Michelle Mello and colleagues: "...communication-and-resolution programs will not lead to higher liability costs when hospitals adhere to their commitment to offer compensation proactively."

Health Aff (Millwood). 2017 Oct 1;36(10):1795-1803. doi: 10.1377/hlthaff.2017.0320.

Outcomes In Two Massachusetts Hospital Systems Give Reason For Optimism About Communication-And-Resolution Programs.

Mello MM1, Kachalia A2, Roche S3, Niel MV4, Buchsbaum L5, Dodson S6, Folcarelli P7, Benjamin EM8, Sands KE9.

Author information

1

Michelle M. Mello (mmello@law.stanford.edu) is a professor of law at Stanford Law School and a professor of health research and policy at Stanford University School of Medicine, in California.

2

Allen Kachalia is an associate professor of medicine at Harvard Medical School and chief quality officer at Brigham Health, both in Boston, Massachusetts.

3

Stephanie Roche is a quality analyst at Beth Israel Deaconess Medical Center, in Boston.

4

Melinda Van Niel is a project manager at Beth Israel Deaconess Medical Center.

5

Lisa Buchsbaum was a project manager at Beth Israel Deaconess Medical Center at the time this research was conducted. She is now a patient safety program manager at Regions Hospital, in St. Paul, Minnesota.

6

Suzanne Dodson was a project manager at Baystate Medical Center, in Springfield, Massachusetts, at the time this research was conducted. She is now retired.

7

Patricia Folcarelli is interim vice president for health care quality at Beth Israel Deaconess Medical Center.

8

Evan M. Benjamin is a professor of medicine at Tufts University School of Medicine, in Boston, and senior vice president at Baystate Health, in Springfield.

9

Kenneth E. Sands was senior vice president at Beth Israel Deaconess Medical Center at the time this research was conducted. He is now chief epidemiologist and chief patient safety officer at HCA, in Nashville, Tennessee.

Abstract

Through communication-and-resolution programs, hospitals and liability insurers communicate with patients when adverse events occur; investigate and explain what happened; and, where appropriate, apologize and proactively offer compensation. Using data recorded by program staff members and from surveys of involved clinicians, we examined case outcomes of a program used by two academic medical centers and two of their community hospitals in Massachusetts in the period 2013-15. The hospitals demonstrated good adherence to the program protocol. Ninety-one percent of the program events did not meet compensation eligibility criteria, and those events that did were not costly to resolve (the median payment was $75,000). Only 5 percent of events led to malpractice claims or lawsuits. Clinicians were supportive of the program but desired better communication about it from staff members. Our findings suggest that communication-and-resolution programs will not lead to higher liability costs when hospitals adhere to their commitment to offer compensation proactively.