Why is Maintaining Continuous Professional Liability Insurance So Important?
Over the years, NLPB has published numerous reminders – emails, Apothecary and PostScript articles, webinars – regarding the importance of professional liability insurance (PLI) and the expectation that all registrants maintain coverage but still each year, when audited, we find registrants who have not maintained adequate liability insurance coverage.
The Legal Basis
As a reminder, this requirement is absolute, as stated in sections 14-17 of the Pharmacy Act, 2012 and sections 8-9 of the Pharmacy Regulations, 2014. The legislation sets the requirement for registrants to have PLI coverage but gives the board the authority to set the criteria for this coverage – which can be found in the Interpretation Guide – Professional Liability Insurance Requirements for Registration. Additionally, registrants should note that section 85(c) of the NLPB Bylaws includes “practicing pharmacy while not covered by a policy of professional liability insurance acceptable to the board” in the definition of “Professional Misconduct”.
The Practical Concerns
Having sufficient PLI coverage is essential to protect both you and your patients. Even the most skilled and diligent practitioners make mistakes from time to time. Fortunately, most mistakes are caught before medications go out the door and do not result in harm. But, once in a while, the worst-case scenario happens, and a medication error occurs, or patient counselling goes wrong. When a patient is harmed by a mistake made or advice given by their practitioner, that patient may be entitled to damages (a financial award from the practitioner) to compensate for medical expenses incurred as a result of the mistake or lost wages if the patient loses work. In some circumstances, these damage awards can be significant, particularly if a patient requires medical care for an extended period of time, or is unable to return to work in their previous career. The patient may also be entitled to additional damages for pain and suffering, which are generally granted by a court to the patient suffering as a result of the mistake. If a patient dies after a medication error, their family may also be entitled to cost recovery for expenses and damages.
Having appropriate PLI coverage helps ensure that your patient gets the support and resources they need to prevent any further undue suffering after a mistake has occurred, pays the damages awarded to the patient, and also pays for a lawyer to handle any court matters. You will likely have only minimal involvement in the legal and financial processes, which greatly reduces the stress on both you and your employer. However, if you do not have active PLI coverage when such a mistake occurs, you may be held personally liable for any financial damages that result from the mistake. This means that you may be personally responsible for paying your patient’s related medical bills for the rest of their life, compensating for their lost wages, and paying for lawyers to handle the court matters. If you don’t have the finances in your bank account to pay these bills, you may lose your investments, vehicles, or even your home. In addition, the pharmacy you work for may also be held liable for damages that result from your mistake. In the worst case, your injured patient may suffer even further if you do not have appropriate insurance and you or your pharmacy cannot cover the cost of the damages they are entitled to.
What Can I Do To Make Sure This Doesn’t Happen To Me or My Patients?
In order to help ensure that these extreme situations do not happen to you,
- Do not rely solely on reminders from your insurer or the board – we all know e-mails sometimes get lost, missed, or sent to junk mail. While reminders are a helpful trigger, ensuring your policy is up to date is your responsibility and relying on another organization to remind you might not be enough to protect you or your patients.
- Set a recurring reminder in your calendar or on your phone for one month before your policy expires to make sure you remember to renew on time.
- Pharmacists-in-charge should check in with staff (including relief staff) on a regular basis to ensure no one misses their policy renewal date. Adding it to your Staff Meeting standing agenda may be helpful.
- If you do miss your renewal date, contact your insurer immediately upon discovering the lapse and make sure that they back-date your renewal to the day your policy expired.
If you have any questions about this requirement or the coverage criteria, please contact NLPB at firstname.lastname@example.org
Secure Storage of Methadone
In response to recent NLPB Quality Assurance activities and a break-and-enter resulting in theft, registrants are reminded that methadone stock bottles must be stored in a safe or cabinet that can be securely locked, as is required of all narcotics and controlled drugs. In the event that the bottles are too large to fit in the primary storage area, a secondary storage area meeting the Standards must be available and utilized. Methadone must not be left outside of secure storage areas when registrant staff are not on site.
If methadone is stored outside of a safe or cabinet during operating hours, when registrant staff are present, ISMP Canada recommends that this area be located outside of public view
(https://www.ismp-canada.org/download/safetyBulletins/2020/ISMPCSB2020-i9-Methadone.pdf). Similarly, methadone preparation and storage areas should be restricted to those under the supervision of pharmacy staff, with no opportunity for unauthorized patient access.
Diluted preparations must be stored in an appropriate secure location (e.g. lockable fridge) until they are released to the patient.
If you have questions about these requirements or want to ensure that your pharmacy’s storage areas are appropriate, contact NLPB at email@example.com.
Call for Expression of Interest – Working Group on Point of Care Testing and Laboratory Testing by Pharmacists
NLPB is seeking interested registrants to serve as members of a working group affiliated with the NLPB Pharmacy Practice Advisory Committee. The primary role of this working group is to consider the practices of point of care testing and laboratory testing and make recommendations regarding guidelines and/or standards of practice related to these practices.
