Tag Archives: malpractice

Las Vegas Sun caps series by showing solutions

In the Las Vegas Sun reporter Marshall Allen wraps up his wide-ranging Do No Harm series on hospital quality by showing how Nevada hospitals could be approaching medical errors differently.

lasvegassunHis focus is the Seven Pillars program at the University of Illinois at Chicago, which should be familiar to Covering Health readers. The key to the program is a commitment to admitting errors and discussing them with patients, an approach that improves the patient experience and reduces the risk of malpractice suits.

To cap off the series, the Las Vegas Sun included the thoughts of Allen’s boss, Publisher and Editor Brian Greenspun.

Related

The Chicago chapter of AHCJ recently hosted a discussion about medical errors and transparency, which included David Mayer, M.D., who, with Tim McDonald, M.D., has co-founded an organization dedicated to the prevention of patient harm. Most recently, McDonald and Mayer were awarded a $3 million federal grant to implement and evaluate patient safety efforts on a larger scale. AHCJ members can read about the discussion and listen to Mayer’s comments.

Editor’s note:

Allen completed part of this series while on an AHCJ Media Fellowship on Health Performance, supported by the Commonwealth Fund

Innovative approaches to malpractice, errors

American Medical News reporter Kevin O’Reilly writes about a presentation by David Mayer, M.D., University of Illinois at Chicago Institute for Patient Safety Excellence co-director, at an AHCJ Chicago chapter event. The event shed light on some ways to tackle malpractice and errors in a way that will benefit both physicians and their patients.

David Mayer, M.D.

David Mayer, M.D.

Mayer talked about turning doctors away from the “deny and defend” approach to malpractice and toward an open disclosure of medical errors. He seeks to reduce malpractice suits through a “seven pillars” approach. Here’s a quick summary of how things work:

  1. Patient safety incident reporting: Push for fast reporting of possible incidents
  2. Investigation: Figure out if something really went wrong.
  3. Communication and disclosure: Keep patient and family informed during the entire process. Even if it involves very bad news.
  4. Apology and remediation: Don’t just apologize, tell them how you’re going to fix the damage and/or offer compensation.
  5. System improvement: Change the system to prevent it from happening again, invite the patient and family to participate.
  6. Data tracking and performance evaluation: Keep a massive database of all safety incidents and use it with impunity, even for public outreach.
  7. Education and training: Carefully monitored continuing education that is informed and directed by error monitoring and in-house incidents.

Meyer’s pillars are going to be implemented in nine Chicago-area hospitals, thanks to a $3 million grant from the HHS Agency for Healthcare Research and Quality. The grant is one of seven “demonstration grants” the AHRQ awarded as part of its program to evaluate “Patient Safety and Medical Liability” projects. The agency also awarded 13 smaller planning grants.

Calif. malpractice cap: Model or cautionary tale?

The San Francisco Chronicle‘s Victoria Colliver reports on how a discussion of a health reform-related push for medical malpractice reform can learn from California’s 34-year old law capping malpractice awards at $250,000.

First, the case against the cap: It’s too small (1975’s $250,000 is equal to about a million of today’s dollars) to make malpractice suits worth a lawyer’s while.

Critics object to the fact the $250,000 cap hasn’t been adjusted for inflation in 34 years . They also argue that because the law allows unlimited awards for economic losses, such as lost wages and ongoing medical costs, it discriminates against children and seniors, who have limited earnings if any, as well as against the families of those who died and did not have high medical costs.

“It’s economic suicide for a medical malpractice lawyer in the state of California to undertake too many or any cases that are capped at just 250,000,” said Erik Peterson, a San Francisco medical malpractice attorney who agreed to take on the Volkmuth’s case, even at a loss.

inflation1 Cap proponents say the law helps keep costs down and to attract physicians to the state.

Supporters say the law has resulted in improved access to care for patients because it has persuaded doctors to stay in California without fear of skyrocketing insurance premiums.

Lisa Maas, executive director of Californians Allied for Patient Protection, pointed to her group’s research, which shows the average annual premium for a specialist in obstetrics and gynecology in Los Angeles was about $90,000 last year, compared to nearly $195,000 a year for the same specialist in Nassau and Suffolk counties of New York, a state without medical malpractice reforms.

Malpractice reform joins health system debate

Erica Werner of The Associated Press reports that Ezekiel Emanuel, a key adviser on health issues to President Obama and brother of White House chief of staff Rahm Emanuel, offered some hints recently about the role of malpractice lawsuit reform in the debate over changes to the country’s health care system.

Ezekiel Emanuel

Ezekiel Emanuel

At a meeting of the American Medical Association, Ezekiel Emanuel said:

“I’m not going to give you any details because I can’t. I just can tell you I’ve been thinking long and hard about that,” Emanuel, an oncologist and the brother of White House chief of staff Rahm Emanuel, told the doctors when asked about malpractice lawsuit reform. “It hasn’t gone unnoticed. So stay tuned.”

Mary Ann Geier, organizer of Health Camp Philadelphia, posted on Twitter that she wonders what the hidden agenda is and whether it might not be incompatible with true reform. She says it’s something the average person can’t figure out. Reporters, what can you tell us?

Senate Finance Committee Chairman Max Baucus, D-Mont., has proposed developing “alternate litigation models,” similar to proposals offered by Obama and Hillary Clinton.

Sen. Ron Wyden, D-Ore., says malpractice reforms are key to overhauling the health care system.

“I think it’s an essential piece for there to be enduring reform, reform that will stick and will get a significant bipartisan vote in the United States Senate,” Wyden said.

Perhaps Wyden will expand on those comments when he speaks at Health Journalism 2009 on April 17.