Transcript Effective Risk Management Strategies in Outpatient

Effective Risk Management
Strategies in Outpatient
Methadone Treatment: Clinical
Guidelines and Liability
Prevention Curriculum
MODULE 3
The Relationship between Risk
and Practice in the OTP
OTP Ideal Standard of Care
From admission, each patient receives:
• Individualized clinical care
 Ongoing
 Documented
• Competent staff
• Good clinical judgment
 OTP clinical practice standards
 Incorporating best- and evidence-based practices
* Adapted from CSAT Workshop on Risk Management - 2005
OTP Core Liability
Failure to:
•
*Borrowed from CSAT Workshop
on Risk Management-2005
 Document
 Communicate risks
 Review and correct
 Consider what’s “reasonable”
and “foreseeable”
 Assess for impairment
 Attend to RED flags
Informed Consent
Informed Consent for OTPs
Patients should understand:
▫ Basic science of addiction
▫ Methadone treatment
 Benefits
 Risks
 Alternatives
The Right Thing to do: Phased
Informed Consent
Consents: A Valuable RM Tool
• Providing information via consents may
increase and motivate patient involvement in
treatment
• Phased informed consent
▫ Helps share or “transfer” risk
▫ Provides patient buy-in
▫ Identify understanding and comprehension
related to treatment
Added
at Admission
Integrate Patient’s
Family
Impairment-A Severe
Exposure
• Trends show impairment as an increasingly
likely factor in more claims filed against OTPs
High Risk for Impairment
• During the induction process
• Drug-Drug interactions with methadone
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Benzodiazepines
Alcohol
Cocaine
Other sedative-hypnotic medications
Muscle relaxants
Do Not Bury your
Head in the Sand
• Duty to take action
• Duty to warn
In Summary
• DON’T IGNORE
• Duty to warn
• Duty to make reasonable inquiry and assess
• Obtain Phased Informed Consent
• Document, document, document