HIM 452: Quality Management and Data Analysis
Unit 2 Impaired Physician and Risk Management
AHIMA Competencies
2018 Health Information Management Graduate Degree Curriculum Competencies
Domain V. Health Law and Compliance
V.3. Evaluate risk management strategies across the health continuum.
CASE STUDY- IMPAIRED PHYSICIAN AND RISK MANAGEMENT
Evaluate current situation, determine root cause using cause-and-effect diagram and recommend solutions and strategies.
Derek Johnson , MD, has been an anesthesiologist at Community Hospital of the West for 15 years. He is 45 years old. The physician is board certified to perform all kinds of anesthesia procedures, including every type of surgical procedure and obstetrical anesthetic procedure. His colleagues have noticed that he has become more and more haggard looking, but they ascribe this to the hectic work schedule that anesthesiologists often must maintain.
One day, Dr. Johnson was admitted to the intensive care unit at Community Hospital of the West. The news quickly spread through the organization. He was suffering from a compromised immune system and was close to dying from septicemia that had developed from abscesses in his arm as a result of infections. Some of the OR nurses discussed the situation on their dinner break and speculated that Dr. Johnson was a drug addict. The current policy of the hospital was that anesthesiologists were not required to account for the narcotics that they administered to patients postoperatively. Some of the OR nurses had noticed that over the past six months to a year that Dr. Johnson’s patients had morphine for pain prescribed and that Dr. Johnson would administer this himself, even for patients who were not complaining of pain. Some of Dr. Johnson’s patient’s how were experiencing high levels of pain experienced little pain relief after supposedly receiving morphine administered by Dr. Johnson.
One of the nurses reported that three months earlier she had cornered the chief of anesthesia service and told him of Dr. John’s narcotics irregularities. No wanting to challenge or accuse a fellow physician, the chief said indignantly that there must be some other explanation and terminated the conversation. The nurse did not discuss the problem with anyone else-not the director of surgical services, the chief of surgery, the director of nursing, or the administrator.
The possibility of personal addiction among healthcare workers is a job-related issue. Individuals who have access to pain medication and who frequently medicate others to help relieve pain can become caught in an addictive cycle themselves, especially when system processes fail to hold professionals accountable for narcotic use or abuse in the provision of patient care. Most agencies offer employees access to confidential counseling. Unfortunately, many times those who has problems with alcohol or drugs are unable to see their problem and justify their use in a variety of ways. It is unfortunate that the facility did not have a mechanism in place for confidentially reporting the suspected abuse. It may have been possible to offer the physician a professional intervention that could have saved him physically and mentally from such severe trauma.
Reference: Shaw, P. and Carter, D., Quality and Performance Improvement in Healthcare, 7th edition – Chapter 11 Case Study, pp. 213-214.
TASKS:
1. Read the case study provided.
2. Conduct additional research on a topic related to the case study. To conduct your research, identify
two articles relevant to the case study. Articles cannot be older than 2015. The textbook cannot be
used as a reference.
DELIVERABLES:
1. A 4 page, double-spaced paper that is APA formatted. *
2. Provide a title page.
3. Provide a reference page following the APA formatting.
4. Your paper should answer the questions:
a) What observations were made or what evidence was there to indicate that Dr. Johnson had a
narcotics problem?
b) Does Community Hospital of the West bear any responsibility for Dr. Johnson’s predicament?
Why or why not?
c) What are the root causes of this situation?
d) Build a cause-and-effect diagram based on the finding of this case study.
d) What are the costs to the organization in terms of reputation, patient safety, marketing, and
organizational culture?
e) What would you recommend Community Hospital of the West do to
mitigate the impact of these costs?
*The title page and reference page are not included in the required 4-page paper. Those pages are in addition to the required 4 pages.
Unit 2 Case Study: Impaired Physician and Risk Management 2
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