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Effective Risk Management Strategies in Outpatient Methadone Treatment: Clinical Guidelines and Liability Prevention Curriculum MODULE 3 The Relationship between Risk and Practice in the OTP OTP Ideal Standard of Care From admission, each patient receives: • Individualized clinical care Ongoing Documented • Competent staff • Good clinical judgment OTP clinical practice standards Incorporating best- and evidence-based practices * Adapted from CSAT Workshop on Risk Management - 2005 OTP Core Liability Failure to: • *Borrowed from CSAT Workshop on Risk Management-2005 Document Communicate risks Review and correct Consider what’s “reasonable” and “foreseeable” Assess for impairment Attend to RED flags Informed Consent Informed Consent for OTPs Patients should understand: ▫ Basic science of addiction ▫ Methadone treatment Benefits Risks Alternatives The Right Thing to do: Phased Informed Consent Consents: A Valuable RM Tool • Providing information via consents may increase and motivate patient involvement in treatment • Phased informed consent ▫ Helps share or “transfer” risk ▫ Provides patient buy-in ▫ Identify understanding and comprehension related to treatment Added at Admission Integrate Patient’s Family Impairment-A Severe Exposure • Trends show impairment as an increasingly likely factor in more claims filed against OTPs High Risk for Impairment • During the induction process • Drug-Drug interactions with methadone ▫ ▫ ▫ ▫ ▫ Benzodiazepines Alcohol Cocaine Other sedative-hypnotic medications Muscle relaxants Do Not Bury your Head in the Sand • Duty to take action • Duty to warn In Summary • DON’T IGNORE • Duty to warn • Duty to make reasonable inquiry and assess • Obtain Phased Informed Consent • Document, document, document
