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From The Resource Line

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Risk Resource Line
1-866-Rx4-RISK

General Liability>>

February 2012

Avoiding Slips, Trips & Falls
at Your Practice

Most healthcare providers are aware of common slip-and-trip hazards. However, familiarity with your environment may have allowed you to adjust, making it easy to overlook, or even to not notice, situations that can cause injury to others less familiar with the surroundings. In this article we will examine the mechanics, environment and client profile that lead to injuries, and we will provide strategies to improve the safety of your office setting.

Read the full story »

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RISK ALERT UPDATE>>

February 2012

Risk Alert:
Physician Assistants Performing EMGs

In Summer 2010, we published a Risk Alert reporting on a recent court's decision which concluded that physician assistants are not legally permitted to perform EMG tests, nor are they authorized to assist a duly licensed physician in performing the procedure if the assistance consisted of actually inserting the needle electrode into the muscle (per EMG statute (N.J.U.S.A. 45:9-5.2(a)). The case was appealed and very recently, the supreme court upheld this decision.

Read the original Risk Alert here »

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Risk Management>>

January 2012

Psychiatrists & Psychologists:
Failure to Diagnose

When is a medical condition masquerading as a behavioral health issue? Or conversely, how does one discern when mental health symptoms are obscured by a presentation of physical ailments?

The challenge is something akin to the question of which came first: the chicken or the egg?

Read the full story »

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Risk Management>>

January 2012

Dentistry: Diagnosing Diabetes

A recent report titled “Identification of unrecognized diabetes and pre-diabetes in a dental setting” published in the Journal of Dental Research (July, 2011) finds that patients with certain dental conditions may be at greater risk for the disease.

Read the full story »

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News

December 2011

Now available!

The Chiropractic Office Practice Toolkit

Available exclusively for Princeton policyholders, the Chiropractic Office Practice Toolkit was created to assist chiropractors and office staff with risk management needs. Within the toolkit are risk management guidelines, reproducible forms, and helpful checklists.

Designed to assist you and your staff to better negotiate the malpractice litigation hazards that exist in office settings, the toolkit features ideas for policy and procedure development and simple fixes for the issues that are driving litigation, settlements and verdicts.

To access the toolkit, chiropractors must have an account on the policyholder secure site at www.PrincetonInsurance.com. Go to our home page and look for “Policyholder Log In” in the upper-right corner. Once logged in, you will be able to access the toolkit. If you haven’t yet created an online account, follow the prompts on the screen.

Should you have problems registering, call our Help Desk at 609-452-9404 ext. 5333 (someone will be able to assist you Monday through Friday, 8:30 a.m. to 4:30 p.m.). If you have questions regarding the toolkit, please call our Risk Resource Line at
1-866-Rx-4RISK (1-866-794-7475).

Go to PrincetonInsurance.com now to access your toolkit »

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Risk Management>>

December 2011

Risk Alert

When an emerging topic becomes particularly prominent in our day-to-day interactions with healthcare providers, our physician risk consultants will issue a Risk Alert in order to spread awareness of the issue. In this Risk Alert, our staff discusses ways to avoid patient injury when dealing with hot liquids in the ambulatory setting.

Hot Liquids: Avoiding Patient Injury

Burns or scalds attributable to hot beverages pose a serious concern for any organization providing food service to consumers. This concern is particularly worrisome for healthcare facilities treating already physically compromised patients....

Read the full story »

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Risk Management>>

October 2011

Part 3 in a 3-part series

The Use of Diprivan (Propofol) in GI Procedures

As the Conrad Murray trial becomes more complex and prosecutors delve deeper into the events leading up to the death of Michael Jackson, awareness of the drug propofol, its uses and contraindications is increasing in the public eye. In this the third and final article of our three-part series, we examine the current state of affairs in terms of who is administering propofol in healthcare settings throughout the country and offer an analysis of the pros and cons for using gastroenterologist-directed propofol (GD-P).

Read the full story »

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News

September 2011

Changes coming to Risk Review Online
Current site will give way to more searchable, readable content

Risk Review Online, the exclusive risk management and patient safety site of Princeton Insurance, is getting a face lift! As you may have already noticed, we are in the midst of transitioning from a quarterly newsletter to a new format that allows for quicker reading, more frequent updates and improved delivery of timely information on a variety of topics that our policyholders can use to avoid risk and employ best patient safety practices. In the coming months you will notice even more changes as we move to the final design. Eventually we hope to encourage dialog through the use of comment boxes at the end of each story as well as offer better search capabilities by tagging each article with related terms, dates and categories.

Articles appearing in Risk Review Online are written primarily by members of the Princeton Insurance Healthcare Risk Services Department, ranging from such professional liability topics as communication breakdowns to specialty-specific risk management guidance, claims analyses and more. The site also features our responses to questions received through our healthcare risk resource line, in addition to information about continuing education opportunities.

Risk Review Online archives dating back to 2006 will be fully searchable, and all articles can be downloaded and saved as PDFs for easy sharing and printing.

As always, feel free to contact our Healthcare Risk Services Department or call our Healthcare Risk Resource Line at 1-866-Rx-4RISK if you have a question about a risk management/patient safety issue or have a topic you’d like us to cover on the site.

