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February 3, 2016

How Stanford Hospital cut malpractice lawsuits in half

Daily Briefing

Some providers are using "communication and resolution" programs to engage with patients who might otherwise file a malpractice lawsuit, Laura Landro reports for the Wall Street Journal.

It's rare for hospitals to apologize or offer compensation to patients who say they are victims of medical errors. Hospitals typically don't want to offer money until they're sure a malpractice claim is going to be filed, and fear an apology could work against them as evidence of liability.

But some providers take a different approach, actively reaching out to patients after a possible error to offer an apology, an explanation, and—if warranted—compensation.

Don't want to be sued? Here's what doctors should do.

Stanford Hospital surgery patient Gary Avila saw that approach in action with Stanford's Process for Early Assessment, Resolution, and Learning (Pearl) program.

After a surgeon accidentally damaged one of Avila's nerves, affecting the use of his hands, Stanford reached out to Avila and offered:

  • An apology;
  • An explanation of what went wrong;
  • A waiver of his medical bill; and
  • A monetary settlement that both parties agreed to keep confidential.

Months later, Avila appreciates the approach Stanford took. "I'm not fully recovered, but well on the way and very happy with the outcome," he says.

The doctors most likely to be sued—and what they learn from it

Communication and resolution programs sometimes offer patients compensation even when a health system determines that doctors met the standard of care. For instance, such patients at Stanford can receive up $5,000 for out-of-pocket expenses.

"Sometimes we recognize that patients need to heal and need answers, and even if we aren't obligated to provide compensation, it is still the right thing to do," Jeffrey Driver tells the Journal. Driver is CEO of Risk Authority Stanford, a subsidiary of Stanford Health Care and Stanford Children's Health that provides risk-management services.

Benefits for providers

Between Pearl's launch in 2009 and 2014, Stanford's frequency of malpractice lawsuits dropped by 50% compared with 2003 to 2008. The average cost of individual malpractice claims also dropped by 40%.

Hidden in the SGR deal: Malpractice suits can't use federal quality metrics

Amid Stanford's success, more hospitals are beginning to adopt communication and resolution programs—driven in part by pressure from lawmakers, patient safety groups, and accrediting organizations to take more action to prevent medical errors.

For instance, the federal Agency for Healthcare Research & Quality has funded several communication and resolution demonstration programs that:

  • Train hospital staff to immediately report errors, without fear of punishment; and
  • Urge hospitals to learn from errors to develop  preventive measures (Landro, Wall Street Journal, 2/1).

Does your organization need more legal protection?


Many physicians worry that more personal performance data means increased malpractice risk. In fact, concern over this issue has led some organizations to begin taking advantage of special data protections extended to Patient Safety Organizations.

But this is a questionable strategy.


More from today's Daily Briefing
  1. Current ArticleHow Stanford Hospital cut malpractice lawsuits in half

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