Beth Israel, Massachusetts hospitals test liability reform

Beth Israel Deaconess Medical Center (BIDMC), Massachusetts General Hospital and Baystate Health are among three major health systems in the state that are testing a "disclosure, apology and offer" process, making legal action a last resort, the Massachusetts Medical Society said Wednesday.

As an alternative to the current tort system--which many providers eschew--the disclosure, apology and offer process promotes honesty and transparency, according to Kenneth Sands, senior vice president for healthcare quality at BIDMC. Under this alternative model, when unanticipated adverse outcomes occur, institutions, healthcare professionals and their insurers disclose that information to the patient and family. They then investigate and explain why it happened and establish systems to improve patient safety and reporting. When appropriate, they apologize and offer fair financial compensation without the patient having to resort to legal action.

"We are proposing to create a centralized resource to support this new model. By conducting programs in seven hospitals, specifically chosen to allow demonstration in various hospital settings and within different malpractice insurance models, we can assess impact on patient safety, malpractice claims and overall liability costs," Sands said in an announcement. "At the same time, we will be educating the public and the broader healthcare community, and thus building a foundation for medical liability reform in the Commonwealth." 

Seven hospitals in the state (Beth Israel Deaconess Medical Center in Boston, Beth Israel Deaconess Hospital-Needham, Beth Israel Deaconess Hospital-Milton, Baystate Medical Center in Springfield, Baystate Franklin Medical Center in Greenfield, Baystate Mary Lane Hospital in Ware, and Massachusetts General Hospital) are testing the approach with aims of liability reform.

As many providers believe, the current tort system leads clinicians to practice defensive medicine, upping costs for physicians, the organization and the patients. And even if providers win the case, should it go to court, it can still be a hefty price to pay. Most importantly, however, the current approach to medical liability "discourages transparency, inhibits communication between caregivers and patients," Alan Woodward, chair of the Massachusetts Medical Society committee on professional liability, said.

The new approach of acknowledging the event, saying "I'm sorry" and offering compensation could lead to faster resolution of cases, enhanced reporting of medical errors and a more accountable system, according to the plan summary.

For more information:
- read the medical society announcement
- here's the executive summary (.pdf)

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