1. Be as calm as possible. Before Audubon could alert former patients that they might have been infected, the media reported the story and hundreds of agitated patients were calling up in panic. Mr. Ashby says it doesn’t help to be agitated when the calls flood in. The ASC was able to continue operations without any patients or surgeons cancelling any cases.
2. Be prepared for extra spending. Audubon spent $300,000-$400,000 on measures to deal with malpractice suits, hiring a public relations firm and paying for hepatitis C testing of former patients. Mr. Ashby learned the ASC’s malpractice insurance did not cover this expense. The policy only covers actual legal claims and not related expenses.
3. Hire a public relations firm. Even though it costs a lot to hire a PR firm to answer media calls, Mr. Ashby says it was worth it. “Since they were disconnected emotionally, they were better able to take the inquiries than we were,” he says. Though the media focused on the hospital where the tech had worked much longer and actually infected some patients, the ASC definitely shared the spotlight.
4. Respond to patients’ concerns. This meant reaching out to about 1,200 former patients who were at risk for contracting hepatitis C in the several weeks that the surgical tech was working at Audubon. For about a month, former patients were invited to come to the ASC, talk with a nurse on staff about hepatitis C infections and pick up a form to apply for hepatitis C test. Several hundred former patients came to the ASC during the first few days. They could also access a Q&A on the ASC’s website.
5. Quickly identify the problem. What is the extent of the damage, if any? At Audubon, this meant making sure patients took the test for hepatitis C. Quest Diagnostics performed the tests at another site. Only a few at-risk patients refused to have the test done. While some tests came back positive, none of the positive tests matched the exact kind of virus the surgical tech had.
6. Hire an attorney you’re comfortable with. The insurance company picked an attorney for Audubon very early, but no one at the ASC knew the attorney and the ASC requested to switch to an attorney surgeons and staff had worked with before. “I’m glad we did that because we had a good comfort level with her,” Mr. Ashby says.
7. Deal with any litigation. One patient with a positive test result sued the ASC, but the case was dismissed when it was shown this person’s infection did not come from the accused tech. (Random hepatitis C tests frequently turn up a few positive patients.) A few former patients who did not test positive recently filed another lawsuit claiming emotional stress, but that case is expected to be dismissed, too.
8. Redouble safety measures. Even though it appeared the surgical tech did not steal Fentanyl syringes at the ASC, Audubon has taken steps to make sure drugs a not left unattended for even a few minutes. For example, anesthesiologists are not allowed to fill syringes and leave them unattended in the cart even for a few minutes, even though this is an efficiency measure. “This incident made us very aware of our procedures,” Mr. Ashby says.
9. Beef up hiring practices. When hiring the surgical tech, the ASC went through all the usual background checks. When hired, she had not yet been fired by the hospital and Mr. Ashby says it is not easy to check references with a current employer. The employer could take action against the employee if he or she learned she was seeking work elsewhere. To resolve this, Audubon now contacts the old employer six weeks after the employee is hired to ask about any employment issues.
10. Step up drug testing. Audubon has always tested employees for drugs before hiring, but now it also tests for drugs 90 days after hiring.
Learn more about Audubon Surgery Center.
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