If you have any questions about the working group’s role, please contact Melanie Healey, Associate Registrar-Professional Practice, at firstname.lastname@example.org.
If you are interested in participating, please submit your name, contact information, a brief bio, and a few lines about why you’d like to be a member of the working group to email@example.com by March 12, 2021.
Thank you in advance for your interest in serving your profession.
Did You Know? – Health Canada & ISMP Advisories & Newsletters
Did you know that NLPB maintains a page on our website dedicated to sharing Health Canada and ISMP advisories and newsletters?
On this page, we regularly post:
- Health Canada advisories for both the public and health professionals
- monthly issues of Health Canada’s Health Product InfoWatch newsletter
- upcoming ISMP Canada Education Events
- monthly issues of ISMP Canada’s Safety Bulletin
- monthly issues of ISMP Canada’s Safe Medication Use Newsletter
All of these sources contain valuable information designed to improve medication safety and help health professionals provide quality care to their patients.
One particular article of interest in a recent ISMP Canada Safety Bulletin was entitled “Medications Most Frequently Reported in Harm Incidents over the Past 5 Years (2015–2020)”. The information presented in this article highlights that while awareness of high-alert medications and the need for related safeguards has increased over time, there are a number of medications that continue to cause patient harm. Pharmacists should ensure that they are investigating and implementing effective strategies for reducing the risk for error and harm for high-alert agents.
For more from Health Canada and ISMP, visit the Health Canada & ISMP Advisories page of the NLPB website.
Opioid Dependence Treatment Centre of Excellence- Project ECHO NL: Opioid Use Disorder
Would you benefit from support in providing opioid agonist maintenance treatment (OAMT)?
To help increase educational opportunities for pharmacists currently delivering or interested in providing OAMT, the Provincial Opioid Dependence Treatment Centre of Excellence, located within Eastern Health, replicated the Project ECHO model. Originally developed to improve access to care for hepatitis C patients living in rural areas of New Mexico, there are now 960 ECHO programs worldwide and a body of evidence attesting to the model’s effectiveness for enhancing provider knowledge and ability in the treatment of opioid use disorder (e.g. Holmes et al., 2020; Kawasaki et al., 2019).
Project ECHO NL: Opioid Use Disorder offers free, virtual learning sessions to link health care providers with an interdisciplinary team of mentors with experience in managing substance use care. Each session is one hour in duration and includes a lecture aligning with the weekly curriculum topic and the discussion of a de-identified patient case presented by one of the participants. The schedule and registration details can be found on the Project ECHO NL website at: https://mha.easternhealth.ca/adults/opioid-treatment-and-naloxone/echo/
Benefits for pharmacists include:
- Acquire new skills and competencies in OAMT
- Join a community of learners and decrease feelings of professional isolation
- Professional Development: Sessions are eligible for Mainpro+ credits, considered an acceptable accredited learning activity by the Newfoundland and Labrador Pharmacy Board
- Schedule rotates between early morning and lunch timeslots
- Minimal equipment and preparation required to participate via Zoom
Pharmacists are integral to increasing access to OAMT throughout Newfoundland and Labrador. As a primary target audience, if you have any feedback about this initiative and ways in which we can facilitate your participation, please contact Kate Lambert at firstname.lastname@example.org.
Session 6: Decoding Urine Drug Screens (UDS)
February 16, 2021
12:00 p.m. – 1:00 p.m. NST
Session 7: Sublocade: Indications and Use
March 2, 2021
8:30 a.m.– 9:30 a.m. NST
To register, please contact Chelsea Hynes at email@example.com.
- Registrant Contact Information – Registrants are responsible for ensuring that the contact information on their registrant profile, including email address and practice site, is accurate at all times. The NLPB primarily uses email communication to send newsletters, renewal reminders, practice site assessment information, professional development audit information, calls for interest for committees, and other alerts. If the email address on file is incorrect, important information may be missed and/or disclosed to the wrong person. If your contact information changes, please log into the NLPB Online Registrant Portal to update your file with your new contact information as soon as you can.
- Forgot Your Password? – You can retrieve your NLPB Online Registrant Portal password at any time. Under the Login box, click the message that says, “Forgot your password? Click here to restore it.” On the next screen, enter your NLPB username, if you know it, or your email address. Click “Retrieve.” In a few minutes, you will receive an email with your username and password. Once you are logged into your profile, you can change your password.
- Receipts & Invoices – NLPB’s Online Registrant Portal maintains all receipts created by the system. If for any reason, you need a receipt or to view an invoice, you can do so from your registrant profile. Once logged in, click on “Renewal Other/Invoices” and then select either “view invoice” or “print invoice” next to the one you are interested in.
This e-newsletter contains information on a wide variety of topics intended to enhance the practice of pharmacy in the province of Newfoundland and Labrador. As it is published and circulated to all registrants on a monthly basis, it is the expectation of NLPB that all registrants are aware of the matters contained therein.