INTERVIEWS

Guest: Mark A. Underwood MD

Presenter: Neal Howard

Guest Bio: Dr. Underwood received his medical training at the University of Texas Southwestern Medical School in Dallas followed by pediatric residency training at UCLA. After 12 years as a pediatrician in Great Falls MT, he and his family went to New Zealand for a year where he provided pediatric care in underserved areas and consultations at the medical school in Hamilton. Upon returning to the U.S. he completed a fellowship in neonatology at UC Davis and then joined the faculty in 2006 and became the chief of the division of neonatology in 2014. He loves working with parents, nurses, pharmacists and other specialists to provide the best care for infants. His research focuses predominantly on necrotizing enterocolitis, human milk and probiotics. This research includes clinical trials of probiotics and prebiotics in premature infants and studies of promising protective therapies in animal models of necrotizing enterocolitis and pulmonary hypertension. He also enjoys international collaborations and has taught courses to physicians, nurses, and birth attendants across Africa, Central Asia, Eastern Europe and the Middle East.  

Segment Overview: Dr. Mark Underwood explains study results that shows how nine out of ten babies are missing important “good” bacteria that helps protect babies and promotes a healthy immune system.

Segment Overview: Dr. Shar Najafi, Senior Vice President of Behavioral Health for Equality Health in Arizona, discusses her mission to provide mental medical care that encompasses the mind and body to those affected by health disparities.

Guest: Dr. Shar Najafi

Presenter: Neal Howard

Guest Bio: Dr. Shar Najafi serves as the Senior Vice President of Behavioral Health for Equality. Prior to joining the Equality executive team, she served as the Vice President of Outpatient Services with Southwest Behavioral and Health. She was responsible for the planning of programs and strategies for achieving outpatient clinic and operational service goals. She developed and implemented several programs, including hospital navigator services, children’s integrated high needs case management, intensive outpatient protocols, school-based counseling, telehealth models of care, and an integrated Autism Center of Excellence.

Dr. Najafi received her doctorate in Psychology in 2010 and a Master’s in Clinical Psychology in 2006 from the Harold Abel School of Psychology.

Segment Overview: Professor Suzanne Smeltzer talks about advocating for improved disabled patient care and Villanova’s partnership with the National League for Nursing (NLN) to launch an online educational program designed to provide nurse educators with the tools they need.

Guest: Prof. Suzanne Smeltzer, EdD, RN, FAAN

Presenter: Neal Howard

Guest Bio: An internationally known scholar, researcher, educator and author, Suzanne Smeltzer, EdD, RN, FAAN, has directed the College of Nursing’s Health Promotion for Women with Disabilities Project, funded by a grant from the Bristol-Myers Squibb Foundation. Committed to making health promotion practices and services accessible and acceptable for those who are physically and cognitively challenged, she has done extensive research on the health issues of people with multiple sclerosis and other disabilities, how to improve the health and wellness of those with disabilities, and how to integrate disability content into the education and training of healthcare professionals.

Segment Overview: In this Health Supplier segment, Greg Sancoff, CEO and Founder discusses Live Pure, a designer and manufacturer of products that help customers assess the quality indoor air and safety of their indoor environments.

Guest: Greg Sancoff

Presenter: Neal Howard

Guest Bio: Gregory E. Sancoff is founder and CEO of Live Pure. He is a successful inventor, investor and management specialist with 35 years of business experience. His innovation, ingenuity and problem-solving expertise, have resulted in 71 patents, either granted or pending. Prior to Live Pure, Greg was Chairman, CEO and President of Juliet Marin Systems, and he has served in executive positions including President/Chief Executive Officer and Chairman of the Board of Directors, in all companies he has founded or acquired. These companies include Block Design/Block Medical, IVAC, and ONUX Medical.

Guest: Dr. Mark Stephan

Presenter: Neal Howard

Guest Bio: Dr. Mark Stephan serves as the Medical Director for Equality Health. Prior to joining Equality Health, Dr. Stephan served as the Vice President of Clinical Integration for Physician Integration at Dignity Health where he was responsible for the development and expansion of clinically integrated networks across the enterprise. Previously he served as the Chief Medical Officer for Arizona Care Network (ACN) where he integrated Care Coordination into the ambulatory physician network, negotiated a uniform set of network quality metrics with commercial payors and helped the network achieve shared savings on multiple contracts. Prior to that, Dr. Stephan acted as Medical Director for St. Joseph’s Family Medicine Residency Program. Dr. Stephan founded the Wesley Health Center (FQHC) in South Phoenix and served as Medical Director from 2007 through 2012 where he successfully implemented EHR and Open Access scheduling, introduced diabetes group visits and integrated mental health care into the office.  He practiced Family Medicine for 19 years, including hospital medicine and obstetrics in rural and urban settings until 2008.  

 Segment Overview: Dr. Mark Stephan, VP and Medical Director for Equality Health in Arizona discusses next-generation technical capabilities that are finally making healthcare data operational — the HealthBI CareEmpower Platform. Learn more at www.equalityhealth.com.

