Managing frontline medico-legal risks during COVID-19: from webinars to app sponsorships
A year ago, COVID-19 was nothing more than some news broadcast from somewhere far away. It now continues to dominate world headlines, drive politicians’ decision-making and affect people’s lives and livelihoods across the globe. Many have suffered severe hardship as a result of the pandemic, and social distancing and the wearing of masks is likely to persist as a reminder of what has become known for many as annus horribilis.
On the flip side, the year has brought with it abundant acts of kindness and generosity and highlighted the resilience of South Africans. It has also emphasised the commitment and skills of our country’s healthcare practitioners, young and old alike, and of whom many have gone beyond the call of duty.
For those on the frontline, topics like personal protection, infection control and triaging took on a novel meaning in 2020. The Health Professions Council of South Africa had no choice but to amend its guidelines on the practice of telemedicine within a few days. Private and state healthcare facilities had limited time to plan for surges in acutely ill patients. Volunteers had to be called on to be on standby and step outside of their usual scope and place of practice, if required. Professional societies and clinical leaders were looked upon to provide up-to-date guidance to peers in a rapidly changing environment.
At EthiQal, the priority – other than ensuring business continuity in the face of employees being forced to work remotely overnight – was to provide focused support to individual practitioners and their professional bodies. Other than our medico-legal advisors and risk management team engaging policyholders at a personal level and on a daily basis to understand ‘on-the-ground’, evolving challenges experienced during COVID-19, educational material addressing these was collated to act as a quick reference. Dissemination of professional guidelines and question-and-answer sessions were furthermore facilitated via webinars, which were still a novelty just a few months ago. Whilst Zoom fatigue has set in amongst some in the meantime, online, real-time, face-to-face engagements remain a key tool in staying connected (with many busy practitioners indeed preferring this route of engagement at this stage, especially taking into consideration that it can occur in the comfort of one’s home).
With a significant number of EthiQal clients being surgical specialists in private practice, the safe return to safe surgery post hard lockdown was a natural priority. Work by professional bodies, like the Federation of South African Surgeons (FoSAS), was supported by raising awareness of their efforts and key messages.
In terms of promoting patient and doctor safety, the South African Society of Obstetricians and Gynaecologists’ (SASOG’s) leadership must be commended on not only actively supporting its membership with COVID-specific guidance during the pandemic, but also on following through on historic risk management plans, despite trying circumstances. Of particular note is the development and implementation of an app to support its various risk management initiatives aimed at enhancing patient care, assisting practitioners with ready access to information and reducing professional indemnity fees. Other than providing a platform that allows ready dissemination of information within a rapidly changing environment, the app, which was sponsored by EthiQal as part of the insurer’s collaborative risk management approach, allows easy access to critical information at the bedside.
It also provides exciting opportunities for strengthening morbidity and mortality meetings in private hospitals going forward. Where poor clinical outcomes have occurred on the basis of human error and system failures, these meetings allow for interrogation of the former in a non-confrontational manner, with the aim of promoting learning, identifying communication gaps and developing checks and balances to avoid similar mistakes in future. With the ability to log meeting attendance on the app, proof of this can theoretically be submitted to third parties like funders and indemnifiers as evidence of active risk management focused on the provision of quality care (and which should ideally lead to advantages for the practitioner).