Inappropriate or negligent behavior that can be tied to the responsibilities of another caregiver increase that caregiver's risk of being named in a malpractice action.

Physicians who are actively engaged in clinical practice are always at risk for claims of malpractice based on the behavior of nurses and other employees. Nurses are rarely held legally accountable for the actions (or inactions) of their physician co-workers, but they, too, can be named in malpractice claims. Paying close attention to the following activities by other caregivers involved in your patients' care can reduce the likelihood of events leading to potential claims:

Documentation

• Make certain that the assessment of patient status written in the medical record matches the clinician's observations. Avoid inappropriate affixing of medical diagnostic labels to observations.
• Review descriptions of iatrogenic injury placed in the medical record for inappropriate assignment of blame or which assign causation to iatrogenic events without supporting data such as: "burn due to electrocautery," "elevated temperature due to complications of surgery," or "low Apgar due to anoxia."
• Seek translation of illegible medical orders which can be misinterpreted and/or misunderstood.
• Reconcile conflicting medical orders from a variety of specialists.
• Question apparently inappropriate medical orders.

Communication

• Follow up on any critical diagnostic test results which are not reported and/or noted in the medical record in a timely fashion.
• Do not share negative, inappropriate information about a colleague with patients/staff.
• Track patient phone calls to make certain an appropriate response is made.
• Establish guidelines for telephone advice so that it is given with sufficient experience, protocols, and documentation.

Supervision

• Insist that appropriate supervision is sought by those carrying out delegated medical functions.
• Evaluate the clinical competence of those delegated to carry out particular medical functions.

Problems that arise in these areas which alter or disrupt patient care need to be resolved by those directly involved. Addressing interpersonal conflicts early on can avert having to face the consequences of letting them escalate into an area of potential liability.

Additional Resources

1. Closed Claim Abstract: Communication Among Providers
2. Can Teamwork Enhance Patient Safety? [PDF]
3. From Theory to Practice: An Interview with Dr. Michael Leonard [PDF]
4. I'm a Surgeon, Not a Teammate [PDF]