Effects Of A Communication-And-Resolution Program On Hospitals’ Malpractice Claims And Costs

Abstract

To promote communication with patients after medical injuries and improve patient safety, numerous hospitals have implemented communication-and-resolution programs (CRPs). Through these programs, hospitals communicate transparently with patients after adverse events; investigate what happened and offer an explanation; and, when warranted, apologize, take responsibility, and proactively offer compensation. Despite growing consensus that CRPs are the right thing to do, concerns over liability risks remain. We evaluated the liability effects of CRP implementation at four Massachusetts hospitals by examining before-and-after trends in claims volume, cost, and time to resolution and comparing them to trends among nonimplementing peer institutions. CRP implementation was associated with improved trends in the rate of new claims and legal defense costs at some hospitals, but it did not significantly alter trends in other outcomes. None of the hospitals experienced worsening liability trends after CRP implementation, which suggests that transparency, apology, and proactive compensation can be pursued without adverse financial consequences.

A Guide to Investigating Suspected Outbreaks of Mucormycosis in Healthcare

“…Although there may be legal risks to the institution, disclosing potential outbreaks may increase public perception of the hospital’s integrity and reduce the chance that the public will view the hospital as having withheld information from patients. One recent study at four Massachusetts hospitals found that malpractice claims did not increase following implementation of a communication-and-resolution program through which the hospitals communicated with patients about adverse events and took responsibility when appropriate [35]. Hospitals should consult their legal counsel, communications experts, and state public health department for additional assistance.…”

What Is Ethically Informed Risk Management?

“…24,25 Aligning the principles of risk management ethics with those most often referenced by clinicians creates a shared ethical vocabulary and helps establish the legitimacy of the broader suite of principles among patients and other stakeholders. 26,27,28,29 Nonmaleficence The obligation to avoid actively causing harm ("first do no harm"), as opposed to the broader obligation to prevent harm from being caused Apart from disclosure/apology and compensation programs, 27,30,31 current literature provides scant support for assessing how risk management practice can inflict (or avoid inflicting) harm.…”

“…• Concerns about restorative justice underlie disclosure/apology and compensation programs. 27,30,31 Respect for Autonomy A duty to (1) refrain from attempting to control and constrain the autonomous actions of others and (2) actively support autonomous decision making, especially by disclosing relevant information.…”

A Systems Thinking Approach to Understanding Public Trust in Healthcare Services and Doctor-patient Relationship in the Contexts of Medical Errors

“…shown that a prompt sincere apology and communication to investigate the case and develop future prevention from healthcare providers can reduce the situation's escalation to a lawsuit in several countries and settings [18][19][20]. Physicians who understand and can respond appropriately to the emotional needs of their patients are less likely to be sued [21].…”