patient not safe at home who does doctor report to

If a patient slips and falls, most hospitals and nursing homes require their staff to document the fall and notify family members or caregivers. The mechanism for recording and reporting a patient fall will vary depending on the state and the in-house mechanism the healthcare facility uses.

Full Answer

Can a physician refuse to authorize a patient to report?

Exceptions can be made if a physician reasonably believes that a patient’s refusal to authorize reporting is coerced and therefore does not constitute a valid informed treatment decision. Physicians should also protect patient privacy when reporting by disclosing only the minimum necessary information.

Can you sue a doctor and keep their information confidential?

The act of filing a lawsuit and making this information public is treated as express consent for the doctor to disclose confidential information regarding the treatment at issue. You can’t sue a doctor and then use confidentiality to prevent them from defending the allegations.

Are patients in your exam room being abused?

Patients in your exam room may be experiencing one of a number of forms of abuse—domestic violence, human trafficking or other violence—and identifying those being abused can sometimes be tough.

What are some of the patient safety situations causing most concern?

Below are some of the patient safety situations causing most concern. Medication errors are a leading cause of injury and avoidable harm in health care systems: globally, the cost associated with medication errors has been estimated at US$ 42 billion annually (10).

What is considered neglect of a patient?

Neglect includes the failure to properly attend to the needs and care of a patient, or the unintentional causing of injury to a patient, whether by act or omission.

Who is responsible for protecting patients individually identifiable health information?

All health care providers considered “Covered Entities” under HIPAA (most are) are responsible for complying with the two related rules of HIPAA: Privacy52 and Security53. The HIPAA Security Rule sets out specific protections that all covered providers must follow to protect health information.

Who owns the patient health record and who controls the use of the information within the record?

Your physical health records belong to your health care provider, but the information in it belongs to you. Having ownership and control over that information helps you ensure that your personal medical records are correct and complete.

What should be reported to the Joint Commission?

Quality Reports include:Accreditation decision and date.Programs and services accredited by The Joint Commission and other bodies.National Patient Safety Goal performance.Hospital National Quality Improvement Goal performance.Special quality awards.

Who is the owner of the patient record?

Although the medical record contains patient information, the physical documents belong to the physician. Indeed, the medical record is a tool created by the physician to support patient care and is an asset of the practice.

Who owns the medical records or the patient's chart?

doctorsTraditionally, a patient's medical information has been segmented into charts that exist in various places – the offices of the doctors involved, hospitals, etc. Each doctor's chart is a medico-legal record of the advice given to the patient by the doctor, resides in the doctor's office, and is “owned” by the doctor.

Who is responsible for a patient's healthcare record and why?

There are 21 states in which the law states that medical records are the property of the hospital or physician. The HIPAA Privacy Rule makes it very clear that, with few exceptions, patients should be given access to their records, in a timely matter, and at a reasonable cost.

Who is able to contact The Joint Commission to report a serious safety concern?

The public can also submit a complaint to The Joint Commission via The Joint Commission's website: www.jointcommission.org. Scroll down to “Filing a Complaint.” The Joint Commission also has a complaint telephone number at (800) 994-6610 where you can speak to a Joint Commission representative.

What is considered a patient safety event?

A patient safety incident is any unplanned or unintended event or circumstance which could have resulted or did result in harm to a patient. This includes harm from an outcome of an illness or its treatment that did not meet the patient's or the clinician's expectation for improvement or cure.

What does JCAHO look for?

Surveyors from JCAHO will ask questions that relate to their top priorities, including: Improving patient identification. Improving communication between caregivers. Improving accuracy of drug administration.

What chapter is Patient Safety and Quality in Home Health Care?

Chapter 13 Patient Safety and Quality in Home Health Care

How do individual patient variables affect home health care?

In addition to deliberate choices made by informed and capable patients regarding their care, individual patient variables may also influence home-based outcomes in ways that are different from those patients who are hospitalized . Ellenbecker and colleagues10, 11reported that reading skill, cognitive ability, and financial resources all affect the ability of home health care patients to safely manage their medication regimens. Yet, none of these variables may play a meaningful role in the safe administration of medications to hospitalized patients.

Why is home health important?

Home health care clinicians seek to provide high quality, safe care in ways that honor patient autonomy and accommodate the individual characteristics of each patient’s home and family. Falls, declining functional abilities, pressure ulcers and nonhealing wounds, and adverse events related to medication administration all have the potential to result in unplanned hospital admissions. Such hospitalizations undermine the achievement of important home health care goals: keeping patients at home and promoting optimal well-being. Nevertheless, the unique characteristics of home health care may make it difficult to use—or necessary to alter—interventions that have been shown to be effective in other settings. Therefore, research on effective practices, conducted in home health care settings, is necessary to support excellent and evidence-based care.

