There are several different theories as to the origin of the phrase Mind Your P's And Q's. One explanation suggests that this phrase would be used by parents to educate their children to not forget to use those polite words when they speak to people. Possibly, it meant "please" and "excuse me." Young children would pronounce them as Ps and Qs. In the world of compliance polite words can also play a part in honoring your policies and procedures (P&P's).
It was recently reported in the Washington Post that a man was awarded $500,000 due to comments an anesthesiologist made during his colonoscopy. Although the man was under conscious sedation at the time the comments were made, it did not matter; by pressing record on his cell phone prior to the procedure so he could save any instructions the physician would give him, the patient's recording caught the anesthesiologist making insulting statements:
- "After five minutes of talking to you in pre-op, I wanted to punch you in the face and man you up a little bit."
- After the medical assistant noted the man had a rash, the anesthesiologist warned her not to touch it, you might "get some syphilis on your arm or something, It's probably tuberculosis in the penis, so you'll be all right."
- Additionally, the medical assistant noted that the man reported getting queasy when watching a needle placed in his arm, the anesthesiologist
remarked, "well, why are you looking then, retard?"
These are just a few of the insulting P's and Q's the anesthesiologist was recorded saying during the patient's colonoscopy, that resulted in the jury awarding $100,000 for defamation, $200,000 for medical malpractice and $200,000 in punitive damages $500,000 total.
Follow P and P's
For the incident above, there are some questions that should be considered:
- Was this an isolated incident for the anesthesiologist?
- Was the behavior of the anesthesiologist a regular occurrence?
- Did this behavior occur with other patients?
- Could this incident have been prevented if someone would have reported the anesthesiologist for her behavior in previous patient encounters?
While you may not be able to completely control the actions of an individual completely, your policies and procedures should encourage anyone involved in patient care, to respect the rights of all patients.
A policy that is critical for all employees to be aware of and a policy that must be followed is your organization's Sanction Policy. It is a requirement under HIPAA to have a sanction policy where covered entities "apply appropriate sanctions against workforce members who comply with the security policies and procedures of the covered entity." This sanction policy should categorize sanctions according to the nature of the privacy or security incident, and should be modifiable depending on the severity of the incident(s).
In the incident above, by having an enforceable sanction policy that encourages employees to report any known or suspected non-compliance with the organization's policies and procedures it may have discouraged the anesthesiologist from behaving the way she did and may have encouraged the medical assistant to report the insulting comments.
This is just one of many examples that demonstrate the importance of all employees following an organization's policies and procedures. Policies and procedures shouldn't just be something your organization must do to be compliant; rather, they should establish a culture of professionalism, dignity and respect for all patients and healthcare professionals. Now more than ever before, it is important for employees to mind their P's and Q's and follow their P and P's.
If you have any questions about HIPAA policies and procedures, need help developing an enforceable sanction policy, or have any other compliance questions, please feel free to comment below or send us an email at [email protected]healthcarecompliancepros.com or reach us by phone toll-free at 855-427-0427.