter in a Healthcare Facility,” presented by Major (Ret.) Najolia, Retired SWAT Commander and Training Director, Jefferson Parish Sheriff’s Office. Click here to read more


June 2016: Violence in the Emergency Department – According to a publication from the American College of Emergency Physicians, more than 70% of emergency nurses reported physical or verbal assault by emergency patients or visitors. More than 75% of emergency physicians experienced at least one violent workplace incident in a year. This amount of violence causes a wide variety of issues, even past the obvious physical component. Other concerns include stress to the Emergency Department staff and patients, increased difficulty recruiting and retaining personnel as well as decreased quality of care from a distracted staff. Click here to read more


May 2016: Active Shooter: Awareness and Response – While active shooter incidents are on the forefront of public awareness due to the 24-hour media cycle, the actual statistics do bear out that the trend is on the upswing. The FBI reports that all active shooter incidents increased from an average of 6.4 per year between 2000 and 2006 to 16.4 per year from 2007 to 2013. In fact, the next active shooter incident is already being planned and final preparations may be underway at this time. Click here to read more


April 2016: Opioids and Chronic Pain – Chronic pain is the most debilitating condition in workers’ compensation, as well as the most costly from a financial standpoint for employers and insurers. While chronic pain is not precisely defined, it is generally regarded as pain that persists or progresses over a long period of time, in contrast to acute pain that arises suddenly. Unlike acute pain, chronic pain persists and is often resistant to medical treatment. Click here to read more


March 2016: Workplace Accidents: Breaking the Chain of Events– An accident can be described as an unexpected event that causes unintentional injury. While many factors must be present for an accident to occur, all accidents are caused. They may be the result of human error, involve an unsafe behavior or unsafe condition, or a combination of all. A noted pioneer in industrial safety, H.W. Heinrich developed a theory of accident causation in 1931 that states that the occurrence of an injury invariably results from a fixed and predictable sequence of events, with only the last one being the accident itself. If one event in this sequence is removed, the necessary sequence is broken and the injury is likely avoided. Click here to read more


February 2016: Risk Management & Loss Prevention – LHA Trust Funds have the tools to help you focus on loss prevention strategies like hazard identification risk assessments, employee education and training. We look forward to being a continued risk management partner. Together we can ensure that your employees have a safe work environment for their protection and yours. Click here to read more


January 2016: Happy New Year – In the spirit of the New Year, we would like to reintroduce a value added, no cost online safety training platform, Aurora Pictures. The training is offered at no cost to LHA Trust Fund members. We are proud to continue to provide our members complimentary access to the latest with Aurora Pictures to provide our members with on-demand access to over 220 safety, human resource and healthcare training topics, as a compliment to the comprehensive risk management and loss prevention services we provide for our members. Click here to read more

Workers' Compensation Claims and Conclusions

June 2016: The Aging Workforce – “The Aging Workforce” terminology has been a common theme in recent years. There are several reasons for the tag line, including economic recession, younger adults obtaining more advanced degrees and staying in school and increases in retirement requiring the older members of the workforce to stay employed. In an effort to keep workers’ compensation costs reasonable, employers are finding their workforce to be in need of special needs as far as physical requirements are concerned. Click here to read more


March 2016: Factual Frustrations – While the goal of workers’ compensation is to provide necessary medical care to an injured worker and return him/her to gainful employment, we often find situations in which settlement of a claim is the only course of action to close out any potential future exposure. Many factors are considered in order to reach an amicable resolution with all parties concerned. Some factors are not easy to digest, yet must be taken into consideration to provide a lower claim cost, which in turn reduces the experience rating on premiums. Click here to read more

2015 LHA Trust Funds Newsletters

Claims and Risk Newsletter

December 2015: Transfers of patients to and from healthcare facilities often present significant risks related to “failure to communicate.” It is vital that hospitals include policies, forms and processes for transfer in the education process for nurses, physicians and anyone on the healthcare team who has the responsibility to document or communicate pertinent information for the transfer. The responsibility of ensuring complete and accurate documentation for the transfer of a patient to the next level of care rests with the hospital. Click here to read more


