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Effects Of A Communication-And-Resolution Program On Hospitals' Malpractice Claims And Costs
Allen Kachalia1, Kenneth Sands2, Melinda Van Niel3
1Allen Kachalia ( akachalia@bwh.harvard.edu ) is chief quality officer at Brigham Health, in Boston, Massachusetts.
Health Affairs (Project Hope)
|November 6, 2018
Summary
Implementing communication-and-resolution programs (CRPs) after medical injuries may reduce new claims and defense costs. Hospitals can adopt transparent communication and compensation strategies without negative financial consequences.
Area of Science:
- Healthcare Management
- Patient Safety
- Medical Malpractice
Background:
- Hospitals increasingly adopt Communication-and-Resolution Programs (CRPs) to improve patient communication and safety post-medical injury.
- CRPs involve transparent communication, investigation, explanation, apology, and proactive compensation for adverse events.
- Concerns persist regarding potential liability risks associated with CRP implementation.
Purpose of the Study:
- To evaluate the liability effects of implementing CRPs in four Massachusetts hospitals.
- To compare trends in claims volume, cost, and resolution time before and after CRP implementation against non-implementing peers.
Main Methods:
- Quasi-experimental study design comparing hospitals with and without CRPs.
- Analysis of before-and-after trends in medical malpractice claims data.
- Inclusion of claims volume, cost, and time to resolution as key metrics.
Main Results:
- CRP implementation showed association with improved trends in new claims rates and legal defense costs at some hospitals.
- No significant alteration in other liability outcome trends was observed.
- No hospital experienced worsening liability trends post-CRP implementation.
Conclusions:
- Transparency, apology, and proactive compensation through CRPs can be implemented without adverse financial consequences.
- CRPs represent a viable strategy for enhancing patient safety and communication while managing liability.
- Further research may explore long-term liability impacts and broader adoption of CRPs.