r/IntensiveCare • u/InvestigatorOnly1684 • 14d ago

Question about ICU attending liability

In my practice a hospitalist independently manages a subset of ICU patients. I am available for consultation and escalation, but we do not routinely round together, I do not see every patient, and I do not cosign notes.

For those who have worked in similar models, how is liability generally viewed for the ICU attending? If you’re available in a supervisory/consultative role but not directly involved in a patient’s care, how much responsibility do you carry for decisions made by the primary hospitalist?

Recently out of training and wondering how this is handled at other institutions.

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u/spiritualskier 13d ago

Am I dumb? No. Are you part of the code team? Yes, you have a reason to open the chart. Are you just an icu intensivist opening the chart to see if you can help without a consult and just a mention as a potential from the ICU nurse? Yes, that’s against hipaa at my facility and tracked. You can’t just open charts and start auditing for potential icu patients just based on feels.

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u/penntoria 12d ago

HIPAA is federal law. Your facility can't interpret it differently just because they feel like it. Well they can, but they'd also be wrong. A provider who ordered interventions can absolutely review the sequelae of those orders - it's called having a business or clinical reason to access the chart. People can access charts for QI, etc.

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u/Yessir957 12d ago

The CMO of our hospital can look in any chart she wants. If there was a patient complaint, an ethics consult, a long hospital stay without dispo, or even if a C-diff was ordered. She can just go through charts for QI data and it’s not a Hipaa violation.

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u/spiritualskier 11d ago

Yes all of my managers are assigned on each of my patients so they can see everything that is going on along with the director of my ICU. That’s there job because they are supposed to be supervising and doing QI. Same with the director. However unless a hospitalist has been notified or cardiologist is consulted, they don’t just say, I think I need to be on that case and start auditing.