November 2015: Venipuncture is one of the most frequently performed procedures in healthcare. Along with thrombophlebitis and accidental arterial puncture, nerve injury is one of the more common injuries associated with venipuncture. Nerve injury can range from temporary to permanent. Although the injury might often not manifest until several hours after the actual venipuncture, in this claim the potential injury was noted immediately when the patient began complaining of burning and numbness. Click here to read more


October 2015: Corneal abrasions are one of the most common peri-operative injuries. Although not necessarily a high value claim, they cause significant patient dissatisfaction due to the pain, which many patients describe as worse than the pain from their surgical site. Click here to read more


September 2015: This month’s Claims & Risk Newsletter is related to a specimen from a biopsy was lost on its way to the lab and was unable to be tested. Unfortunately, this is not an uncommon occurrence so we review best practices for the transportation of specimen to the lab. Click here to read more


August 2015: This month’s Claims & Risk Newsletter is related to a suicide at a facility’s Geri-psych unit and how your facility can take proactive steps to prevent negative outcomes, like this one, from occurring. Click here to read more


July 2015: This month’s Claims and Risk Newsletter is related to the process of medication reconciliation and the importance of having an effective process in place at your facility. This should begin upon admission and occur anytime a patient is transitioned to another level of care or discharged. Click here to read more


June 2015: Elopement risk is a common issue in today’s emergency rooms. The claims we are looking at this month relates to a student at a local high school, who on the day of the incident was acting bizarre and somewhat aggressive. After being admitted to a nearby hospital, he bolted from the ER and attempted to swim across a pond and drowned. The most obvious risk-related factor in incidents of this nature pertains to patient assessment, timeliness of communication between caregivers and need for specific education regarding both. Click here to read more


May 2015: Sometimes it is necessary to have a member of your nursing staff ride along with a patient while being transported via ambulance. As a general rule, nursing staff should not ride along in the ambulance since it raises a significant liability for the hospital; however, it is understandable that occasions can arise where the pros outweigh the cons when the outcome of the patient is at stake. We present risk reduction points to consider as well as the best way to educate your nursing staff for when instances when they will have to ride along with a patient in an ambulance. Click here to read more


April 2015: Claims involving agency nurses are often complicated. This month we discuss agency nurses and how the hospital is responsible in claims involving agency nurses. Also, we review what the Louisiana Department of Health and Hospitals licensing standards have to say about the hospital’s responsibilities. Click here to read more


March 2015: This month’s Claims & Risk Newsletter highlights Immediate Use Steam Sterilization (IUSS) method and how to use it properly. This method of sterilization is meant to be used in the event that an instrument needs quick cleaning because it is needed immediately and a sterile replacement is not available. Click here to read more


February 2015: Preventing patient falls is at the top of the list for every caregiver. National statistics tell us more than 1 million patient falls occur annually and approximately 30% of those falls result in some type of injury and 10% result in serious injuries. Click here to read more


January 2015: This month’s Claims and Risk Newsletter highlights the need for testing of competence of nurse’s skills, including those that are rarely used. Click here to read more

eNSIGHTS

November 2015: eNSIGHTS at a Glance: High Rate of Errors in U.S. Health Care, Cardiac Procedures: Hospitals Fined $250 Million, U.S. Urges Major Shift in Managing Hypertension, and Building Boom in Cancer Centers.


September 2015: eNSIGHTS at a Glance: Remarkable Gains for Medicare Patients, Widespread Cyber-Attacks in Health Care, Financial Risk for Hip, Knee Surgeries and Tough Warnings on Analgesics.


July 2015: eNSIGHTS at a Glance: OSHA Expands Enforcement, Quality of Health Data Questioned, CMS Will Cut Providers Slack on ICD-10 and New Class of Heart Drugs Approved.


May 2015: eNSIGHTS at a Glance: High Drug Costs are Here to Stay, Worker Injuries to be Made Public, Robots Doing the Heavy Lifting and Hospitalized at Home.


March 2015: eNSIGHTS at a Glance: Obamacare Hangs in the Balance, Mixing Alcohol and Medications, Massive Data Breach at Anthem and Hospital Ratings Don’t Make Sense.


