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EFM Case Study #12: Chain-of-Authority (1 hour Monograph)

Hours: 1.00

Best suited for: Obstetricians and family practice physicians. Midwives, obstetric nurse practitioners, residents and other interested healthcare practitioners skilled in EFM and EFM stakeholders are also welcome to participate.

Original Release Date: December 22, 2016
Review Date: June 22, 2019
Expiration Date: December 22, 2019

Description: Differences in clinical opinions regarding the interpretation of EFM data or other clinical factors between two perinatal practitioners can and will happen. Choosing not to share a clinical opinion when it is clinically indicated or refusing to take into consideration another’s opinion into a patient’s plan of care has been shown to increase malpractice risk. Researchers identified that even if there is a resolution process many practitioners fail to share their clinical opinions due to lack of administrative support to do so. Clinical differences should be anticipated and prepared for but not all facilities have nor support use of a multidisciplinary resolution process. Creating a simple, unbiased, collaborative resolution process is required by all facilities that offer care to pregnant patients. A Chain-of-Authority offers an easy solution when differences in opinion exist but creating a safety culture that supports the free expression of clinical opinions is paramount. All resolution should start with the primary nursing and medical practitioner and end when a collaborative compromise is reached. This monograph defines the Chain-of-Authority process, outlines proper procedure to invoke it through the evaluation of two case studies, and offers risk management and patient safety considerations for success.

Learning Objectives: Upon completion, participants should be able to
1) Critique two EFM Case Studies and critical thinking drills involving clinical disagreements and
    the use of a Chain-of-Authority (COA).
2) Outline the steps to invoking COA in your facility; if no COA policy, assist in developing one.
3) List two risk management solutions that increase successful conflict resolution before, during,
    and after invoking COA. 

Learning Assessment: There will be a post test for this activity with a minimum performance requirement of 8 out of 10 correct answers.

Estimated time to complete activity: 1 hour

Residents will earn a certificate of completion. Physicians will earn CME credit. 

CME Information - Read

Method and Medium: To obtain CME credit, view the entire online presentation, complete the evaluation and post test and print your certificate online.

CME Credit: 1.0

State Requirements: Based on information from state licensing authorities published by the AMA, this program meets specific CME requirements for the following states:
Connecticut - This activity includes content in Risk Management
Massachusetts - This activity includes content in Risk Management
Pennsylvania - This activity includes content in Risk Management / Patient Safety
Texas - This activity includes content in Ethics and/or Professional Responsibility

CME Disclosure Policy: LAMMICO requires planners, speakers, faculty and all those who influence the content of a CME activity to disclose any financial relationships they have with commercial interests that are relevant to the CME activity. The disclosures shall be reviewed for any conflict of interest and subject to a mechanism for resolution of conflict of interest. A disclosure statement of relevant financial relationships will be made to the audience prior to the activity.

Disclosure: The author, editors and planning committee members for this activity have no relevant financial relationships to disclose.

About the Authors: Dr. Kenneth Brown - Read Bio and Carol A. Curran RNC, MS, OGNP - Read Bio

Managing Editor: Dawer Azizi, MHA, CPHRM, LAMMICO Director of Risk Management

Editor: Sharon Cusanza, MSN, RN, NEA-BC, LAMMICO Senior Risk Management Education Specialist

Content Advisors/Planning Committee Members - Read

Electronic Hardware and Software Requirements - Read

Web Master Contact Information: For assistance, contact Shea Ivey at 866/398-1038 or help@medicalinteractive.com
If clicking the link above does not work, please copy and paste the email address in the "To" field of your preferred email account.

Disclaimer: This activity is presented as risk management education. It is not legal advice, nor does it establish medical standards of care. Standards of care vary depending on the unique presentation of each patient. The information contained herein is not a substitute for the reasonable discretion of skilled and informed clinicians at the point of care.

Copyright Information: Copyright © 2016

Member and Subscriber Access
Interested in a CME program like this for your team or facility? Contact us to schedule it and talk about pricing.

This course is offered through Experix, a wholly owned subsidiary of Physicians Insurance, and is based on more than 30 years' experience in providing continuing medical education. This course is complimentary for Physicians Insurance members.

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