What is the goal of home health care?

A primary goal of home health care is to discharge the patient to self or family care and avoid subsequent hospitalizations. Unplanned admission to the hospital is an undesirable outcome of home health care that causes problems for patients, caregivers, providers, and payers. Unplanned hospital admissions are associated with complications, morbidity, patient and family stress, and increased costs.31An estimated 1,034,034 home health care patients were hospitalized in 2004. The national rate of unplanned hospital admissions for home health care patients has gradually increased from 27 percent in 2000 to 28 percent in 2006,32and it is the only publicly reported home health care patient outcome that has never improved at the national level.33

What is the most common adverse event for home health care?

Emergent care for injury caused by falls or accidents at home is one of the most frequently occurring adverse events reported for patients receiving skilled home health care services.19Thirty percent of people age 65 and older living in the community fall each year. One in five of these fall incidents requires medical attention.20Falls are the leading cause of injury-related death for this population.21Among the elderly, Stevens22reported direct medical costs in 2000 totaled $179 million for fatal fall-related injuries and $19 billion for nonfatal injuries due to falls.

How does home health care differ from hospitals?

The home health care environment differs from hospitals and other institutional environments where nurses work. For example, home health care nurses work alone in the field with support resources available from a central office. The nurse-physician work relationship involves less direct physician contact, and the physician relies to a greater degree on the nurse to make assessments and communicate findings. Home health care nurses spend more time on paperwork than hospital nurses and more time dealing with reimbursement issues.8, 9Certain distinctive characteristics of the home health care environment influence patient safety and quality of outcomes: the high degree of patient autonomy in the home setting, limited oversight of informal caregivers by professional clinicians, and situational variables unique to each home.

What are the characteristics of home health care?

Another distinctive characteristic of home health care is that clinicians provide care to each patient in a unique setting. There may be situational variables that present risks to patients that may be difficult or impossible for the clinician to eliminate. Hospitals may have environmental safety departments to monitor air quality and designers/engineers to ensure that the height of stair risers is safe. Home health care clinicians are not likely to have the training or resources to assess and ameliorate such risks to patient safety in the patient’s home.

What is the Westat project?

Based on a scan of peer-reviewed and grey literature and subject matter expert interviews, the project examined safety issues in the home, including challenges, funding mechanisms to support safe home care, and conceptual frameworks that seek to structure these disparate issues. This report concludes with opportunities for research to advance the science of patient safety improvement in the home.

How long has the IHI Forum been around?

The IHI Forum is a four-day conference that has been the home of quality improvement (QI) in health care for more than 30 years. Attend this year's conference virtually or in-person.

Why is the health care system shifting away from inpatient care?

The health care system continues its shift away from its historically predominant focus on inpatient care, driven by economics, demographics, patient preference, and technology. Yet patient safety in the home care setting is less well understood than patient safety in other settings.

What are the challenges of patient safety in the home?

Challenges related to patient safety in the home are wide ranging and include fragmentation of care; household hazards; ill-prepared family caregivers; limited training and regulation of home care workers; inadequate communication among patients, caregivers, and providers; and misaligned payment incentives.

What are the three actionable recommendations to improve workforce safety?

This article describes three actionable recommendations to improve workforce safety. Telemedicine: Center Quality and Safety.

Why is it important to have a safety plan?

Maintaining a powerful safety program is essential to the long-term health of your department, organization, or health care system — and to ensuring that your patients receive the safe and reliable care they deserve. To position your organization for success, attend IHI’s Patient Safety Executive Development Program.

What are the elements of a telemedicine framework?

The framework includes six elements to consider: access, privacy, diagnostic accuracy, communication, psychological and emotional safety, and human factors and system design.

Why does patient harm occur?

For example, a patient in hospital might receive a wrong medication because of a mix-up that occurs due to similar packaging. In this case, the prescription passes through different levels of care starting with the doctor in the ward, then to the pharmacy for dispensing and finally to the nurse who administers the wrong medication to the patient. Had there been safe guarding processes in place at the different levels, this error could have been quickly identified and corrected. In this situation, a lack of standard procedures for storage of medications that look alike, poor communication between the different providers, lack of verification before medication administration and lack of involvement of patients in their own care might all be underlying factors that led to the occurrence of errors. Traditionally, the individual provider who actively made the mistake (active error) would take the blame for such an incident occurring and might also be punished as a result. Unfortunately, this does not consider the factors in the system previously described that led to the occurrence of error (latent errors). It is when multiple latent errors align that an active error reaches the patient.

What is medication without harm?

Medication Without Harm (2017); with the aim of reducing the level of severe, avoidable harm related to medications globally by 50% over five years.

How many hospitalized patients have health care-associated infections?

