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Well-crafted policies and procedures are an essential part of the operation of modern health-care facilities. They promote practice consistency and are believed to improve clinical outcomes; however, in the event of a bad outcome, policies and procedures become evidence in litigation, and “violations” frequently become the central focus of malpractice claims.
When violations of policy are brought up by claimants, they argue that the policies and procedures prove the applicable standard of care. Defendants counter that policies and procedures are “aspirational guidelines” or “best practices,” but not proof of the standard of care.
Most courts allow policies and procedures to be introduced as evidence that the jury can consider while evaluating standard of care arguments, and recent appellate decisions throughout the country trend toward allowing evidence of violations of policies and procedures as evidence of malpractice. In rare cases, a violation or deviation from written policies and procedures may be considered negligence per se, supporting a finding of liability. On the other end of the spectrum, violations of policies and procedures may be considered inadmissible in some situations. The modern trend appears to be toward the middle of these extremes, where evidence of “violations” of policies and procedures is admissible, but does not alone establish a breach of the standard of care. In this article, we look at the different approaches across the country.
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