Do Written Disclosures of Serious Events Increase Risk of Malpractice Claims? One Health Care System's Experience

Painter, Lisa; Kidwell, Kelley M.; Kidwell, Richard P.; Janov, Cheryl; Voinchet, Robert; Simmons, Richard L.; Wu, Albert W.

doi:10.1097/pts.0000000000000178

Cited by 12 publications

(15 citation statements)

References 37 publications

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“…Research suggests that disclosing errors of which patients are unaware does not lead to more malpractice cases. [37][38][39][40] It seems unlikely that gathering patient and family reports of errors of which patients are already aware would increase malpractice risk. Moreover, engaging patients and families may drive hospitals to bridge the gap between safety reporting and improvement.…”

Section: Discussionmentioning

confidence: 99%

“…Of these, 717 completed FSIs. Their median (interquartile range) age was 32.5 (26)(27)(28)(29)(30)(31)(32)(33)(34)(35)(36)(37)(38)(39)(40) years; 380 (53.0%) were nonwhite, 566 (78.9%) were female, 603 (84.1%) were English speaking, and 380 (53.0%) had attended college. Of 717 parents/caregivers completing FSIs, 185 (25.8%) reported a total of 255 incidents, which were classified as 132 safety concerns (51.8%), 102 nonsafety-related quality concerns (40.0%), and 21 other concerns (8.2%).…”

Section: Main Outcomes and Measures-error And Ae Ratesmentioning

confidence: 99%

See 1 more Smart Citation

Families as Partners in Hospital Error and Adverse Event Surveillance

Khan¹,

Coffey²,

Litterer³

et al. 2017

JAMA Pediatr

110

115

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Medical errors and adverse events (AEs) are common among hospitalized children. While clinician reports are the foundation of operational hospital safety surveillance and a key component of multifaceted research surveillance, patient and family reports are not routinely gathered. We hypothesized that a novel family-reporting mechanism would improve incident detection. OBJECTIVE To compare error and AE rates (1) gathered systematically with vs without family reporting, (2) reported by families vs clinicians, and (3) reported by families vs hospital incident reports. DESIGN, SETTING, AND PARTICIPANTSWe conducted a prospective cohort study including the parents/caregivers of 989 hospitalized patients 17 years and younger (total 3902 patient-days) and their clinicians from December 2014 to July 2015 in 4 US pediatric centers. Clinician abstractors identified potential errors and AEs by reviewing medical records, hospital incident reports, and clinician reports as well as weekly and discharge Family Safety Interviews (FSIs). Two physicians reviewed and independently categorized all incidents, rating severity and preventability (agreement, 68%-90%; κ, 0.50-0.68). Discordant categorizations were reconciled. Rates were generated using Poisson regression estimated via generalized estimating equations to account for repeated measures on the same patient. MAIN OUTCOMES AND MEASURES Error and AE rates.RESULTS Overall, 746 parents/caregivers consented for the study. Of these, 717 completed FSIs. Their median (interquartile range) age was 32.5 (26-40) years; 380 (53.0%) were nonwhite, 566 (78.9%) were female, 603 (84.1%) were English speaking, and 380 (53.0%) had attended college. Of 717 parents/caregivers completing FSIs, 185 (25.8%) reported a total of 255 incidents, which were classified as 132 safety concerns (51.8%), 102 nonsafety-related quality concerns (40.0%), and 21 other concerns (8.2%). These included 22 preventable AEs (8.6%), 17 nonharmful medical errors (6.7%), and 11 nonpreventable AEs (4.3%) on the study unit. In total, 179 errors and 113 AEs were identified from all sources. Family reports included 8 otherwise unidentified AEs, including 7 preventable AEs. Error rates with family reporting (45.9 per 1000 patient-days) were 1.2-fold (95% CI, 1.1-1.2) higher than rates without family reporting (39.7 per 1000 patient-days). Adverse event rates with family reporting (28.7 per 1000 patient-days) were 1.1-fold (95% CI, 1.0-1.2; P=.006) higher than rates without (26.1 per 1000 patient-days). Families and clinicians reported similar rates of errors (10.0 vs 12.8 per 1000 patient-days; relative rate, 0.8; 95% CI, .5-1.2) and AEs (8.5 vs 6.2 per 1000 patient-days; relative rate, 1.4; 95% CI, 0.8-2.2). Family-reported error rates were 5.0-fold (95% CI, 1.9-13.0) higher and AE rates 2.9-fold (95% CI, 1.2-6.7) higher than hospital incident report rates.CONCLUSIONS AND RELEVANCE Families provide unique information about hospital safety and should be included in hospital safety surveillance in order to facilitate better des...

