Saturday, November 30, 2013

Reducing Medical Mistakes

We have previously noted the on this site that there are an alarming number of deaths each year due to errors in a hospital setting.  It seems that each month another article comes out that reevaluates the evidence and concludes an evening higher number than the last.  Regardless of the source, though, the number is alarmingly high. 

If everyone can agree that the number of individuals being harmed at the hands of healthcare negligence is too high, then next questions asked must be “why?” and “how do we stop it?”  The Wall Street Journal recently published an article attempting to address both of these questions.    

Based upon the percent of total amount of medical negligence payouts (a debatable metric, but sufficient for the purposes of the article), the WSJ concludes that diagnostic problems constitute the most serious source of medical negligence.  As an attorney who spends a great deal of time reviewing potential medical negligence, I would agree that a significant amount of the cases that come across my desk are failures to diagnoses, of which many of the failures have lead to devastating harm.  Even more than the number of claims and the types of harm, though, failure to diagnose claims are troublesome because so often they go to the core of what we as patients expect from our healthcare providers.  Most often patients visit a doctor’s office (or hospital) to either make sure there is no diagnosable malady (routine checkup) or find out what is causing a concerning sign or symptom.  Society can accept that there may be problems for which science hasn't found a cure, but we expect if a diagnosis is available, it be made appropriately.  

There are many factors that can contribute to failing to properly diagnose a patient, and thus there is no one solution to the problem.  We have previously written on efforts to establish systems of care akin to what has become the standard in the aviation industry.  The WSJ discusses several additional potential solutions including the mining of information in electronic medical records, changing the way physicians approach diagnostic decision making, and the use of electronic diagnostic systems.  Additionally, the article suggests several ways in which patients can help avoid reduce these errors, too.

There is enough uncertainty in medicine—sometimes described as more of an art than a science—that sprinkling in avoidable errors by healthcare providers is a recipe for chaos.   It is virtually universal that the earlier a disease is diagnosed, the better the chance a patient has for a positive outcome.  While the number of individuals harmed by medical negligence remains disturbingly high, it is important to know that there are real attempts to being made to try and reduce the frequency—and resulting harm—of such errors.    

Friday, November 15, 2013

Help Prevent Resident-to-Resident Abuse

There have been a lot of stories in the news about bullying, harassment and other abusive behavior directed from one individual to another—most recently in the Miami Dolphin’s locker roomSuch conduct is, of course, not isolated to schools or locker rooms.  One place it is not often thought of, though, is in nursing homes.  However, resident-to-resident abuse does occur and it is something that residents and their families should be aware of and for which nursing homes have a duty to try and prevent.    
The first thing someone will think of when the issue of “nursing home abuse” is raised is a staff member mistreating a resident.  In fact, we have written a number of posts on this blog discussing various aspects of negligence and abuse in a nursing home setting arising from the acts of nursing home operators and often over-worked and under-trained staff.  However, it is important to point out that a very real yet often overlooked source of nursing home abuse stems from resident-to-resident abuse. 
Last year a study was published in the Journal of Elder Abuse and Neglect titled Resident-to-Resident Abuse in Nursing Homes as Reported by Nurse Aides.  The authors evaluated the phenomenon of resident to resident abuse in nursing homes and found “that both the scale and scope of resident-to-resident abuse is high in nursing homes” and that it was “common enough to be considered an issue of concern impacting the quality of life and safety of many residents.”
A family confronted with a situation of resident-to-resident abuse may think there is no recourse against the nursing home if the culprit of abuse is another resident as oppose to the nursing home staff.  We believe that the law dictates otherwise.  For instance, under Missouri law nursing homes or long term facilities must “ensure” that each resident admitted to its facility “[i]s free from form mental and physical abuse . . . .”  R.S.Mo. 198.088(6)(g).  The law does not distinguish whether the abuse comes from nursing home staff, another resident, or even a complete stranger.   

Your loved one has a right to live in a nursing home free from abuse from staff and from his or her fellow residents.  If there are issues with resident-to-resident abuse we would encourage you to bring these issues to the nursing home's attention immediately and ensure that they correct the situation.
-Tom and Ryan