January 2015: eNSIGHTS at a Glance: Broad Implications from Sony’s Plight, The Promise of Mobile Stroke Units, IRS Final Billing, Collections Guide and Severe Flu Anticipated.

General Liability Newsletter

December 2015:  Floor Cleaning and Matting, Part Two – Facilities should use the highest quality rubber-backed mats possible and those certified “High Traction” by the National Floor Safety Institute (NFSI) to prevent buckling and ripping. Instituting proper cleaning procedures, mat programs and chemical use training will help reduce or eliminate slips and falls in a healthcare facility. Click here to read more


November 2015:  Floor Cleaning and Matting, Part One – Proper floor cleaning techniques are key to fall prevention. Keeping patients, visitors and staff on their feet is a top priority in any healthcare facility. Unfortunately, many healthcare providers often fail to consider the environmental components in their facility and only consider a person’ psychological factors. This attitude ignores the one environmental component that all employees, patients and visitors alike come into contact with: the floor. Click here to read more


October 2015:  Identifying Hazards – The same slip, trip, and fall hazards that contribute to visitor injuries create unsafe conditions resulting in employee workplace injuries. Elevated awareness along with STF accident prevention training and a well-developed systematic and routine facility-wide inspection are key for preventing slip, trip and fall accidents in your facility. Click here to read more


August 2015:  Unsafe Acts, Unsafe Conditions, Lack of Focus – these are primary contributing factors when we study claims resulting from slips, trips, and falls. Nearly one million people visit the emergency rooms across the U.S. yearly because of slip, trip and fall accidents. It is of utmost importance that we understand how and why slip, trip and fall accidents occur in our facilities. It is equally important that we establish prevention procedures to reduce and eliminate STFs on facility property, facility grounds and in our buildings. Click here to read more


July 2015:  The leading cause of injury sustained by visitors and vendors in our member facilities is Slip, Trip, and Fall. Our claims data tells us that 87% of the general liability claims in our LHATF member population during the period 2010-2014 were caused by STF accidents. Those claims accounted for 78% of total incurred dollars for general liability claims in the LHATF as a whole during the same calendar year period. There is a direct correlation of the environments related to visitor, vendor and employee injuries in healthcare facilities. The wet floor that our visitors slip on is the same wet floor that our employees slip on; the crack or fault in the parking lot pavement that causes a fall with injury to a visitor is the same cause factor that results in injury to our employees who fall in the parking lot on their way to clock-in. Click here to read more


June 2015:  In order to have a comprehensive slip, trip, and fall prevention program include floor cleaning, maintenance, and employee training. As important as the chemicals used to clean floors as, it is equally important to train the housekeeping staff and environmental services staff how to properly mix, use and apply the cleaning agents. Also, the facility safety management team should conduct routine inspections of parking lots, sidewalks, walkways, stairs, steps, entryways and elevators to ensure that these are free from hazards that could contribute to slips, trips and falls. In addition to being trained, housekeeping environmental services and maintenance staff should also be knowledgeable about policies and procedures related to slip, trip and fall accidents. Click here to read more


May 2015:  National statistics tell us that about 14% of all losses in the insurance industry are attributable to slip, trip and fall accidents. Claims data for LHA Trust Fund members tells us that visitor slip, trip and fall accidents are number one in both frequency and severity across our membership, with the top three locations of visitors falls happening where the highest rate of pedestrian traffics occurs: the hallway/corridor, parking lot and lobby.  Click here to read more


April 2015:  According to the All Injury Program, a cooperative involving the National Center for Injury Prevention and Control, the Centers for Disease Control and Prevention and the Consumer Product Safety Commission, falls are the leading cause of nonfatal, unintentional injuries treated in hospital emergency rooms. A combination of deficiencies in housekeeping, design, lighting, visibility and attention are usually the culprits in slips, trips and falls. Click here to read more


March 2015:  In March’s newsletter, we bring you part 3 of a series of recommended best practices for reducing slip, trip and fall incidents in your facility. This month, we offer a suggested Slip, Trip and Fall Prevention Campaign Calendar that you can employ at your facility. Click here to read more


