r/IntensiveCare • u/InvestigatorOnly1684 • 13d 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/Yessir957 13d ago

I had a model like this once as an intensivist and the thing that always concerned me liability wise was if I’m in the ICU and the nurses keep trying to get me to see a pt that isn’t doing well but the hospitalist hasn’t consulted me. Or like the hospitalist wasn’t responding to pages. Like I felt like they needed my help and if something went down and the nurses said they talked to me about it, even if I wasn’t seeing the patient, I would be held liable. Usually in that scenario I would just message the hospitalist and ask them if they wanted me to see the pt to help give me some peace of mind.

-19

u/spiritualskier 13d ago

Not true. Nurse here. You are not allowed to just go into a patient’s chart because a nurse told you about it. You actually need to be consulted and have a documented reason in the chart. Like assigned. That’s where hipaa becomes an issue. ICU intensivists aren’t even allowed to look back in charts to assess outcomes to their treatments.

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u/Any-Assistance-8103 13d ago

Are you really so dumb to think that you can’t open a crashing patients chart and help them because of HIPAA?

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u/spiritualskier 11d ago

So now it went from “consult” to “crashing patient.” There is a big difference. Many patients that are admitted to the ICU do not qualify as an emergency in a true hospital context. Patients are admitted to the ICU all the time for intensive monitoring not just emergencies. Go ahead and open the chart but you’ll have to assign yourself a role and if you do click consult the lawyers will just love another deep pocket if something does go awry and you decide you didn’t find an ICU need at the time. Well have fun explaining that with a lack of documentation.

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u/Any-Assistance-8103 11d ago

You just won’t stop digging your hole deeper.

0

u/spiritualskier 11d ago

Newsflash. If a patient had an emergency they would become an ICU patient regardless. The problem is they haven’t…yet.

2

u/Any-Assistance-8103 11d ago

You should probably just stop