Michelle M. Mello (
Allen Kachalia is an associate professor of medicine at Harvard Medical School and chief quality officer at Brigham Health, both in Boston, Massachusetts.
Health Aff (Millwood). 2017 Oct 1;36(10):1795-1803. doi: 10.1377/hlthaff.2017.0320.
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.
通过沟通和解决计划,医院和责任保险公司在不良事件发生时与患者进行沟通;调查并解释发生了什么;并在适当的情况下道歉并主动提出赔偿。利用项目工作人员记录的数据和对相关临床医生的调查,我们研究了 2013 年至 2015 年期间马萨诸塞州的两个学术医疗中心和两个社区医院使用的一个项目的案例结果。这些医院很好地遵守了项目协议。91%的项目事件不符合赔偿资格标准,而那些需要解决的事件的费用也不高(中位数支付额为 75,000 美元)。只有 5%的事件导致医疗事故索赔或诉讼。临床医生支持该项目,但希望工作人员能更好地进行沟通。我们的研究结果表明,当医院遵守主动提供赔偿的承诺时,沟通和解决计划不会导致更高的责任成本。