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Tough Call: Patient Care via Telephone

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Tough Call: Patient Care via Telephone

By Jock Hoffman, CRICO

Related to: Ambulatory, Communication, Diagnosis, Primary Care, Nursing

Health care constantly intersects with challenging decisions, perhaps none more unsettling than the choice between waiting, or acting on an ambiguous presentation. If the patient is not physically present (e.g., on the phone or emailing), then the provider has even fewer cues to guide that decision. When the remote communication of history, symptoms, and status involves third parties (parent, interpreter, answering service, etc.) the risks associated with making a “wait” or “don’t wait” decision increase significantly. Such situations are even further complicated if the patient (or spouse or parent) is hesitant to leave home for the doctor’s office or the nearest emergency room barring a sense of urgency. Physicians and nurses who routinely have remote care encounters are encouraged to review this case study from a recent CRICO malpractice claim.

Malpractice case studies present an important opportunity for providers to learn by exploring what went right, what went wrong, and what could have been done differently. Although these cases often represent negative and emotionally charged circumstances, positive learning can emerge from examining them. Staff from CRICO’s Patient Safety Department continually select and develop case studies (of closed claims or lawsuits) that offer teaching opportunities. More than 75 such case studies are available. Clinician facilitators who choose to incorporate abstracts from malpractice claims into their clinical presentations may want to read the suggestions offered in 10 Tips for Presenting Closed Claims Abstracts for Grand Rounds.

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February 29, 2012
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