RE: Pt. Scenario

Lee -

I think your post is worth far more than $.02 - I think that is an excellent approach and something to be kept in mind by those of us who write policy. Perhaps even more important than the original draft of a policy is to maintain it as a "living policy" meaning that as we learn new things or encounter new situations, we amend the policy to reflect current realities. I advocate a review of each policy and procedure at least every other year or when any significant change in the nature, scope or management of the organization occurs.

A catch-all emergency clause can be valuable provided that it is tightly coupled to accountability and documentation and I think you articulated that in a way better than I could have.

regards!

paul

-----Original Message-----
From: flightmed-admin@flightweb.com [mailto:flightmed-admin@flightweb.com]On Behalf Of Lee Watson
Sent: Saturday, January 05, 2002 4:16 PM
To: flightmed@flightweb.com
Subject: RE: Pt. Scenario

Paul,

In my experience as a manager, writing both clinical and administrative protocol/policy/procedure, you must always leave flexibility, allowing for the experience and judgment of those in your charge. I would argue that the main reason you wound up as a defendant originally was because the policy didn't allow for variation. One must remember that we are practicing a form of medicine - which will always be as much an art as it is a technical science. Not every situation or patient fits into the "cookie cutter" the way some administrators and medical directors think they should (no offense intended - been there myself).

One nice thing to do is to have a "catch all" policy stating that a clinician, acting in good faith to his/her duty to the patient, may under unforseeable circumstances, deviate from policy and procedure as long as the deviation, rationale for deviation (benefit/risk), and patient outcome are documented.

Just my .02 worth...

Lee Watson

lwatson286@adelphia.net