Kenneth Rothfield, MD, MBA, CPE

Speaker Profile

• Serves on the board of the Physician-Patient Alliance for Health & Safety.
• Nationally recognized for his work in emergency airway management, opioid safety and respiratory monitoring.
• Awarded the Circle of Honor Award for Innovation in Patient Safety from the Maryland Patient Safety Center.

Joan Rivers arrived at Yorkville Endoscopy in midtown Manhattan for what was supposed to be a routine endoscopy. Hours later she slipped into a coma and never recovered. The iconic comedienne's death put the quality of care provided at outpatient facilities in the media's crosshairs, says Kenneth Rothfield, MD, MBA, CPE, system vice president and chief medical officer at Saint Vincent's Healthcare in Jacksonville, Fla. He'll wrap up this year's conference by discussing what went wrong on that fateful day in his presentation "Lessons Learned from the Death of Joan Rivers: Ensuring Patient Safety in Outpatient Surgery."

• A wake-up call for surgical facilities. This incident has increased media scrutiny on outpatient surgical facilities. What has been the result of that attention? For starters, it created uncertainty for patients. It's very difficult from the patient perspective to assess the quality and safety of an outpatient center. The media has posed more questions about the safety of centers than it has answered. But there is a potential positive from the increased attention. It may be a wake-up call for some centers to re-evaluate their policies and practices.
• What will you discuss about the case? I'll review the known facts from the report issued by the Department of Health and Human Services as well as accusations from the lawsuit filed by Joan's daughter, Melissa. Why was the vocal cord biopsy performed? Did an uncredentialed ENT provider perform the procedure? Was there an anesthesiologist in the room? Did Ms. Rivers's personal doctor take an inappropriate "selfie" during the case? These are the key points we'll discuss.
• Lessons for us all. All facilities can learn lessons from the incident. There are potential pitfalls to caring for VIPs. And although having appropriate equipment is a prerequisite, the need for regular drills for treating uncommon crises cannot be overemphasized. We'll discuss the benefits of operationalizing a crisis management checklist for the medical complications most likely to occur in the outpatient setting.

• What barriers do facilities continue to face when ensuring patient safety? Some of most common safety risks are cultural. When there is low psychological safety, nurses and anesthesia providers may not speak up. There's also a lack of training and drilling for complications. Potential solutions include expanded checklist adoption and regular team training. Even more basic precautions involve an organizational infrastructure that includes respectful communication and a just culture, meaning individuals aren't punished for human error, but are held accountable for decisions.

• Are there special precautions facilities must take when caring for a celebrity? There's a risk that facilities will make different decisions that contrast with routine care. Trying to provide an "extra special experience" for VIPs is dangerous. Medical providers are at risk for becoming starstruck, or establishing a relationship with the VIP for personal or professional gain. We'll address VIP privacy concerns and the importance of avoiding deviation from standard procedures and techniques when caring for local or national celebrities.