While there is no quick fix for the litigation crisis facing healthcare as a whole, a little bit goes a long way when it comes to attitudes.

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ast month, The Associated Press¹ published a brief yet thought-provoking article on medical mistakes and resulting litigation. The article, written by Ms. Lindsey Tanner, discussed a simple step toward heading off lawsuits: apologizing for errors. While this may seem like an unrealistic solution to the healthcare litigation crisis, some institutions, including the University of Michigan Health System, have noticed a difference since doctors have started owning up to their mistakes. The University of Michigan has seen a significant drop in annual attorney fees, malpractice lawsuits, and notices of intent to sue. The organization has been encouraging its doctors to apologize for mistakes since 2002. While an apology may not prevent someone from suing, it may help preserve relationships between patients and clinicians. Often, the patient being upset with the way in which the doctor or clinician handled the situation plays a bigger role in the decision to sue than the actual mistake.¹ “Sorry” may be the magic word in some circumstances, but much more is needed to make the litigation crisis disappear into thin air.
       While the result of a medical error or dissatisfaction with the care provided may lead one to sue, the quality of human care provided to patients, or lack thereof, may be the first warning bell for family members of patients in long-term care—possibly years before a lawsuit is considered. In her article, “Attitudes are Contagious: Is Yours Worth Catching?” Nancy Collins, PhD, RD, LD/N, provides a look at litigation through the eyes of an expert witness. Dr. Collins illustrates the importance of human care by giving examples of cases encountered in her practice. Two examples in particular will hit home. In one lawsuit, a patient’s son was asked “What are your complaints about the nursing home?” He described how the nursing home ignored his mother’s requests for toileting assistance. While visiting, his multiple requests for assistance for his mother were ignored, and he was told that it was “fine” for his mother to urinate in the bed and that the night shift would “clean her up.” In another case, when asked the same question, the daughter of the patient in question relayed examples of how her mother was dressed in hospital gowns rather than her own clothing, which had been brought from home. Facility staff told the daughter her mother was being dressed in a hospital gown because the facility was understaffed. Lack of good human care, and not necessarily medical care, may be fresh in the minds of those suing, even after years have passed. Dr. Collins concludes with this message: Treat everyone the way you would want to be treated or how you would want your own family members to be treated.

       This issue of ECPN offers several additional articles. Look for suggestions for caregivers of those with Alzheimer’s disease by Jane Painter, EdD, OTR/L, and Sharon Elliot, MS, OTR/L, BCN, BCG; tips for proper perineal care from Cynthia Fleck, RN, BSN, ET/WOCN, CWS, DAPWCA, MBA; the latest from the Centers for Medicare and Medicaid Services regarding International Classification of Diseases, Ninth Revision, Clinical Modification (ICD-9-CM) codes and how they affect the Outcome and Assessment Information Set (OASIS) from Ben Peirce, RN, ET, CWOCN; and lastly, guides to pain-free wound management by Cynthia Fleck, RN, BSN, ET/WOCN, CWS, DAPWCA, MBA.

I hope you enjoy this issue of ECPN. Look for exciting new changes, including a smaller, more reader-friendly size, in the coming year! As always, I welcome your feedback.