Medicolegal Toolkit

The Medicolegal Toolkit consists of a series of modules of varying duration, which utilize assorted methods of instruction ranging from formal didactics, to group activities, to asynchronous exercises, for residency programs to incorporate into their curriculum as needed. The topics contained within the toolkit include:

Decision-making capacity
Good Samaritan laws
Liability insurance
Medical malpractice
Medico-legal documentation
Regulatory mandates
Risk mitigation
Root cause analysis

Each module comes with all of the material necessary for utilization at your program, as well as a list of pre-reading resources, an instructor's guide which provides explicit detail as to implementation, and a summary handout for learners to take home with them after the session.

Implementation Options

TOPIC & CONTENTS	TIME	PRE-READING	MATERIALS	INSTRUCTOR'S GUIDE	SUMMARY HANDOUT
Decision-Making Capacity Group Exercise	1 hour	Appelbaum PS. Assessment of patients' competence to consent to treatment. N Engl J Med. 2007; 357:1834-184 Schwartz N. Medical decision-making capacity in the ED. July 2, 2018. http://epmonthly.com/article/medical-decision-making-capacity-in-the-ed/	Discussion Guide Download Cases Download	Instructors Guide Download	Handout Download
Good Samaritan Laws Didactic	1 hour	McGrane K, Moore GP, Cookman L. Special report: Good Samaritan law and the emergency physician: where are you covered? Relias Media. 2009; 1-7. Stewart PH, Agin WS, Douglas SP. What does the law say to good Samaritans? Chest. 2013; 143(6): 1774-1783.	PowerPoint Download	Instructors Guide Download	Handout Download
Liability Insurance Didactic	30 min	AAEM. (2013, March 04). Episode 2: Key Contract Terms. Emergency Physician Advocates: Medical-legal issues in emergency medicine. Retrieved from https://www.aaem.org/UserFiles/WoodPodcast1edited.mp3 AAEM. (2013, May 08). Episode 4: Asset Protection. Emergency Physician Advocates: Medical-legal issues in emergency medicine. Retrieved from https://www.aaem.org/UserFiles/media/aaem-podcast-episode-4.mp3 Jena, A, et. al. (2011). Malpractice Risk According to Physician Specialty. New England Journal of Medicine. 365:629-636. Retrieved from https://www.nejm.org/doi/full/10.1056/NEJMsa1012370	PowerPoint Download	Instructors Guide Download	Handout Download
Medical Malpractice Asynchronous Module	1 hour	Zane RD. The legal process. Emerg Med Clin N Am. 2009;27:583-592. Studdert DM, Mello MM, Brennan TA. Medical malpractice. N Engl J Med. 2004;350(3). Kuhn W. Malpractice and emergency medicine. Emergency Medicine Reports.  1990;11(2). Carlon JN Foster KM, Pines JM ert al. Provider and practice factors associated with  emergency physicians’ being named in a malpractice claim. Ann Emer Med. 2018;71:157- 164.	PowerPoint Download	Instructors Guide Download	Handout Download
Medico-Legal Documentation Didactic Chart Review Exercise	45 min 45 min	Top 10 Principles on How to Avoid Getting Sued Grassie C, Nauss M, Schmitz G, et al., ACEP Medical Legal Committee. Top 10 principles on how to avoid getting sued in emergency medicine: an information paper. American College of Emergency Physicians. October 2013. Top Ten Documentation Mistakes Video presentation of Dr. Greg Henry and Dr. Gillian Schmitz discussing the top ten documentation mistakes. American College of Emergency Physicians. April 2017.	Chart Review Tool PowerPoint Download	Instructors Guide Download	Handout Download
Regulatory Mandates Didactic Group Exercise	30 min 30 min	EMTALA Fact Sheet. (2009). ACEP.org. [online] Available at: https://www.acep.org/life-as-a-physician/ethics--legal/emtala/emtala-fact-sheet/#sm.0001k7is7419ujduuu2gdoenk5g53 Moskop JC, Marco CA, Larkin GL, Geiderman JM, Derse AR. From Hippocrates to HIPAA: privacy and confidentiality in emergency medicine--Part I: conceptual, moral, and legal foundations. Ann Emerg Med. 2005 Jan;45(1):53-9. Moskop JC, Marco CA, Larkin GL, Geiderman JM, Derse AR. From Hippocrates to HIPAA: privacy and confidentiality in emergency medicine--Part II: Challenges in the emergency department. Ann Emerg Med. 2005 Jan;45(1):60-7. Review. PMID: 15635312. Zibulewsky J. (2001). The Emergency Medical Treatment and Active Labor Act (EMTALA): what it is and what it means for physicians. Proceedings (Baylor University Medical Center), 14(4), 339-46.	Case Download Case Answers PowerPoint Download	Instructors Guide Download	Handout Download
Risk Mitigation Didactic with Group Exercise	45 min	https://www.nytimes.com/2015/06/02/upshot/to-be-sued-less-doctors-should-talk-to-patients-more.html https://www.nytimes.com/2018/10/04/well/live/doctors-errors-apologies.html https://www.bmj.com/content/353/bmj.i2139 https://www.ncbi.nlm.nih.gov/pmc/articles/PMC1201002/	PowerPoint Download	Instructors Guide Download	Handout Download
Root Cause Analysis Didactics Group Exercises	1.5 hours 2.5 hours	AHRQ Patient Safety Primer/Systems Approach: https://psnet.ahrq.gov/primers/primer/21/systems-approach AHRQ Patient Safety Primer/RCA: https://psnet.ahrq.gov/primers/primer/10/Root-Cause-Analysis CMS Guidance for Performing RCA: https://www.cms.gov/medicare/provider-enrollment-and-certification/qapi/downloads/guidanceforrca.pdf	Didactics Download Q&A Forms Download Timeline Documents Results Download CXR 1 Download CXR 2 Download EKG Paced Download	Instructors Guide Download	Handout Download