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Section: Discussionmentioning

confidence: 99%

Section: Main Outcomes and Measures-error And Ae Ratesmentioning

confidence: 99%

Families as Partners in Hospital Error and Adverse Event Surveillance

Khan¹,

Coffey²,

Litterer³

et al. 2017

JAMA Pediatr

110

115

View full text Add to dashboard Cite

show abstract

“…Physicians are concerned that if compensation is given, there will be increase reporting to the NPDB and increase insurance premiums. In a study of implementation of a bill requiring disclosure of error in Pennsylvania in 2009, Painter et al 20 showed an increase in amount of compensation with disclosure compared to similar claims when disclosure did not occur. However, no CRP was known to occur in Pennsylvania during the study period.…”

Section: Resultsmentioning

confidence: 99%

Changes in liability claims, costs, and resolution times following the introduction of a communication-and-resolution program in Tennessee

LeCraw

Montanera

Jackson

et al. 2018

Journal of Patient Safety and Risk Management

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Objective: To investigate whether a malpractice reform known as collaborative communication resolution program can improve transparency after an adverse outcome without resulting in higher malpractice liability costs, relative to traditional "deny and defend" approaches. Methods: Collaborative communication resolution program started at Erlanger Health System in January 2009. We compare liability outcomes before and after collaborative communication resolution program implementation. Annual liability measures evaluated were the number of filed claims, time interval to resolve an event, defense costs, settlement costs, and total liability costs. We describe the process through which events were resolved under collaborative communication resolution program. Results: One percent of adverse events when there was no medical error received compensation under collaborative communication resolution program; no medical error occurred in 65% of adverse events; 43% of events with injury from medical error were resolved with apology alone. Compared to pre-implementation levels, there was a decrease in the average number of new claims filed (CF) (1.

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“…The implementation of this act was not associated with an increase in medical malpractice claims. 51 In 2001, the University of Michigan Health System (UMHS) implemented a program mandating full disclosure of medical errors to patients along with prompt compensation. Since the implementation of this program, UMHS has experienced a significantly decreased rate of malpractice claims, total payouts, and liability cost.…”

Section: Ethical Considerationsmentioning

confidence: 99%

Medical malpractice in spine surgery: a review

Medress¹,

Jin²,

Feng³

et al. 2020

Neurosurgical Focus

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Medical malpractice is an important but often underappreciated topic within neurosurgery, particularly for surgeons in the early phases of practice. The practice of spinal neurosurgery involves substantial risk for litigation, as both the natural history of the conditions being treated and the operations being performed almost always carry the risk of permanent damage to the spinal cord or nerve roots, a cardiopulmonary event, death, or other dire outcomes. In this review, the authors discuss important topics related to medical malpractice in spine surgery, including tort reform, trends and frequency of litigation claims in spine surgery, wrong-level and wrong-site surgery, catastrophic outcomes including spinal cord injury and death, and ethical considerations.

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Do Written Disclosures of Serious Events Increase Risk of Malpractice Claims? One Health Care System's Experience

Abstract: Supplemental digital content is available in the text.

Cited by 12 publications

References 37 publications

Families as Partners in Hospital Error and Adverse Event Surveillance

Families as Partners in Hospital Error and Adverse Event Surveillance

Changes in liability claims, costs, and resolution times following the introduction of a communication-and-resolution program in Tennessee

Medical malpractice in spine surgery: a review

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