LTCS is collaborating with the CHAG to offer the following training to its member-institutions.
BACKGROUND
Justification
Patient rights have become topical in present day Ghana. Therefore, any act against patient interest finds itself on social media with attendant backlashes which ultimately affect integrity of organizations and the services/products they offer to the public.
The health sector issues are more worrying because sometimes these ends up in injury or death and it raises disaffection within the public space; fueled by active social media commentators and those genuinely affected. The quest to sue professionals and owners of facilities has gained notoriety. Case law in Ghana in recent times is replete with such cases affecting all service providers -Teaching hospitals, Ghana Health Service facilities, Quasi-government institutions like 37 Military Hospital, Christian Health Association of Ghana (CHAG) member facilities and the private sector. The future promises to be worse. In 2021 for example, a registered NGO, “Advocacy for Medical Malpractice Victims” based in Kumasi, started advertising for such cases to pursue on behalf of victims or relations.
Needless to mention, depending on the nature of injury or death and the circumstance of the victim (age, sex, occupation, etc.), demands for compensation may run into millions of Ghana cedis, some capable of closing down any non-government owned health facility, with attendant slur on integrity of the owner.
Dealing with these matters may take two forms. Some may target the professionals; in which case the license of the professional is put into jeopardy if the allegation of professional malpractice is proved at the relevant Council. Others may elect to bring an action for negligence against both the professional and the employer under a principle of law called “vicarious liability”. Either form is not good for any employer or healthcare professional.
Objectives
Against this background, it is important to train key health care providers systematically to:
Training Approach
A three-session module is proposed, subject to discussion, to deliver a long-lasting effect of the training that will permeate the entire system. This is because as adult learners, it is imperative to allow time to assimilate the content of each session.
TOPICS & DETAILS
To make the sessions practical and useful, a number of experienced Lawyers and Judges, themselves trainers in the legal profession have been put together to deliver the lectures. A few other experts will take up some sessions.
1. 7-DAYS SPECIAL TOPICS
The topics have been carefully selected to cover basic knowledge necessary to run a health facility, either as owner or healthcare professional.
A. Topic: Attitude of Ghanaian Courts to Medical Harm/Injury and Death
Synopsis
Medico-legal cases are mostly brought by aggrieved parties to the Courts for determination. Some of these go through full trial. Others get settled through Court supervised arbitration. Whatever method is deployed, Lawyers for parties weigh the chances of success in advising clients one option or the other. Ultimately, it is the Judges who determine the issues in any such case. This lecture will help participants understand what Judges consider in awarding damages, if at all, and how these decisions are arrived at. Current trends of awards will also be highlighted as guide.
In this session participants will learn:
Strategy: Didactic presentation using power point slides interspersed with discussions. Real medico-legal cases determined by the superior Courts will be discussed.
Duration: 2-hours per session.
Trainer: Sir Dennis Dominic Adjei (Justice of the Court of Appeal (Ghana) & Judge, African Court on Human Rights, Arusha, Tanzania)
B. Suing & Defending Medical Negligence
Synopsis
Medico-legal cases are grounded in the law of Torts, namely intentional torts, (trespass, assault, battery, and intentional infliction of emotional distress) and negligence. The law has specific requirements to successfully prosecute or defend these torts. A basic understanding of these will assist owners and workers about what occasions a tortious action and to take steps, to prevent them.
In this session participants will learn:
Strategy: Didactic presentation using power point slides interspersed with discussions. Relevant medico-legal cases will be used as examples to explain these principles.
Duration: 2-hours
C. Professional Negligence/Misconduct – The Law, Procedure and Rights of Defendant
(Doctors & Physician Assistants; Nurses & Midwives; Pharmacists & Pharmacy Assistants; Biomedical Scientists, Laboratory Scientists/Technologists, Radiology/X-Ray Technicians & Technologists)
Synopsis
Patients and/or relations may choose to prosecute harm/injury, near misses, inappropriate conduct or death with the professional regulatory bodies. In this case, the Councils established by the Health Professions Act, 2013 (Act 857) applicable to Medical, Nursing, Pharmacy and Allied Health practitioners will be forums to deal with these matters at first instance, not the Courts.
