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).
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.