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Effective Risk Management Strategies in Outpatient Methadone Treatment

This module highlights the relationship between risk and practice in outpatient methadone treatment. It provides guidelines for risk management, informed consent processes, integrating patient's family, and addressing impairment risks. It emphasizes the importance of documenting and communicating risks to ensure a safe and effective treatment environment.

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Effective Risk Management Strategies in Outpatient Methadone Treatment

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  1. Effective Risk Management Strategies in Outpatient Methadone Treatment: Clinical Guidelines and Liability Prevention Curriculum MODULE 3 The Relationship between Risk and Practice in the OTP

  2. OTP Ideal Standard of Care From admission, each patient receives: • Individualized clinical care • Ongoing • Documented • Competent staff • Good clinical judgment • OTP clinical practice standards • Incorporating best- and evidence-based practices * Adapted from CSAT Workshop on Risk Management - 2005

  3. Understand your Risks More Effective Risk Management Understand yourStrategies

  4. OTP Core Liability Risks • *Borrowed from CSAT Workshop on Risk Management-2005 • Document • Communicate risks • Review and correct • Consider what’s “reasonable” and “foreseeable” • Assess for impairment • Attend to RED flags Failureto:

  5. RM Strategy: Informed Consent “informed” Consent must be “voluntary” Patient’s signature Informed Consent PROCESS

  6. Informed Consent for OTPs Patients should understand: • Basic science of addiction • Methadone treatment • Benefits • Risks • Alternatives

  7. The Right Thing to do: Phased Informed Consent Phased Informed Consent PROCESS

  8. Consents: A Valuable RM Tool • Providing information via consents may increase and motivate patient involvement in treatment • Phased informed consent • Helps share or “transfer” risk • Provides patient buy-in • Identify understanding and comprehension related to treatment

  9. Added Risks at Admission • Patient is unknown and history may be unreliable • Patients’ responses to methadone may be variable • Patient may not adhere to treatment recommendations

  10. RM Strategy: Integrate Patient’s Family • How can we get patient families and significant others involved in their treatment? Maybe we could: • Invite participation of family in patients treatment • Have patients sign Release Confidential Information • Educate family members about warning signs of potential overdose

  11. Impairment-A Severe Risk Exposure • Trends show impairment as an increasingly likely factorin more claims filed against OTPs DANGER Ahead

  12. High Risk for Impairment • During the induction process • Drug-Drug interactions with methadone • Benzodiazepines • Alcohol • Cocaine • Other sedative-hypnotic medications • Muscle relaxants

  13. RM Strategy: Do Not Bury your Head in the Sand • Duty to take action • Duty to warn

  14. In Summary • DON’T IGNORE • Duty to warn • Duty to make reasonable inquiry and assess • Obtain Phased Informed Consent • Document, document, document

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