The procedure and rules applicable to determining such cases are not exactly the same as those handled by the Courts.
The decisions of these Councils, if found culpable, may lead to punishments that could affect ability to practice, sometimes permanently. It is therefore in the interest of professionals to understand the standards of practice and conduct expected by the respective regulators.
In this session participants will learn:
Strategy: Didactic presentation using power point slides interspersed with discussions. Cases managed at the Medical & Dental Council levels that concluded at that level or ended up at appeals to the Courts will be used as examples to explain these principles.
Duration: 2-hours per session.
D. Communicating Incidents and Harm
Synopsis
Medical interventions always involve emotions and high expectations of patients and relations. Therefore, where unexplained or unexpected harm/death occurs, it is necessary to manage the communication in a way that alleviates hurt and is assuring. If managed effectively, it could prevent a number of actions against medical professionals and owners of health facilities.
Learning to communicate in these matters is as important as understanding the principles and remedies in managing medico-legal and professional negligence or misconducts.
In this session participants will learn:
Strategy: Didactic presentation using power point slides interspersed with discussions. Practical examples and videos to drive home presentation will used deployed during this training.
Duration: 2-hours
E. Errors & Deaths in Caregiving– A Pathologist’s Perspective
Synopsis
Most medico-legal cases and professional negligence complaints that end up in death of relations are informed by perceived wrong doing in the process of care. This therefore is the push to seek justice for the deceased and appease relations.
Pathologists who examine deceased persons are better placed to highlight some of the causes of deaths leading medico-legal cases. It will also refresh practitioners’ knowledge and generate discussions o current treatment regimes.
In this session participants will learn:
Strategy: Didactic presentation using power point slides interspersed with discussions
Duration: 2-hours
F. Medication Errors, Injury and Death
Synopsis
Although relatively less problematic, medication error related medico-legal cases and professional negligence complaints arise from drug administration.
The issues around medication safety involves the system of purchases, storage, prescription, administration and monitoring among others. Pharmacists and Technicians play important roles in this system but Nurses mostly administer medications, therefore this cadre is of particular interest in this session.
In this session participants will learn:
G. Technology use in Patient Record Management & Reporting
Synopsis
The process of healthcare delivery involves taking, processing and holding data on patients. Currently service providers use softwares; sometimes used improperly yet in most situations Managers and health care professionals are unaware of the implications. These are important for litigating and uses when medico-legal cases arise.
It is important to draw attention of professionals and Managers about the need to take and hold reliable data on patients.
In this session participants will learn:
Strategy: Didactic presentation using power point slides and videos on issues with software applications in health care.
Duration: 2-hours per session.
**This Package may be tailored to suit the needs of other health service providers in both public, quasi-government and private sector.
2. SPECIAL SEMINAR ON MANAGING INFORMATION TO PUBLIC ABOUT NEGLECT, INJURIES AND DEATH IN CAREGIVING
Synopsis
Medical emergencies present the most vulnerable moments for patients, families and sometimes entire communities. As medics and health professionals battle to save lives, patients and relatives struggle to understand what has happened, why it happened and what the likely consequences are or could be. The struggle between the need to save lives and the public exploration of “the what and why” generate inexorable tension that sometimes escalate in ways that compromise patient safety and the jobs of health professionals and create legal liabilities. The outcomes of such situations depend in part on how information relating to the matter is handled. As more and more of such medico-legal incidents become matters of public concern because of the passions they engender among the population, there is the need to build the capacity of health professionals and managers in assuaging public anxiety, demonstrating empathy and sustaining credibility for their facilities and their professionals.
This session is designed to empower participants with the basic PR and communications skills to sustain public trust in health delivery by their facilities in moments of private or public emergency.
In this session participants will learn:
Strategy: Role plays, didactic presentation interspersed with discussions and case studies.
Duration: Half-day Seminar (4 hours)
Note: This Seminar can be tailored to suit any organization’s needs.
