Hospitalists face liability risks based on their role as an inpatient’s attending physician, covering physician, consultant, and/or co-manager. Two common problem areas are confusion regarding the hospitalist’s role in the patient care continuum and miscommunication during the different phases of inpatient care, especially during handoffs. The following tips can help hospitalists reduce liability risks.
First, make sure that you, your group, and the hospital all agree on your job description and privileges. Explain the hospitalist’s role to the patient and family. For example, are you covering for the attending physician or serving as the attending physician? Who will coordinate care with specialists? Clarify your role with the other care providers to avoid confusion among the healthcare team regarding the specific components of a patient’s care.
Hospitalized patients are most vulnerable to communication breakdowns during the following transitions:
Standardized communication tools, such as the SBAR format (Situation, Background, Assessment, Recommendation) help effectively manage communication between providers. At a minimum, communicate the patient’s diagnosis, current condition, recent changes in condition or treatment, and any anticipated changes. Check with the hospital to find out which communication tools or protocols it uses.
Use only approved translators. Document the name of the translator according to facility policy. Family is the last resort for translation.
Checklists can be helpful in obtaining basic yet vital patient information from either the patient or the primary care provider. Find out the patient’s code status, current medical status, preferences, medications, testing (completed, pending, and planned), and any new diagnosis that may be necessary for you to effectively manage his or her care.
Use the following questions to organize handoff communications:
The guidelines suggested here are not rules, do not constitute legal advice, and do not ensure a successful outcome. The ultimate decision regarding the appropriateness of any treatment must be made by each healthcare provider considering the circumstances of the individual situation and in accordance with the laws of the jurisdiction in which the care is rendered.