Training & Mitigating Liability: 2 Case Studies & 2 Things You Can Do Today in Your Practice
A new technician performing Goldmann Tonometry
Training your staff is critical for patient care AND medical liability risk management.
Case 1:
A scribe is documenting a plan for the provider. The provider called out to the scribe that he wanted the patient to start prednisolone eye drops OD, a corticosteroid used to treat inflammation in the eye. Instead, the scribe documented “prednisone”, also a corticosteroid. but typically used systemically for various autoimmune conditions. The scribe E Rx’d a Medrol dose pack.
This medical error error was not found until the patient’s follow up appointment. Once discovered, the scribe stated she had not heard of “prednisolone” but knew about prednisone, so she thought the provider had dictated that instead.
Case 2:
An ophthalmic technician was prepping a patient for a Yag laser. After referring to the chart, she consented the patient for a Yag capsulotomy in the right eye. The patient said “it’s not my right eye, it’s my LEFT eye.” The tech looked at the chart again and saw that OD was documented as the surgical eye. She told the patient it was indeed the right eye which was planned for the laser. She prepped and consented the right eye and never mentioned the discrepency to the surgeon. Instead, she sat the patient at the Laser with an orange sticker above the right eye and the laser procedure ensued.
The scribe had scribed the wrong eye. The patient’s worse PCO was OD>OS, so the right eye was to be done first, then the other.
Upon investigation it was discovered that the scribe wrote the wrong eye in the plan. Thankfully, it did not harm the patient but it was a medical error nonetheless. The real failure was the the tech at the surgery center who did not bring everything to a screeching halt when there was a question about the site and side of the surgery.
The patient was angry and never showed for follow up.
Did You Know?
Many malpractice carriers offer 2-5% discounts on your premiums when you have documented training? This discount alone would more than pay for professional training. Reach out to Eye Tech Training and ask how we can help your technicians learn and grow so they orovide the best data to your doctors.
What You Can Do Today:
Have a staff meeting and share these cautionary tales. Let your surgical staff and surgery scheduler know if the patient EVER has a question that everything STOPS. A time out is a must. Even for minor procedures.
Make a policy that scribes must VERBALLY REPEAT medication names and instructions to the provider before the patient leaves the exam room.
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