Disclosure Approach Could Limit Malpractice Claims

A workgroup is focused on coming up with recommendations on tort reform that will head to the 2013 legislature

August 17, 2012 -- Lawmakers are expected to take up tort reform when the Oregon Legislature convenes next February.

To get those discussions moving, a Patient Safety and Defensive Medicine Workgroup is developing draft legislation that includes issues such as confidentiality, mediation, dispute resolution, litigation, discovery and patient safety.

Disclosure – informing patients when a serious medical event has occurred in a hospital setting – is also on the table. Such an approach has been successful at Mercy Medical Center, Dr. Robert Dannenhoffer, a Roseburg pediatrician, told the workgroup earlier this week.

All medical staff and employees have participated since 2001, and are required to disclose serious events in a non-punitive hospital reporting system, while the hospital works in good faith with families to make them “whole,” said Dannenhoffer, who’s also CEO of Umpqua Health Alliance, a newly designed coordinated care organization.

Patients, he said, are not necessarily looking for money, but want their losses covered and want to make certain the same mistakes don’t occur again.

A disclosure program has been under way since 2001 at the University of Michigan Health System, said Richard Boothman, a former trial attorney.

Its quality and safety division is closely tied to the disclosure program, with money invested in improving patient safety, Boothman said. As a result, medical malpractice claims have decreased from 53 to 31 per year, while the average cost per lawsuit has dropped from over $400,000 to around $228,000, and the time to resolution has gone from 20 to 8 months.

Physicians are very satisfied with this program, with 98 percent of 419 surveyed indicating their approval. Approximately 86 percent of plaintiff’s lawyers also agreed, saying transparency allows them to make better decisions about which claims to pursue.

“The long-term benefits are clear to us,” Boothman said. “We’ve seen some remarkable things happen.”

The biggest challenge in enacting such reforms is getting past the malpractice aspect and reaching the real goal -- patient safety, Boothman added.

In July 2001, there were 262 pending claims involving the system, which is now down to 64, with 10 claims ending up in court last year. Claims are down despite the fact that clinical activity has doubled since then, and twice as many patients are now receiving
care, Boothman said.

However, he cautioned that many people are invested in the status quo, including judges and defense attorneys.

Currently most Oregon hospitals offer early disclosure, Robin Moody, with the Oregon Association of Hospitals and Health Systems, told the workgroup.

Moody said she was “disappointed” that a section of the draft bill dealing with litigation was so short. Even in a “model” system like Michigan’s, she said, several cases still end up in litigation.

Image for this story by Rick Bennett (CC BY-NC-SA 2.0) via Flickr.

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