5 Things To Do To Improve Patient Care

Can’t decide what resolutions to make for 2015? How about making a resolution to improve patient care and reduce liability? We know from our experience in handling more than 20,000 claims and lawsuits against psychiatrists that your highest risk exposures are related to psychopharmacology and treating patients with suicidal behaviors. We also know that there are specific steps you can take to ensure that you are delivering the best possible clinical care, which reduces your professional liability exposure. Take our quiz below to help you determine if you and your patients would benefit from any practice-related resolutions.


1. Do you utilize your state’s Prescription Monitoring Program (PMP) to determine all of the medications being prescribed for your patient?

□ Yes □ No

If no – Consider utilizing this important source of clinically relevant information, which you may not learn of by any other means. Some states currently require physicians to check the database prior to prescribing, and more states are expected to adopt this requirement in the future. To locate information about your state’s PMP, visit http://www.nascsa.org/rxMonitoring.htm.

2. Do you receive timely safety alerts for the medications you prescribe?

□ Yes □ No

If no – Consider signing up for the FDA’s MedWatch program (http://www.fda.gov/Safety/MedWatch/ucm228488.htm) to receive medication safety updates and alerts. This resource can be very useful in fulfilling the expectation that you stay informed about the current risks associated with the medications you prescribe.

3. Do you utilize a suicide assessment tool when evaluating patients’ suicidality?

□ Yes □ No

If no – Consider using some type of assessment tool, as patient safety theory tells us that use of a replicable process minimizes the risk of an important aspect of the assessment being overlooked. One such tool is the SAFE-T card, which is available for download at http://store.samhsa.gov/shin/content//SMA09-4432/SMA09-4432.pdf.

4. Do you know the procedure to involuntarily hospitalize a patient in crisis?

□ Yes □ No

If no – Consider contacting your local hospital or colleagues to ensure you know exactly what to do in such a situation. You do not want to find yourself frantically trying to locate this information when a patient presents to your office in crisis.

5. Do you know the exact definition of “close observation” at all facilities where you practice?

□ Yes □ No

If no – Consider reviewing all policies and procedures at all facilities where you have privileges. Facilities, in their internal policies and procedures, have widely varying definitions of close observation for patients at risk. We have seen from our cases the tragic results that can occur when a psychiatrist, believing he or she has ordered that a patient receive one-on-one monitoring, has unknowingly called for far less frequent observation. It is imperative that you and the other treaters are speaking the same language, which may be unique to that particular facility.

If you answered “yes” to all of the questions, keep up the great work! If you answered “no” to one or more questions, implementing the suggested advice may go a long way in improving patient safety and minimizing your professional liability exposure.

Cheers to a happy, safe, and healthy 2015!

Donna Vanderpool, MBA, JD – Vice PresidentAs Vice President of Risk Management, Ms. Vanderpool is responsible for the development and implementation of PRMS’s risk management services for The Psychiatrists’ Program. Ms. Vanderpool has developed expertise in the areas of HIPAA and forensic practice, and has consulted, written and spoken nationally on these and other healthcare law and risk management topics. She most recently wrote a chapter concerning the risks of harm to forensic experts for Robert L. Sadoff, MD’s book Ethical Issues in Forensic Psychiatry: Minimizing Harm, (Feb. 2011/Wiley). Ms. Vanderpool received her undergraduate degree from James Madison University, and her MBA and JD from George Mason University. Prior to joining PRMS in 2000, Ms. Vanderpool practiced criminal defense law, taught business and legal courses as an adjunct faculty member at a community college and spent eight years managing a general surgical practice in Virginia.

This blog has also been cross-posted on LinkedIn.