Identification and Management of Impaired House Staff Policy

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Impaired House Staff Policy

Radiology Department

Identification and Management of Impaired House Staff Policy

Purpose

The Radiology Department thoroughly supports the Indiana University School of Medicine’s goal to provide an alcohol and drug-free work environment, and to provide quality patient care, it is important to recognize situations where patient care is compromised by resident physician impairment. It is the intent of this policy to provide a means to recognize impaired trainee physicians with the goal of rehabilitating the physician and ensuring patient safety.

Scope

This policy applies to all Indiana University School of Medicine (IUSM) trainee physicians.

Definitions

· Impairment: “The inability to practice medicine with reasonable skill and safety to patients by reason of physical or mental illnesses or alcoholism or drug dependency.” (American Medical Association, 1972)

· Indiana State Medical Association Physician Assistance Prom (ISMA PAP): A program of the Indiana State Medical Association that addresses the needs of physicians impaired by chemical dependence, psychiatric disorders, and physical disability, as well as the needs of disruptive physicians.

· Trainee; any physician who is a training status which includes residents and fellows.

Policy Statement

It is the belief of IUSM and the Radiology Department that an impaired trainee physician is an ill colleague in need of treatment. The approach to impairment should be through medical intervention, care and compassion as opposed to punitive or threatening methods. It is expected that the impaired trainee physician will enter and complete treatment, in order to return to training as soon as possible.

Procedure

Identification of Potential Impairment: Based on available information, there may be reasonable suspicion that an individual may be impaired, thereby placing patients, himself/herself, others, or the affiliated hospital at risk of injury or loss. Observations noted may include, but are not limited to:

· Inappropriate physical appearance

· Altered speech

· Uneven gait

· Reports of behavioral changes from hospital personnel

· Unprofessional conduct

· Poor judgment

· Increase in number of medical errors

· Smell of alcoholic beverages on the breath

· Inappropriate actions or orders

· Accidents, near accidents, or injury on the job or damage to hospital equipment

· Frequent lateness, unavailability, or inappropriate response to phone calls and pages

Suspicion of Impairment: If any person reasonably believes that a trainee physician is rendering care while impaired, he/she shall immediately contact his/her supervisor, clinical director, or department director, who will immediately contact the program director of the trainee’s training program. The anonymity of the individual making the contact will be maintained.

Intervention: If a trainee is believed to be under the influence of drugs or alcohol the resident in question will be directed to wait until the program director or designee arrives, at which time the following shall occur:

· A urine drug screen and blood alcohol level will be obtained at the affiliated hospital emergency department or IUPUI Health Services.

· Any costs associated with testing, and not covered by the trainee’s medical insurance, are the responsibility of the resident.

· If after testing and evaluation, a trainee is found to be impaired, the trainee will immediately be relieved of responsibilities.

· If a trainee refuses to participate in testing and clinical evaluation, the trainee must not be permitted to continue to provide services.

· The program director, or designee, must immediately arrange for alternative care for the trainee’s patients.

· The trainee must not be allowed to drive; the program director, or designee, must assure that alternate transportation is arranged.

· The program director must make a full report to the Associate Dean for Graduate Medical Education and contact ISMA PAP for further assessment, and if necessary, treatment in accordance with the IUSM Alcohol and Drug-Free Workplace Policy.

· If a trainee displays conduct that raises suspicion of physical or mental impairment that could compromise patient care, even if the trainee does not appear to be rendering care under the influence of drugs or alcohol, the program director shall mandate evaluation of the trainee by the IUSM Office of Counseling Services and /or ISMA PAP.

Confidentiality

Confidentiality of the trainee seeking referral or has had a formal or mandatory referral for assistance will be maintained, except as limited by law, ethical obligation, or when the safety of a patient is threatened. In all instance, every effort to protect the confidentiality of the individual referred for assistance will be made.

04/29/2006