February 2015:  In February’s newsletter, we bring you part 2 of a series of recommended best practices for reducing slip, trip and fall incidents in your facility. This month, we review what two central Illinois hospitals achieved significant reductions in employee and visitor slips, trips and falls by employee awareness and education campaign with communication. Click here to read more


January 2015: In January’s newsletter, we present part 1 of a 3-part series of recommended best practices for reducing slip, trip and fall incidents in your facility. We review what two central Illinois hospitals achieved significant reductions in employee and visitor slips, trips and falls by identifying the top causes of loss along with program development and loss prevention. Click here to read more

Workers' Compensation Newsletter

December 2015: Safety Process: Proactive vs. Reactive – The Miriam-Webster dictionary defines proactive as “controlling a situation by making things happen or by preparing for future problems. Workplace safety is an important issue that is all too often taken for granted. The direct costs related to a workplace injury are easily identifiable in the form of medical bills and lost wages. However, the indirect costs related to lost productivity, hiring and training a replacement worker, decreased employee morale, time spent by administrators and supervisors on the claim, among many others, are not so easily quantifiable but are absolutely absorbed by the employer. Click here to read more


November 2015: The National Institute for Occupational Safety and Health (NIOSH) defines workplace violence as consisting of physically and psychologically damaging actions that occur in the workplace or while on duty. Bullying is repeated, unwanted harmful actions intended to humiliate, offend and cause distress in the recipient. Bullying actions include those that harm, undermine and degrade. Actions may include, but are not limited to, hostile remarks, verbal attacks, threats, taunts, intimidation and withholding of support. Click here to read more


October 2015: An Experience Modification Factor, or E-Mod, is typically seen on a workers’ compensation premium invoice but is sometimes misunderstood. The E-Mod is one factor that can be controlled and reduced without a reduction in staffing levels. Learn how you can be a savvy employer and utilize several methods to drive down the E-Mod and ultimately your insurance premiums. Click here to read more


September 2015: We have all heard of “Best Practices” on numerous occasions. The business world defined, “Best Practices” as: Commercial or professional procedures that are accepted or prescribed as being correct or most effective. Prompt and efficient reporting of all insurance claims is an integral component of Risk Management Best Practices. Failure to properly and promptly report claims typically contributes to a negative claim outcome. Click here to read more


August 2015: If you’re a nurse, physical therapist, occupational therapist or other healthcare worker who provides direct patient care, you should take a closer look at how body mechanics can help minimize and prevent back injury when transferring, moving or handling patients. The number one cause of workers’ compensation claims in the healthcare industry on a national level as well as among the LHAWC Fund members is overexertion of the body. Most of these injuries come from patient lifting and transferring. Click here to read more


July 2015: Effective Emergency Disaster Action Plans – Are you prepared for an emergency of disaster to strike your hospital? Don’t think it cannot happen to you…it can. Whether it be a weather-related disaster, a violent situation, an active shooter, mass casualty, security breach, bomb threat, hazardous spill or medical emergency, it is vital that your facility and employees are ready and act according to the facility’s emergency disaster action plans. Click here to read more


June 2015: Sizzling Summer Heat – Heat-related illnesses kill more people yearly in the United States than tornadoes, hurricanes, floods, and lightning combined. If ignored, high temperatures and high humidity combined with strenuous activities can cause a number of issues including: dehydration, heat cramps, heat exhaustion and the dangerous heat stroke. A proactive approach and early recognition of danger can help manage these situations during the upcoming summer months. Click here to read more


May 2015: May I Assist You? – Overexertion or injuries from lifting, pushing or carrying cost businesses about $12.75 billion in direct annual expenses. Learn how to stay injury free when lifting objects and to not be afraid to ask for help when a lead seems unsafe to lift alone. Click here to read more


April 2015: April Fool’s – When someone tries to commit Workers’ Compensation fraud, the joke is on them. Learn how to protect yourself from fraudulent claims. Click here to read more


March 2015: Best of Luck – Good luck is not enough when it comes to providing a safe workplace. It takes a lot of time and energy to protect your best assets…your employees. Click here to read more


February 2015: A Healthy Heart – February is Heart Awareness Month and this month’s newsletter highlights the leading cause of death in the United States: Heart Disease and ways to be active with a hectic work schedule.


