Risk Management and Pediatric Patients

Risk Management and Pediatric Patients
There are serious risks involved in hospitalization, especially for pediatric patients who cannot articulate specifics about how they feel, and how those feelings are changing. Each year, more patients die of hospital-caused infections, medication errors, and other adverse events than from any other cause. One of the most critical reasons for this is the worldwide shortage of qualified nurses. Many patients’ deaths or injuries can be traced directly to the problem of short staffing. Another factor adding to the problem is the concept of risk management used by many hospitals, and its current focus.

Families whose patient suffers death or injury rapidly become acquainted with the hospital’s Risk Management staff. In the distant past, RM was primarily concerned with finding and rectifying errors that might cause harm to patients, often before such harm resulted. Risk Management supervisors were frequently healthcare providers who had moved into administration, and they acted as quality assurance [QA] for the hospital.

But in recent years, as movie star Dennis Quaid found when his 2-week-old twins nearly died as a result of a series of egregious medical errors, Risk Management has changed its focus, and now primarily deals with damage control for the hospital, rather than for the patient. Mr. Quaid told the press that not only did the hospital staff not inform him of the twins’ critical condition during the night, but that he and his wife were met by Risk Management first when they returned to the hospital after taking a brief break to sleep.

These days, at most facilities, it is the lawyers in Risk Management who take control when there is an incident or problem that might result in the hospital’s being sued. Most attorneys advocate the “admit no wrong” position, which can be harmful to patient and family, while protecting the hospital from liability. When the hospital is engaged in damage control, information needed by family and patient sometimes does not get timely disseminated.

The reasons for this change are many, but most of them are related to the fact that the focus of health care provision has changed. Health care provision has become big business, an industry, rather than a calling. The focus has changed from quality assurance, i.e. managing and reducing risks to patients, to damage control, i.e. managing and reducing risks to the hospital. Perhaps that explains why the hospital caring for the Quaid twins neglected to quickly inform their parents when their condition went bad as a result of the administration of the wrong drug.

You can no longer rely on the hospital to tell you when mistakes have been made, or to alert you to a problem caused by the hospital. As a result, it is up to you to be the risk manager for your family. Your primary goal will be prevention – not damage control. Armed with the information in this and the related articles, you will be better able to protect your children and your family from the tragic consequences of hospital-caused infections, medication errors, and other adverse events.

See the related articles “Preventable Pediatric Medication Errors,” “Preventable Pediatric Nursing Care Errors” and "Basics of Protecting Your Child in the Hospital" for additional information on this problem.

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