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Litigation review means more than just malpractice

Ambulatory Safety Monitor, October 14, 2004

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Just because you properly document malpractice litigation doesn't mean you meet AAAHC standard 5.B.5, which calls for periodic review of all litigation involving the organization and its staff and healthcare professionals.

"People don't think they have to document every type of litigation," says Jo Vinson, CASC, RN, operations coordinator at Asumen Healthcare in Dallas. An AAAHC surveyor for more than two decades, Vinson says litigation review also includes business lawsuits, legal action between partnerships, building lease cases, and grievances with contractors.

Make your documents available to surveyors

Charles Terzian, MD, MPH, MJ, clinical assistant professor at the University of Minnesota and an AAAHC surveyor, says surveyors ask to see any litigation from the past five years. The AAAHC also presents the question on the survey application (go to http://www.aaahc.org.)

Place reviews of malpractice suits in your facility's credentialing/privileging section, and all other litigation in your risk management plan, Vinson says. Because cases in litigation are confidential, you need to create a summary sheet to provide surveyors with information about the cause and status of the action. "I don't want details, I just want to track the review," Vinson says. "Surveyors shouldn't push the issue to discuss suits." 

Investors must be in the know

Although you don't have to provide surveyors and patients with litigation details, you must inform your investors, Vinson says.

Inform investors, either during a special meeting or via a certified letter, of anything that could affect the revenue of the center. Although most people communicate by e-mail, Vinson cautions against passing electronic information about litigation because it is accessible to the public.

Surveyors score compliance based on risk

Don't put your center at risk. You'll comply with the standard if you recognize, document, and follow up on all litigation. First, disclose the information to your surveyors. They tend to find litigation while looking for something else.

To keep your facility's risk low, follow these tips:

1. If you think someone might file suit, immediately contact your malpractice carrier for a malpractice claim or your attorney for other litigation. As soon as you make that contact, you will be protected under attorney-client privilege. 

2. Record a paper trail, including documentation of events and correspondence from all involved parties. Paperwork protects the facility, administrators, medical directors, and you.

3. Keep talk to a minimum. Appoint a few, knowledgeable people to the case so work is quick and effective. Talk about cases with relevant committees, governing boards, and lawyers. Go into executive session to discuss lawsuits in order to protect minutes from the meeting.

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