Segment Overview: In this health supplier segment, Mike Crowley and Scott Aronson of Jensen Hughes Engineering and Consulting Services discuss the recent acquisition of Russell Phillips & Associates (RPA) , fire and healthcare facilities safety as well as life protection in large facilities. https://www.jensenhughes.com

Guest: Mike Crowley and Scott Aronson

Presenter: Neal Howard

Guest Bio: Michael Crowley, PE, is a Vice President of Development, focused on Healthcare with Jensen Hughes Engineering and Consulting Firm. His technical experience includes the development of fire protection programs for large facilities and proposing solutions for non-compliant items.
Scott Aronson is the Director of Strategy & Business Development for Healthcare at Jensen Hughes. Scott was most recently a Principal with Russell Phillips & Associates (RPA), working in the healthcare industry since 1994 on areas of fire safety, emergency management and accreditation compliance.

 Segment Overview: Jennifer Flynn discusses a new report that shows malpractice claims against nurse practitioners continue to rise. This report also features a robust self-assessment checklist to help nurse practitioners evaluate the risk exposures of their current practice.

Guest: Jennifer Flynn

Presenter: Neal Howard

Guest Bio: Jennifer Flynn is a representative of the Nurses Services Organization (NSO).

Transcript

Neal Howard: Welcome to the program. I’m your host Neal Howard here on Health Professional Radio. Glad that you could join us. Our guest is Jennifer Flynn, she’s a representative of nurses services organization and she’s joining us today to talk about a brand new report that shows that claims against nurse practitioners are continuing to rise. Welcome to the program Jennifer Flynn, how are you?

Jennifer Flynn: Great. Thank You Neal. Thank you for having us and the thank you for the opportunity to talk about the new report.

N: Are you a nurse practitioner yourself?

J: I am not. I am a Risk Manager for Nurses Service Organization. I’ve been with NSO for over 17 years and this managing the risk management program here at NSL. I’m really dedicated to educating healthcare professionals including nurses and nurse practitioners on the professional liability risk.

N: Now we mentioned the word “claim” in the medical field or malpractice, we automatically get this vision of a doctor losing everything that he’s got.

J: Well, more and more we’re seeing nurses and nurse practitioners bearing the brunt of the malpractice claims and yes, while physicians are sued for malpractice really anyone who is holding a professional license such as a nurse practitioner can be sued for malpractice. They really look in malpractice lawsuits to see that if the nurse had a duty to their patient, was there a breach in that duty which caused the injury to the patient and can they directly correlate the actions or failure to act of that nurse practitioner to the injury of the patient and that’s how the plaintiff’s attorney will try and prove malpractice on the part of the nurse practitioner.

N: Now you mentioned that anyone who holds a professional medical license can potentially be sued for malpractice and potentially lose. What is the glaring difference between the nurse and a nurse practitioner, is one of the other more apt to be sued and why?

J: Well in the NSO program we offer coverage to both nurses and when we refer to nurses or referring to registered nurses, LPNs and LDNs, as well as advanced practice nurses, not just nurse practitioners but also clinical nurse specialists and those professions that fall under that umbrella. The new report that NSO and CNA the underwriter for the NSO program just released or just published really talks about the analyses of claims against nurse practitioners specifically over a five year period. And not only that but we looked at claims over $10,000 or greater to really gain in line of sight into the errors or deviations from standard of care which caused that error or the injury to the patient.

N: Is the rise and claims against NPs based on the fact that there are more people involved in this field, this is not something that was present 30 years ago.
Is that part of the rising claims against them?

J: Well, we don’t know specifically what’s causing the rise and claims. The data that was analyzed for the NSO report is specific to the nurse practitioner insured’s that are in the NSO-CNA program and so to your point, we do have more nurse practitioners in the program than ever before but because the program is a nationwide program and because it looks at a five-year period, the claims that we are seeing are really related to an increased frequency and number of incidents that were reported to us over that five-year period as well as the severity or financial impact of those claims also is on the rise, for example we saw in the previous nurse practitioner claim report that on average when we had a claim against a nurse practitioner, we were paying about $221,000 to an injured third party whereas in this most recent five year data set that average payment has increased to $240,000 on average we’re paying to an injured third party on behalf of a nurse practitioner.

N: What would you say based on the the report would be the number one infraction that most nurse practitioners are being filed against? And are those infractions normally with proof, with good evidence?

J: So that’s a great question. The report actually looks at a few areas where nurse practitioners work. We look at nurse practitioner specialty location or practice setting and then we look at those top allegations that the patient alleged against the nurse practitioner and because we’re only looking at close claims or claims that have resolved, these allegations, and locations and specialties are cases where negligence was proven and so we report on those top areas of laws so that a nurse practitioner might be able to help identify and manage risks that are most likely to impact their practice. So when we looked at areas of specialty, we saw that the three specialties with the highest average paid indemnity, those that money again paid to an injured third party our neonatal, women’s health or obstetrics and emergency medicine, they were the three specialties most affecting nurse practitioners in these close claims. But when we shift to location or practice setting, the greatest number of claims that we saw in the report were related to nurse practitioners working in physician office practices, nurse practitioner owned office practices and aging services facilities or your skilled nursing, your senior living facilities and the like. And for allegations, we saw that about five allegations categories accounted for 95% of all closed claims. Diagnosis related claims had the highest percentage of close claims and accounted for about 32.8% of all close claims. And the average paid indemnity for diagnosis related claims was about $283,000 per claim which is even above the overall total average per claim that we saw in the report. The second highest allegation was related to medication prescribing and then the third category that represented the most claims was treatment and care management.

