Oregon pioneers a new approach to helping patients injured by a healthcare provider under a law that takes effect today. Senate Bill 483, passed by the 2013 Legislature, created an early discussion and resolution program which will be overseen by the Oregon Patient Safety Commission, and allow doctors and patients to have protected and confidential conversations about medical errors.
While the University of Michigan uses a similar approach to help resolve malpractice disputes, Oregon becomes the first in the country to implement a statewide program that covers a broad range of healthcare providers.
Bethany Walmsley, the commission’s executive director, said her agency has spent the last six months drafting administrative rules to govern the new process.
“We’re pleased with how things are going,” Walmsley told The Lund Report. “We feel we’ve been able to draft a set of rules that makes the process clear, and made adjustments to address some of the concerns we’ve heard along the way.”
The public has weighed in by asking for clarification on how the new process will work and suggested streamlining the criteria for who can become a mediator. Walmsley hopes the new process leads to better and more timely outcomes for people who’ve experienced an “adverse healthcare incident.” Last year, the commission recorded more than 650 such incidents through its voluntary reporting process, but the actual number may be significantly higher.
“We hope this process will give patients an opportunity to be heard by their provider,“ Walmsley said. “What we know is that when these events happen, patients want to hear the truth, they want to know how you’re going to prevent it from happening again, and they want an apology.”
A patient or a provider can notify the commission about an incident, and the commission will then connect the two parties for a voluntary and confidential discussion. If no resolution is reached, the commission will find a mediator.
There are also protections in place to encourage participation and dialogue by both parties. Patients do not forfeit their right to file a lawsuit by participating, and, whatever a provider might offer -- such as an apology or compensation – is generally not admissible in a future trial.
The legislation creating the law received strong bipartisan majorities in both chambers and won support from traditionally opposing stakeholders in the world of medical malpractice.
Gwen Dayton, vice president of health policy at the Oregon Medical Association, said doctors want to improve patient safety and change the culture of defensive silence around medical errors.
“We want practitioners to be able to have an honest discussion with their patients when something goes wrong,” Dayton said, “and we recognized that this system where everybody clams up and retreats to their respective corners needed to change.”
Derek Johnson, a former president of the Oregon Trial Lawyers Association, said the model creates the possibility for good outcomes without the often slow and expensive process of a medical malpractice lawsuit.
“Our main concern was that by engaging in this process, patients did not limit or forfeit their full access to the justice system,” Johnson said. “This law protects that right, and I think the model we came up with will improve patient safety, and get a lot more data out there on medical errors so we can hopefully prevent more of them.”
The commission intends to monitor different indicators to evaluate the program over time, including the number of notices filed, who files them, the amount and timing of compensation offered and patient satisfaction. There will also be outreach to provider and consumer advocacy groups to spread awareness about the new program.
While there are many uncertainties about how the new program will play out, Dayton sees tremendous potential for all stakeholders. “This is new and different, and it’s going to be a learning process. We just won’t know until we start.”
Patients harmed during medical care want (and deserve) information and answers, which providers may be afraid to give for a variety of reasons. “Many times, litigation is the only way for patients to get answers, but that destroys the relationship between the patient and provider,” says Dr. Bud Pierce, a physician for Hematology & Oncology of Salem and co-chair of the Task Force on Resolution of Adverse Healthcare Incidents. “The same errors keep happening because providers are not talking and working on solutions to prevent them from happening again. This culture of silence prevents providers from getting the support they need and drives patients into the legal system.”
FOR MORE INFORMATION
To read the original article written by Christian Danielson that appeared on May 14, click here.
To learn more about the work of the Oregon Patient Safety Commission, click here.
