Four risks healthcare executives should monitor in 2018

The healthcare industry saw big changes in 2017. While the debate over the ACA dominated the headlines, it was just the tip of the iceberg as consolidation continued at rapid speed, prescription practices came under scrutiny and the country embarked on a discussion about healthcare costs.

If hospital and healthcare executives thought 2017 was busy, they are in for a rollercoaster of 2018. Fortunately, while this year was marked by several unforeseeable developments, the 2018 forecast looks more predictable, especially as it relates to emerging medical liability exposures. With the right preventions in place, hospitals and healthcare executives will be well positioned to respond.

 Here’s four things you should know. 

     1.     The opioid crisis isn’t going away.

The United States is in the middle of an opioid epidemic, with the Centers for Disease Control and Prevention (CDC) reporting more than 33,000 opioid-related deaths in 2015. More startling is that CDC data indicates nearly half of all opioid overdose deaths involved a prescription opioid.

Given the link between overdoses and legally prescribed opioids, providers face growing scrutiny over their prescription behavior, especially sub-standard practices like failing to consider alternative treatments or obtaining informed consent. If a patient is harmed or injured, providers can potentially face both professional and criminal liability.

With no community left untouched by the crisis, every healthcare organization should develop an opioid prescription risk management plan for 2018. This six-part plan is an effective approach to curbing exposure and should begin with designating a clinical leader responsible for the oversight of pain management and safe opioid prescribing across the organization. Other elements should include:

·      Level-specific recommendations for educating clinicians about safe opioid use.

·      Guidelines for safe opioid prescribing and dosing for post-operative and chronic pain.

·      Criteria for screening and assessing patients for addiction exposure based on diagnosis, planned treatments and risk for respiratory depression upon admission.

·      Resources for patient education on safe opioid treatment, including risks, side effects, potential for sedation, the danger of polypharmacy, and safe storage and disposal at home.

·      Protocols for handling patients with drug-seeking behavior who present in the emergency department, including how to assess red flags that could signal misuse.

     2.     Missed and/or delayed infection diagnoses can lead to catastrophic injuries.

An infection, if caught early, can usually be treated with antibiotics. In some cases, however, an undiagnosed infection can lead to sepsis and devastating consequences, including amputations, organ damage, paralysis and even death.

This is a meaningful challenge providers must contend with. To put it in perspective, the CDC reports that 1.5 million people in the U.S. develop sepsis each year, leading to 250,000 deaths annually. Data also indicates that one-in-three patients who die in a hospital have sepsis. These numbers expose providers to potential liability, which can lead to multi-million dollars in financial settlements, as well as unquantifiable damages tied to unwanted media attention and reputation damage.

Developing an effective infections prevention strategy is critical to reducing this exposure. This strategy should include resources for supporting ongoing infection surveillance, data collection and analysis. Clinical training and education are also important, particularly around triage, early recognition and intervention, and treatment best practices. With so much at stake, healthcare organizations should put infection control and prevention at the top of their risk management and patient safety 2018 agenda.

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