N: So how can a nurse practitioner evaluate where they said in order to improve practice maybe add or take away some things or become more aware of the rise in claims against those in their profession?

J: Well I think that the report allows nurse practitioners to be aware of if they’re working in the specialties or locations. But related to allegations, these are really related to their standards and scope of practice in their state and with their license. And so really having good risk control habits, following recommendations, following your facility’s policies and procedures will really help you not only identify those top areas to enhance your current patient safety measures but also will give you insight and minimizing your exposures to liability risk. And the report itself actually has a self assessment checklist included in the report that really goes through and to the reminder of the standards of care to which you would be held in a malpractice lawsuit. And so you can use that as a good reminder, a good tool for analyzing and making changes to your risk control habits.

N: Is there someplace online that our listeners can go and get some more information about NSO and about the claims against nurse practitioners in general?

J: Sure. The report itself is posted to the NSO website, that’s www.nso.com and it’s in the learning section and beyond the report itself, you can also find the self assessment checklist and you can find legal cases, and articles and newsletters all letting nurse practitioners know about the risk and risk control recommendations for their practice.

N: Jennifer Flynn, thank you so much for sharing with us today. It’s been a pleasure.

J: Thank you. Thank you very much.

N: You’ve been listening to Health Professional Radio. I’m your host Neal Howard with Jennifer Flynn, representing Nurses Services Organization and we’ve been talking about how claims against nurse practitioners are on the rise. Transcripts and audio of the program are available at healthprofessionalradio.com.au and also at hpr.fm. You can subscribe to the podcast on iTunes, listen in and download at SoundCloud and be sure and visit our affiliates page at hpr.fm and healthprofessionalradio.com.au.

Guest: Teneille Newton

Presenter: Tabetha Moreto

Guest Bio: Teneille Newton is a degree-qualified naturopath, clinician, educator and wholefoods guru with more than 20 years’ experience in the natural medicine industry. She have focussed her clinical practice, research, technical writing & educational seminar presentations on the influences of nutrition, herbal, dietary and lifestyle protocols on optimising wellness. Teneille is the founder of The Naturopath’s Kitchen (www.thenaturopathskitchen.net.au) where she creates and shares delicious recipes to create health through fabulous food. Teneille has a passion for understanding genetic variations and how these can influence chronic disease states, as well as the utilisation of clinically relevant health assessments to further advance patient evaluation. Additionally, Teneille specialises in the use of specific dietary strategies to optimise patient outcomes.

Segment Overview: In today’s interview, Teneille Newton, the founder of The Naturopath’s Kitchen comes on the program to discuss all about osteoarthritis ranging from the causes to the treatments for it. She also talks about her passion for naturopathy.

Segment Overview:  In this segment, Jasmine Perry of MacKillop Family Services is on the show to discuss about the many services her organization with a primary focus on foster care. The non-profit organization uses cost-effective ways of promoting their services such as Google and social media especially their Facebook page.

Guest: Jasmine Perry

 Presenter: Wayne Bucklar

Guest Bio: Jasmine Perry is the Carer Recruitment and Development Manager of MacKillop Family Services. She has been working with vulnerable young people for 15 years in Australia and internationally. For the past four years, Jasmine has been working with MacKillop Family Services, focusing on the out of home care systems in New South Wales, Victoria and Western Australia, supporting case managers, foster carers and young people through multiple reforms. As the Manager of Carer Recruitment and Development, Jasmine has centralised the recruitment strategy of foster carers, increasing the number of foster carers to support children and young people in care. She has developed and implemented an organisational wide strategy to support, train, assess, develop and retain over 800 foster carers across New South Wales, Victoria and Western Australia.

Guest: Cameron Fuller

Presenter: Wayne Bucklar

Guest Bio: Cameron Fuller is the General Manager of NAB Health, a position he has held since April 2016. NAB Health, its MedFin and HICAPS businesses, comprise a team of 270 bankers providing banking services to over 30,000 healthcare customers across all modalities within the industry, including Aged Care, Hospitals, Pharmacy and Practitioners. NAB Health has been at the leading edge of banking and health innovation over the past 10 years, including more recently the launch of the HICAPS Go App, the  dedicated nab health website and the introduction of electronic document signing in its MedFin business.

Segment Overview: In today’s interview, Cameron Fuller of NAB Health discusses about the HICAPS Go app which provides patients with a simple and transparent experience which gives them more visibility on their out of pocket expenses before they see their healthcare practitioner and facilitates a completely digital process to pay their bill. He also talks about the importance of helping businesses and professionals in the healthcare industry across the Australia.