Does taking responsibility for errors help hospitals?

Some hospitals may choose to be transparent with patients after medical injuries through communication-and-resolution programmes, as a way to improve patient safety. FILE | NATION

When a medical error happens, hospitals could choose to admit the error, or not, with fears that admitting to an error could result in increased liability costs if patients or their families seek legal redress.

Some hospitals, though, may choose to be more transparent with patients after medical injuries through communication-and-resolution programmes, as a way to improve patient safety.

The approach involves openly communicating with patients after adverse events, investigating specifics, providing explanations and taking responsibility when necessary and proactively offering compensation.

“It allows hospitals to do the right thing – be honest about errors, apologise and compensate patients who are injured by negligence – without adverse financial consequences,” said Dr Allen Kachalia chief quality officer at Brigham and Women’s Hospital in the US, and first author of a paper which looked into such programmes.

Researchers examined if the communication and resolution programme implemented in four hospitals in the US led to more malpractice claims and compensation and legal defence costs and how long it took to find resolutions.

They compared trends in the six years before the CARe (communication, apology and resolutions) programme was implemented and a few years after implementation.

They calculated new claims, new claims receiving compensation, compensation cost, defence cost, total liability cost and average compensation cost.

ETHICAL OBLIGATION

Their results, published in Health Affairs, found that these programmes were associated with improved trends in the rate of new claims and legal defence costs at some of the hospitals. And the approach did not expand liability risk at any of the hospitals.

Instead, the programme allowed hospitals to fulfil their ethical obligations to disclose adverse events and promote patient safety without encountering negative liability consequences.

A claim was defined as any written request for patient compensation that was brought to the liability insurer, whether initiated by the patient, family, or hospital.

After CARe implementation, the team found there was a significant decrease in the rate of new claims at the implementing community hospitals and academic medical centres, a change that was not seen at hospitals that did not implement CARe.

The implementing hospitals experienced a significant decrease in defence costs after implementing CARe. Additionally, there were no significant changes in total liability costs observed nor in the average compensation amount per paid claim at any of the hospitals.

“Our hope is that with these findings, more hospitals will have greater confidence that communicating openly with patients around errors and injury is not likely to create greater liability risk,” said Dr Kachalia.

The findings were published in a special edition on patient safety, which reviewed effective interventions for hospital-acquired infections, new safety risk areas including diagnostic errors and technology-related concerns, and electronic prescribing safety. -Science Daily