January 2015: A Year in Review – Cheers and Happy New Year! Happy New Year! We are wishing you all a happy, healthy and prosperous 2015! Last year was a whirlwind but the accomplishments were plentiful. We wanted to share some statistics with you as we look forward to the new year. Click here to read more

WC Claims and Conclusions Newsletter

November 2015: Social media can be a very beneficial tool in investigating and management of allege work-related injuries or at least, continued disability. Checking with the injured worker’s coworkers who are friends on social media might reveal another side to the injured worker’s alleged inactivity. Click here to read more


September 2015: Sometimes, the pieces of a claim don’t match up to what is reported. After investigating and evaluating the claim, you must choose the path most amicable to both sides. Click here to read more


June 2015: Some workers’ compensation claims go smoothly without much confusion, but then there are those occasional claims that require a flow chart to navigate. The statutes and/or case laws often are misinterpreted by the court both in and out of favor of both sides. Click here to read more


March 2015: Knowing the legal environment in which a workers’ compensation claim is going to be handled will often govern compensability and litigation defenses used to guide a claim. Our judicial system often favors the employee’s perspective, not the employer’s; however, the system does sometimes work in the employer’s favor. Click here to read more

2014 LHA Trust Funds Newsletters

Claims and Risk Newsletter

December 2014: This month’s Claims and Risk Newsletter is about patient handling and hand-offs and how your facility should have policies in place to assist ancillary staff in the transporting process. Click here to read more


November 2014: Our claim this month involves Obstructive Sleep Apnea (OSA), the use of home Continuous Positive Airway Pressure (CPAP) machine and a 52-year-old female patient who presented to the emergency department with abdominal pain. Click here to read more


September 2014: Our claim and risk study this month involves a 70-year-old male who was hospitalized for peri-rectal abscess surgery. The incident occurred during his post-surgical stay. Our post-incident claim investigation brought forth the following information related to the event and the subsequent patient care (or lack of care). Click here to read more


August 2014: A 70-year-old female presented to the ER with dizziness, rapid heartbeat, and minor chest pain and was admitted to the telemetry department. On the second day of the admission, she began to exhibit changes in the mental status including confusion and increased lack of responsiveness. She was transferred to ICU, and a neurology consult was ordered. Click here to read more


June 2014: This month we look at multiple claims that result from injury during discharge. Click here to read more


May 2014: This month, our claim involves poor documentation, apparent lack of nursing action and lack of knowledge of hospital policies and procedures lead to an untoward patient outcome. Click here to read more


April 2014: The primary issue surrounding the “claim-in study” this month is documentation or lack thereof. Hospitals are expected to develop appropriate policies and procedures that govern the use of verbal orders and minimize their use. Click here to read more


March 2014: In our Claims and Risk writing this month, we look at two scenarios that resulted in tragic outcomes and involved the availability to access the key to the restroom when a patient becomes ill or has a problem while inside a locked bathroom. Click here to read more


February 2014: Contractual liability and indemnity language can affect the protection that is intended to be in a general liability insurance coverage agreement. Our Claims and Risk Series writing this month takes on a different format and addresses a matter of importance with respect of the ramifications of indemnity language in business-related contracts and agreements that impact the outcome of claims brought against member facilities. Click here to read more

eNSIGHTS

November 2014: eNSIGHTS at a Glance: Ebola Shakes Up Health Care, Providers Rethink Ebola Interventions, Nigeria and Senegal Stop Ebola, Walmart Expands Healthcare Presence and What the AHA Sees On the Horizon. 


September 2014: eNSIGHTS at a Glance: Walmart Offers $4 Healthcare, Exotic Diseases in the News, NY Hospital Uses Cameras to Check Compliance in OR, Study Questions Low-Sodium diet and Photos of Newborns Come Down Because of HIPAA Concerns.