Health care-associated infections occur in 7 and 10 out of every 100 hospitalized patients in high-income countries and low- and middle-income countries respectively (11).

What is clean care?

Clean Care is Safer Care (2005); with the goal of reducing health care-associated infection, by focusing on improved hand hygiene.

How many patients are harmed in primary care?

Globally, as many as 4 in 10 patients are harmed in primary and outpatient health care. Up to 80% of harm is preventable. The most detrimental errors are related to diagnosis, prescription and the use of medicines (6).

What is the WHO patient safety and risk management unit?

The Patient Safety and Risk Management unit at WHO has been instrumental in advancing and shaping the patient safety agenda globally by focusing on driving improvements in some key strategic areas through:

Why do millions of people die every year?

Every year, millions of patients suffer injuries or die because of unsafe and poor-quality health care. Many medical practices and risks associated with health care are emerging as major challenges for patient safety and contribute significantly to the burden of harm due to unsafe care.

Why do doctors ask about domestic violence?

But, doctors are supposed to ask – because this visit could be a brief window of opportunity to connect a victim to resources. Domestic violence has a major impact on people’s health.

When did the Institute of Medicine recommend screening for women?

The Institute of Medicine recommended screening for women in 2011, the U.S. Department of Health and Human Services followed suit. Two years later, the U.S. Preventive Services Task Force called on clinicians to screen women for partner violence.

Does Chayachati ask about domestic violence?

Chayachati doesn’t ask every patient about domestic violence. He looks for red flags, such as bruises, or black eyes. Several physicians told me they rely on their gut instinct, looking for clues that something else is wrong.

Do doctors ask if you feel safe at home?

Chances are, your doctor also asked you if you feel safe at home, or in your relationship, during a recent visit.

Do you ask your patients about their safety at home?

My husband and I shared the same PCP. After my first visit to the practice, no one ever asked me again whether I was safe at home. I wasn’t. But no one asked because everyone had met my husband, the handsome, charming life of the party. The guy that everyone liked. They all “knew” I was safe at home because he was “such a nice guy.” They knew him, you see. A nice guy like him couldn’t possibly be an abuser.

What to ask a patient about her husband?

Ask your patient if she is safe at home -- even if her husband is handsome and charming, well-dressed and well spoken. Ask even if you know her husband, he's the life of the party or you've worked with him for years. Ask because maybe you've only met Dr. Jekyll; she may be living with Mr. Hyde

Who is Ruby Vee?

Ruby Vee is an original Crusty Old Bat , and has written about the bravest thing she's ever done, what leaving feels like, the elephant in the room and about Alzheimer's. Humor is her nursing superpower, and one day soon, she's going to get that back.

Is a Hospital or Nursing Home Required by Law to Report Falls?

If a patient slips and falls, most hospitals and nursing homes require their staff to document the fall and notify family members or caregivers.

What are the different types of falls?

In most medical settings, falls are categorized as: 1 Accidental Falls: These are falls that happen among patients who have very low risk of falling, but they fall because of the environment they are in. They may fall out of bed or slip on a wet floor. 2 Anticipated Physiological Falls: These are the most frequent types of falls. They’re usually caused by an underlying condition affecting the patient. A patient may have a problem walking, their gait may be abnormal, they may be battling with dementia, or they may be on medication that is affecting their balance or their perception. 3 Unanticipated Physiological Falls: These are falls with patients who appear to be low risk for falls, however, they suffer a unexpected negative event. They may faint, they may have a seizure, or they may have a heart attack or a stroke. 4 Behavioral Falls: These are falls that happen because a patient becomes unruly or acts out for one reason or another. These includes instances where patients fall on purpose.

What is the mechanism for recording and reporting a patient fall?

The mechanism for recording and reporting a patient fall will vary depending on the state and the in-house mechanism the healthcare facility uses. Generally, mishaps such as falls are recorded in an incident report. After the fall, a nurse and a medical provider will likely perform an examination of the patient and document their findings.

What is an accident fall?

Accidental Falls: These are falls that happen among patients who have very low risk of falling, but they fall because of the environment they are in. They may fall out of bed or slip on a wet floor.

What percentage of hospitalized patients fall?

Research shows that up to 50 percent of hospitalized individuals run the risk of falling. Of those who do fall, 50 percent suffer injury. The injuries sustained from hospital falls range ...

Why do patients fall in hospitals?

In many cases, factors such as having beds in a high position, nurses failing to respond to patient calls, and environmental factors within the hospital ( e.g., a wet floor), increase the likelihood of a patient falling.

Why do elderly people fall?

Patient falls are seen with greater frequency among the elderly as a result of age-related health conditions, including delirium, musculoskeletal conditions, neurological conditions, and side effects from medication.

When Does a Doctor-Patient Confidentiality Apply?

