Liability Claims and Costs Before and After Implementation of a Medical Error Disclosure Program

Kachalia, Allen; Kaufman, Samuel R.; Boothman, Richard C; Anderson, Susan G.; Welch, Kathleen B.; Saint, Sanjay; Rogers, Mary A.M.

doi:10.7326/0003-4819-153-4-201008170-00002

Cited by 316 publications

(198 citation statements)

References 24 publications

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“…Both limited-reimbursement and full-compensation model programs have reported that malpractice claims decreased following program implementation. 5,6 Attorney consultations may actually prove helpful in facilitating early settlement, if attorneys confirm that offers are fair and reasonable, or at least more attractive than patients' prospects in lawsuits. Some institutions currently operating disclosure-and-resolution programs refer patients-particularly those who have been seriously injured or appear distrustful-to reputable plaintiff's attorneys who provide good-quality representation and have demonstrated openness toward early settlement.…”

Section: Discussionmentioning

confidence: 99%

“…3 Early disclosure-and-resolution adopters report promising results. [4][5][6][7] However, few publicly available data exist concerning the programs' effectiveness. Even less is known about what accounts for their reported success-and to what extent patients' favorable responses to the disclosure-and-resolution approach are attributable to effective disclosure or apology practices versus compensation offers.…”

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confidence: 99%

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Disclosure-And-Resolution Programs That Include Generous Compensation Offers May Prompt A Complex Patient Response

et al. 2012

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Under "disclosure-and-resolution" programs, health systems disclose adverse events to affected patients and their families; apologize; and, where appropriate, offer compensation. Early adopters of this approach have reported reduced liability costs, but the extent to which these results stem from effective disclosure and apology practices, versus compensation offers, is unknown. Using survey vignettes, we examined the effects of different compensation offers on individuals' responses to disclosures of medical errors compared to explanation and apology alone. Our results show that although two-thirds of these individuals desired compensation offers, increasing the offer amount did not improve key outcomes. Full-compensation offers did not decrease the likelihood of seeking legal advice and increased the likelihood that people perceived the disclosure and apology as motivated by providers' desire to avoid litigation. Hospitals, physicians, and malpractice insurers should consider this complex interplay as they implement similar initiatives. They may benefit from separating disclosure conversations and compensation offers and from excluding physicians from compensation discussions.

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Section: Discussionmentioning

confidence: 99%

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confidence: 99%

Disclosure-And-Resolution Programs That Include Generous Compensation Offers May Prompt A Complex Patient Response

et al. 2012

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“…The adoption of this program has decreased liability claims, patient lawsuits, resolution time, and associated costs. 3 In response to this study, we believe that the cultures of medicine and health care should be even more accepting of physician practices of openly admitting mistakes and apologizing.…”

Section: Discussionmentioning

confidence: 99%

Outdated dermatologic drug samples and obligations to the patient

Wang

Keller

2013

Journal of the American Academy of Dermatology

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“…Evaluation of the programme found a decrease in new legal claims, number of lawsuits per month, time to claim resolution, and costs after implementation of the program of disclosure with offer of compensation. This approach did not increase legal claims and costs even in the notoriously litigious United States (Kachalia et al 2010 ); in fact some decline in litigation was reported in Michigan generally through the latter part of the study period. Several New York hospitals have now implemented similar 'communication and resolution programmes'.…”

Section: Box 72 Medically Induced Trauma Support Services (Mitss)mentioning

confidence: 99%

Safety Strategies in Hospitals

Vincent

Amalberti

2016

Safer Healthcare

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We have developed a series of ideas and proposals in the book which together laid the foundations for fi ve safety strategies described in Chap. 6 . We believe that thinking of safety strategies in this way has three major advantages: fi rst, we can enlarge the range of safety strategies and interventions available to us; secondly we can customise the blend of strategies to different contexts and third the high level architecture of safety strategies may help us think more strategically about safety both day to day and on a long term basisIn this chapter we begin the process of exploring how these strategies might support safety in the hospital. The following chapters address home care and primary care. In each case we provide a short introduction to relevant aspects of safety in each context but do not dwell on well-established fi ndings. Our primary purpose is to provide examples of interventions associated with each of the fi ve strategies and to give a sense of the potential value of such an approach. We recognise that, in the longer term, considerable further empirical work would be needed to develop and confi rm (or discount) our proposals. A Little HistoryHospital care has been the main focus of patient safety for two decades now and we can distinguish a series of phases of exploration and intervention. Each phase brought some success but simultaneously revealed barriers and limitations, which in turn stimulated a new phase of work in an evolving trial and error strategy. With experience and maturity, we understand more today about what is achievable and what has proved illusory. We are much more aware of how diffi cult it is to improve safety in both the short and long term.What has been done in past decades? In the past 15 years we can distinguish three main phases each associated with different types of action and intervention. The earlier strategies have continued as the new ones emerged so that we now have 'a safety layer cake' of practices and interventions. The Enthusiasm of the Early Years, 1995-2002Systematic work on patient safety began in the mid 1990s with an emerging demarcation between a broad concern with quality and a specifi c focus on harm. In Britain for instance the development of clinical risk management, initially targeted at the reduction of litigation, brought a new emphasis on the analysis and reduction of harmful incidents and events (Vincent 1995 ). The methods and assumptions however remained rooted in those of quality improvement; the aim was to identify and count errors and incidents and then fi nd ways of preventing them. Establishing reporting systems to detect and record incidents was at the core of the strategy. This approach was rapidly reconsidered as a result of both massive under-reporting, especially from doctors, and a gradual realisation of the impossibility of resolving the growing number of problems identifi ed in reporting systems (Stanhope et al. 1999 ). A wider vision was needed which was provided by systemic concepts and tools imported from industry. The Adv...

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Liability Claims and Costs Before and After Implementation of a Medical Error Disclosure Program

Abstract: Blue Cross Blue Shield of Michigan Foundation.

Cited by 316 publications

References 24 publications

Disclosure-And-Resolution Programs That Include Generous Compensation Offers May Prompt A Complex Patient Response

Disclosure-And-Resolution Programs That Include Generous Compensation Offers May Prompt A Complex Patient Response

Outdated dermatologic drug samples and obligations to the patient

Safety Strategies in Hospitals

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