July 2014: eNSIGHTS at a Glance: Obesity Weighing Down Public Health, CDC Warns Over Heavy Drinking, Better Results From Enhanced Mammography, Uprising Against Drug Prices and Obamacare Seems to be Working.


May 2014: eNSIGHTS at a Glance: Hepatitis C: Cost of New Drugs Complicates Treatment, Nitroglycerin in Short Supply, A Bigger Tent for Healthcare, Colonoscopies Reducing Cancer Deaths and CDC: Hospitals Misuse Antibiotics.


March 2014: eNSIGHTS at a Glance: Mammography Does Not Save Lives: Canadian Study, Skepticism Over Cancer Screenings, Focus on Diagnoses, AMA Still Fighting ICD-10, High Burden of Chronic Conditions and New Painkiller Called Dangerous.


January 2014: eNSIGHTS at a Glance: New Guidelines Shake Up Heart Care, More Slack on Treating Hypertension, Hospitals Rebound from Recession, Fewer Hospital Re-admissions, CT Scans Increase False Positives for Lung Cancer and More Evidence Bariatric Surgery Works.

General Liability Newsletter

December 2014: Louisiana Appelate Court rules hospital is not liable in visitor slip and fall incident, based on nurse’s testimony. A hospital or other healthcare facility can be held liable in a civil negligence lawsuit if a visitor is injured in a slip and fall accident due to a foreign substance spilled on the floor. In a case handed down by the Court of Appeal of Louisiana, a hospital was ruled not liable, based on the testimony of the nurse. Click here to read more


November 2014: Premises liability refers to the body of law that holds the property owner, or any person in possession of the property, liable for damages suffered on their premises. As it relates to our hospital environment, premises liability hold us responsible for the safety of our visitors while they are on and moving about our property. Click here to read more


October 2014: By far, a slip, trip, and fall event is the most common visitor accident; however, we must also be aware of other factors and conditions that contribute to fall accidents. There are four primary types of accidents that can result in an injury from a fall: Step-and-fall accidents, stump-and-fall accidents, step-and-fall accidents and trip-and-fall accidents. Click here to read more


September 2014: The biggest contributing factors to slip, trip and resulting falls is improper housekeeping and lack of or absence of warning signs. When trip hazards cannot be engineered out by design, one way to elevate awareness and alert pedestrians is to use yellow paint to identify high-hazard walking surfaces and to alert pedestrians to potential trip hazards. Click here to read more


August 2014: Training and education play a major role in slip, trip, and fall prevention throughout the hospital and across the campus. Slip, trip and fall prevention should be a key component of staff, patient and visitor safety in your facility. The safest facilities develop and employ best practices surrounding fall hazards and risky scenarios. Click here to read more


June 2014: Premises/general liability claims for slip, trip, and fall incidents are a reflection of the environment that visitors and vendors encounter while on the facility property and in the building. Our LHA Trust Fund Risk Consultants recommend the use of a survey tool to access slip, trip and fall related risks on hospital property and throughout the facility. Click here to read more


May 2014: There are many different types of hazards that can lead to slip and fall incidents. Common slip and fall incidents include slippery floors, irregular walking surfaces, contaminants on the floor, trip hazards in hallways, etc. Slip and trip injuries can be severe and especially if the person is older or the surface they fall on is a hard surface. Click here to read more


April 2014: Good housekeeping is important in preventing hazards. Keeping work areas tidy will create a better working environment and mean fewer accidents for employees, visitors, guest, and vendors. Click here to read more


March 2014: Slip and trip accidents may have different causes, but often they have the same result. By looking at the contributing factors separately, it is possible to work out more accurately the cause of the slip or trip accident. We present the likely causes of slips and trips and how to have an effective and successful slip, trip and fall prevention program. Click here to read more


February 2014: Implementing an STF prevention program greatly aids in the reduction of STF accidents. The program should include on-site hazard assessments, changes to housekeeping procedures and products, STF preventative procedures and products, general awareness campaigns, programs for external ice and snow removal, flooring changes and slip-resistant footwear for employees. Click here to read more