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Risk Management>>

September 2011

Part 2 in a 3-part series

The Use of Diprivan (Propofol) in GI Procedures

In the first part, which you can read here, we discussed the background of the issue relating to Propofol and who should administer it – gastroenterologists (non-anesthesiologists) or strictly anesthesiologists. The warning label debate, involving the ACG and the ASA, took an interesting turn when the FDA got involved and spoke out in support of keeping the label. Per their standards, individuals administering moderate or deep sedation and anesthesia must have the appropriate credentials to manage patients at whatever level of sedation or anesthesia is achieved. They assert that those practitioners must be qualified

to rescue patients from general anesthesia and be competent to manage an unstable cardiovascular system as well as a compromised airway and inadequate oxygenation and ventilation and that a sufficient number of qualified personnel must be present during the procedure to provide moderate or deep sedation.

Read the full story »

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News

September 2011

Experts speak about the increasing need for safe injection practices in the healthcare setting

On Thursday, September 8, registered nurses, physicians, and other practitioners and staff from various healthcare settings gathered at the NJ Hospital Association Conference & Event Center despite flooded roadways throughout the state to learn about safe injection practices at a conference hosted by the New Jersey Department of Health and Senior Services (NJDHSS) in collaboration with Health Research & Educational Trust of New Jersey.

Read more (PDF)

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General Liability>>

September 2011

Unexpected Medical Record Damage:
protecting your records when water rushes in

Accidents or unexpected disasters can result in extensive water damage to important documents such as medical records and X-ray films. New Jersey has seen its share of flooding, including the most recent damage from Hurricane Irene and subsequent heavy rain. Broken water pipes or an overflowing floor drain can cause unexpected damage to stored medical records in a basement or storage room...
Read the full story »

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Risk Management>>

August 2011

Part 1 in a 3-part series

The Use of Diprivan (Propofol) in GI Procedures

Diprivan (generic name, Propofol) sparked public interest following the June 2009 sudden death of pop star Michael Jackson, who, as widely reported, died of cardiac arrest following the administration of a combination of Propofol and two other benzodiazepines at his home by his personal physician for the treatment of insomnia. Clearly, this is not an appropriate indication or setting for the drug. Propofol is used

most commonly to...

Read the full story »

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Risk Management>>

July 2011

Communication Breakdown among ED Providers

Communication breakdown – especially among practitioners – is one of the major contributors of claims arising in the Emergency Department (ED).

Perhaps nowhere else in the medical community is communication more vital than for the physicians practicing medicine in this demanding and unforgiving environment...

Read the full story »

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From The Resource Line>>

July 2011

An ED physician asks:
What guidance can Princeton Insurance provide regarding "Bridge Orders"?

Answer: This is a great question as we often hear that there can be some confusion between an “order to admit,” an “admission order” and “bridge orders” (which are more commonly referred to as “transition orders”). First, let’s differentiate between the meanings of these terms...

Read the full story »

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Risk Management

June 2011

Don't Forget to Prepare Your "Snowbird" and "Sunbird" Patients

The number of people age 65 or older will grow to 70 million by 2030 according to the Gerontological Society of America, and more and more physicians will be involved with treating seasonal patients. Today’s seniors are more mobile and generally speaking begin to migrate south starting in early November or after the holidays, returning in late April or May for the reverse migration back to the north. This cycle is repeated every year in increasing numbers...

Read the full story » (PDF)

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General Liability

June 2011

Guide to Conducting a Post-Winter Building Inspection

We all suffered through an extremely harsh winter here in New Jersey. Snow, ice, wind and rain can affect the physical condition of your office and property over time. Extreme weather conditions can lead to potential risk exposures, creating unsafe conditions for your patients, staff and building. Now that warmer weather has finally arrived, we recommend that you perform a survey of your office and property’s condition...

Read the full story » (PDF)

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WEBINAR NOW AVAILABLE ONLINE
A CME Opportunity

Risk in the Ambulatory Setting:
An Examination of Emerging Claim Trends in Outpatient/Ambulatory Care

Princeton Insurance, in conjunction with CRICO/RMF*, presents a one-hour webinar free-of-charge, exclusively for Princeton Insurance physician policyholders.

Participants may earn a maximum of 1 AMA PRA Category 1 Credit(s).

Click here to learn more and access the webinar.

*CRICO/RMF is accredited by the Accreditation Council for Continuing Medical Education to provide continuing medical education for physicians.

CRICO/RMF designates this enduring material for a maximum of 1 AMA PRA Category 1
Credit(s)™. Physicians should claim only the credit commensurate with the extent of their participation in the activity.

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Are you registered at PrincetonInsurance.com?
Our insured secure site features exclusive policyholder risk resources like the Physician Office Practice Toolkit. Go there now to check it out and get all the benefits: princetoninsurance.com.

Princeton Insurance becomes a Medical Protective company
Read the press release here.

This Web site is designed to provide information for guidance purposes in regard to the subject matter covered. While all materials presented herein are carefully researched, no warranty, guarantee or representation, either expressed or implied, is offered as to the accuracy of this information. This Web site is created with the understanding that neither Princeton Insurance nor any of its employees are engaged in rendering medical, or legal advice or service. If medical or legal advice or assistance is required, then the services of an appropriate professional person should be retained.