The legal and ethical principle of doctor-patient confidentiality applies to all communications and information within a genuine doctor-patient relationship. The doctor-patient relationship exists whenever a person seeks medical advice or treatment from a doctor and have a reasonable expectation of privacy. The doctor-patient relationship and privacy expectation do need to be expressly stated or put in writing. The relationship and confidentiality can be implied based on the circumstances.

What is a breach of doctor-patient confidentiality?

A breach of doctor-patient confidentiality occurs whenever a doctor (or someone in the doctor’s office) discloses or releases patient information to a 3rd party without the express consent of the patient.

What are confidential medical records?

Confidential information and records include: 1 Any patient treatment-related information (including names) related to appointments, exams, assessments, medical procedures, referrals, diagnosis, or treatment options discussed with the patient 2 Doctor’s conclusions, opinions, or assessments related to patient 3 Medical records of any type including medical history, lab tests, x-rays, and other diagnostic imaging studies 4 Any communications between the patient and doctor or members of the doctor’s office staff.

What is confidentiality in medical?

The confidentiality of patient communications is not limited to conversations between patient and doctor. Confidentiality covers any statements or communications between a patient and other professional staff at the doctor’s office. Your medical records (e.g., medical history, doctor’s notes, diagnostics testing, lab reports, ...

Why is confidentiality important in healthcare?

Knowing that your doctor will keep your personal information confidential is absolutely necessary for effective medical evaluation, diagnosis, and treatment. Without this safeguard, patients would not feel free to disclose certain ...

What is a doctor-patient relationship?

The doctor-patient relationship exists whenever a person seeks medical advice or treatment from a doctor and have a reasonable expectation of privacy. The doctor-patient relationship and privacy expectation do need to be expressly stated or put in writing. The relationship and confidentiality can be implied based on the circumstances.

What is medical record?

Medical records of any type including medical history, lab tests, x-rays, and other diagnostic imaging studies. Any communications between the patient and doctor or members of the doctor’s office staff.

What to do if you don't discuss OB-GYN?

If you don’t discuss this subject with your OB-GYN, your primary care physician should ask similar questions and be able to help. It is crucial to figure out who around you can support you, and that you have a safety net in place when it’s needed most. Remember, to look after yourself is a heroic act.

Is domestic violence a topic?

Domestic violence is an important topic, one some have a hard time talking about, but you can trust that your doctors are here to help.

Do doctors ask if you are depressed?

Your doctor also may ask during your annual checkup if you are depressed. If the answer is yes that you are suffering from depression, your doctor will often ask if you have the support you need at home. Who are you around the most? What is your relationship like with this person? We want to try and determine the cause of your unhappiness.

Is an OB-GYN safe?

This means that whatever is discussed at a doctor’s visit will remain confidential. An OB-GYN or doctor’s office is a safe space to bring up what needs to be shared, especially circumstances of domestic violence and/or abuse. As OB-GYNs and physicians, we’re trained to assist you in these matters. Asking if things are okay at home is neither easy ...

Is it okay to ask if things are okay at home?

Asking if things are okay at home is neither easy to ask nor easy to talk about. But doing so conveys the importance of feeling safe in your home and being treated how you should be in your relationship. Never believe that you are unworthy or that someone else’s abusive behavior is your fault.

What to do if the DMV finds that the driver poses no safety risk?

do nothing (if the Department finds that the driver poses no safety risk), ask for further medical information, conduct a “ reexamination hearing ,” or. in rare cases, immediately suspend or revoke the person’s driving privileges. The DMV must notify the impacted driver in writing of its final decision.

How long does it take to get a DME in California?

This form requires the driver to provide the DMV with a comprehensive health history. The driver must complete and return the DME within 26 days. The driver has to sign the DME under penalty of prosecution for the California crime of perjury.

What happens if the DMV determines that the driver does not pose a safety risk?

The DMV will then review the DME. If it determines that the driver does not pose a safety risk, it will take no further action.

What happens after a driver report is received?

After receiving a report about a driver, the DMV will conduct an initial safety risk assessment of the driver.

Why is my driver's license suspended?

macular degeneration. These conditions are a common cause of driver’s license suspensions for elderly drivers. But drivers of all ages can be affected. Once the DMV receives a report from a physician regarding a driver’s inability to drive safely, it can take any of the following actions:

When do you need to inform the DMV of a mental illness?

Most states require physicians to inform the DMV when they diagnose a patient with any medical or mental condition that may affect the person’s ability to drive safely.

Where is the DMV hearing?

This is an in-person evaluation to determine if a driver has the physical and mental skills to drive a car safely. The hearing takes place at a local California DMV driver safety office and it is conducted by a DMV hearing officer. The hearing officer may do any of the following after conducting the hearing: