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Healthcare providers need to focus on risk management as malpractice claims to home nurses grow

Home nurses are often more sensitive than nurses in other nursing disciplines when it comes to malpractice claims.

That is a fact that has been true for some time. Home nurses, including home care, hospice, and palliative care professionals, have seen a steady increase in professional liability claims since 2011.

Overall, home care accounted for more than 20% of total closed claims against nurses in 2020. This is a sharp increase from 12.4% in 2015 to 8.9% nine years ago. CNA Healthcare Underwriting and Nurse Services Organization (NSO).

In contrast, according to the report, professional liability to nurses in other areas of aging services (independent living, assistive living, memory care, skilled nursing) accounted for only 11.2% of 2020 claims. did.

Georgia Reiner, a risk specialist at NSO, told Home Health Care News that there are several factors that contribute to why home care has more malpractice claims than any other nursing specialty.

For one thing, the eyesight of patients receiving care at home is increasing. This is a trend that only accelerated in 2020 due to the general increase in COVID-19 virus and home hospital models.

“In this country, as the baby boomer generation ages and more patients want to age on the spot, more and more elderly people are at home,” Reiner said. “Some medical institutions are also encouraged to leave patients from hospitals and nursing homes as soon as possible.”

Matt Wolf, a partner at law firm Parker Po, reiterated these feelings, noting that the increase in claims was likely related to the continued shift of the healthcare system to home. .. In addition to the home hospital program, the shift includes home SNF models, home cancer treatment initiatives, and more.

“I think this reflects the fact that more services are being offered in home and community-based environments. I think this is good for both patients and our healthcare system. “I will,” Wolff said. HHCN.

Another factor contributing to the surge in claims: Home-based nurses often lack the institutional support of corresponding nurses in hospitals, skilled nursing facilities (SNFs), and other healthcare institutions. ..

“This may mean that there are few providers available to help us seize important opportunities to prevent adverse events in our patients,” Reiner said. “And fewer technologies are available at home to help seize important opportunities to prevent patient adverse events, and fewer providers can share responsibility in the event of a patient problem. I will. ”

Reiner also pointed out that most of the care done at home is provided by unlicensed assistants and CNAs. This puts more responsibility on home nurses such as RNs, LPNs, and LVNs for the overall care of patients.

crisis management

The findings of the CNA Healthcare Underwriting and NSO reports show that more focus should be placed on what home care providers can do to manage risk.

“Risk management is more important to the mission of the institution than anything else,” Wolff said. “This includes HR, customer service, and clinical practice. In the first place, you need to make sure you’re dealing with the problem or preventing bad events from happening.”

According to Wolfe, there are many things providers can do to manage risk.

For example, good hiring practices allow agencies to hire the most qualified job seekers. A powerful training program ensures that home nurses have all the education and tools they need to succeed.

Similarly, maintaining regular monitoring practices can help detect bad habits and small hiccups of home care staff. This can be fixed immediately.

In addition, providers need to work closely with their malpractice carriers, Wolff emphasized.

“There’s a lot you can do between the occurrence of an adverse event and the filing of a claim,” he said. “I think it’s really important to double the effort towards that agreement. I find and actually find the best way for government agencies to work with malpractice carriers to address these issues. Is strongly advised to try to resolve the dispute before it reaches the alleged level. “

Finally, nurses can take some steps to reduce the likelihood of malpractice claims.

“I think nurses can individually see what they are doing within their limits,” Wolfe said. “They can make sure they are in contact with their doctor or the doctor who has signed the care plan.”

Nurses can also work together to communicate regularly with their offices and administrative staff. If there are concerns about work, the nurse should “speak immediately” and document the concerns, reaffirming that the intervention is appropriate.

Reiner also emphasized the importance of patient evaluation and documentation for nurses.

“In addition to screening at service launch, reassessment should be done at least every 6 months, or whenever the patient’s condition or needs change,” she said. “All of these assessments and reassessments should be documented, including other individuals who may have participated in the process beyond the nurses themselves. Even if there are changes in the patient’s condition, the patient’s You need to trigger a revision of your service plan. “

Nurses should also pay attention to their obligation to delegate to unlicensed assistants and caregivers. According to Reiner, this will prevent providing clinical care that exceeds training and regulatory limits.

Ultimately, it is important to recognize that malpractice claims are part of belonging to the healthcare sector.

“You can’t do anything to eliminate the risks, but whether you’re a nurse, agency manager, or owner, there’s a lot you can do to mitigate these risks so you can get a good night’s sleep. “Wolf said.

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