January 2014: We present the slip, trip and fall basic. Slips, trips, and falls are one of the leading unintentional injuries in the US, accounting for approximately 8.9 million visits to the ER annually, according to the National and Safety Council Injury Facts. Falls are the second-leading cause of unintentional deaths in homes and communities, resulting in more than 25,000 fatalities in 2009. Click here to read more

Workers' Compensation Newsletter

November 2014: The World Health Organization reports 2 million of the 35 million healthcare workers experience percutaneous exposure to infectious diseases each year. This month’s newsletter provides ways to protect your workers from needlestick injuries. Click here to read more


October 2014: Many workplace accidents are caused by unsafe behavior, not unsafe conditions. This month’s newsletter highlights ways to use behavior-based safety effectively. Click here to read more


September 2014: In September’s newsletter, we discuss how to prevent back injuries at work. Learning how to lift objects is important to prevent back injuries but you also need to know how to carry and unload objects safely. Click here to read more


August 2014: Back injuries are among the most common types of injuries as well as being expensive and time-consuming. In this month’s newsletter, we discuss how to maintain a neutral position while you work eliminates potentially harmful strains and helps prevent painful and sometimes disabling musculoskeletal disorders (MSDs). Click here to read more


July 2014: Good safety practices help protect you and your coworkers from injury or illness on the job. Because of that, we take safety very seriously here – and that means that you should consider working safely an important part of your job responsibilities. Click here to read more


June 2014: Motor vehicle accidents are the largest single cause of accidental death – both on and off the job – and are also a major cause of serious injuries. In fact, according to the statistics, during the time you’re reading this article, someone will die in a road accident and 33 people will be injured. That’s why it’s so important to drive defensively and be prepared to respond to traffic conditions and other drivers. Click here to read more


May 2014: Do your employees walk around your facility or down the street with their faces buried in their mobile phones? Even if they’re on hospital business, this is just not a good idea, according to Professor Jack Nusar of Ohio State University. Professor Nusar’s research revealed that more than 1,500 people were estimated to be treated in emergency rooms in 2010 for injuries related to using a cell phone while working. Click here to read more


April 2014: Avoid stress and strain at your computer with this helpful tips to work comfortably and efficiently on the computer while at work. Click here to read more


March 2014: Safety is everyone’s business. it requires the active participation of management, supervisors and employees. No one group can do the job alone. That’s why it’s so important for you to understand your safety responsibilities and always carry them out to the very best of your ability. We also present the do’s and don’ts of office safety. Click here to read more


February 2014: Workplace violence or occupational violence refers to violence, usually in the form of physical abuse or threats that create a risk to the health and safety of an employee or multiple employees. We discuss workplace security and how to be safe and secure on the job. Click here to read more


January 2014: Federal OSHA recently revised its hazard communication standard to align it with Globally Harmonized System of Classification and Labeling of Chemicals known as “GHS,” which was adopted by the United Nations in 2003. Under the GHS, detailed chemical hazard information must be provided in a standardized format called a safety data sheet, or SDS, which now has 16 sections. Click here to read more

WC Claims and Conclusions Newsletter

 


December 2014: The benefits of surveillance video: one of the best resources for a claim investigation is clear and timely surveillance video. It becomes the “eyes” and often times the documentation we need to refute the allegations of a questionable claim. Click here to read more


September 2014: We evaluate each claim in making a determination to defend or seek resolution through an amicable settlement. Factors in the evaluation and determination process include such things as the age of the injured worker, past medical history, ability to return to work and future (unrelated) medical expenses required for the injured worker’s life expectancy. Often times certain extenuating variables must also be given consideration. Click here to read more


June 2014: We investigate each lost time claim. There are a number of ways to gather information. As part of the claim investigation process, feedback from reliable sources should be not overlooked. We recently had a definitive case in point with a hospital employee who had been employed for only a few months prior to reporting a work-related incident. Click here to read more


March 2014: Taught in nearly every continuing education class is a “golden rule” upon which every Claim Examiner must base the investigation and daily handling of workers’ compensation claims: Each claim is separate and apart from the next. Click here to read more