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

• Published in: Health Affairs Vol. 37; no. 11; pp. 1836 - 1844
• Main Authors: Kachalia, Allen, Sands, Kenneth, Niel, Melinda Van, Dodson, Suzanne, Roche, Stephanie, Novack, Victor, Yitshak-Sade, Maayan, Folcarelli, Patricia, Benjamin, Evan M, Woodward, Alan C, Mello, Michelle M
• Format: Journal Article
• Language: English
• Published: United States The People to People Health Foundation, Inc., Project HOPE 01.11.2018
• Subjects: Age; Apologies; Claims; Communication; Compensation; Compensation and Redress - legislation & jurisprudence; Consumer Price Index; Costs; Costs and Cost Analysis - statistics & numerical data; Critical incidents; Emergency medical care; Estimates; Health care expenditures; Hospitals; Hospitals - statistics & numerical data; Humans; Implementation; Injuries; Legal defense; Legal fees; Liability; Liability, Legal - economics; Malpractice; Malpractice - economics; Malpractice - legislation & jurisprudence; Malpractice - trends; Massachusetts; Medical Errors - legislation & jurisprudence; Medical malpractice; Patient communication; Patient Safety; Patients; Professional malpractice; Program implementation; Safety; Settlements & damages; Transparency; Trends; Massachusetts; United States > US; Malpractice Liablity; Disclosure of Errors; Patient Safety
• ISSN: 0278-2715; 1544-5208
• DOI: 10.1377/hlthaff.2018.0720

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.