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Hospital communication-and-resolution programs do not expand liability risk

Some medical centers are wary that willingly admitting errors could result in increased liability costs, which has been a barrier to adoption.

Jeff Lagasse, Associate Editor

Evaluating the liability effects of communication-and-resolution programs at four Massachusetts hospitals, research published in Health Affairs found that these programs were associated with improved trends in the rate of new claims and legal defense costs at some of the sites. And the research found that the approach did not expand liability risk at any of the sites.

The program allowed these organizations to fulfill their ethical obligations to disclose adverse events and promote patient safety without encountering negative liability consequences.


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To be more transparent and to promote communication with patients after medical injuries, many hospitals have implemented a new approach called the communication-and-resolution program, or CRP.

Through these programs, hospitals openly communicate with patients after adverse events, investigating specifics, providing explanations, and when necessary, taking responsibility and proactively offering compensation. Medical centers that have adopted this program believe it will help to improve patient safety and that it is the hospital's ethical obligation to disclose medical errors.

Yet some medical centers are wary that willingly admitting errors could result in increased liability costs. Continuing uncertainty about this issue has continued to be a barrier to the widespread adoption of this program.


A communication-and-resolution program known as CARe (Communication, Apology, and Resolution) was implemented at Baystate Franklin Medical Center, Baystate Mary Lane Hospital, Beth Israel Deaconess Hospital-Milton and Beth Israel Deaconess Hospital-Needham.

The team examined the effect of CARe's malpractice claims volume, compensation and legal defense costs, and the time it took to find resolutions. They compared trends in the six years before CARe and then a few years after implementation at each institution.

They also calculated several quarterly rates for each hospital: new claims, new claims receiving compensation, compensation cost, defense cost, total liability cost, and average compensation cost. A claim was defined as any written request for patient compensation that was brought to the liability insurer, whether initiated by the patient, family, or hospital.

After CARe implementation, the team found there was a significant decrease in the rate of new claims at the implementing community hospitals and academic medical centers, a change that was not seen at hospitals that did not implement CARe. Both academic medical centers experienced a significant decrease for defense costs after CARe implementation. Also, there were no significant changes in total liability costs observed nor in the average compensation amount per paid claim at any of the hospitals.


Those who want to cut down on legal defense and liability costs may want to think about adopting a simple strategy: saying you're sorry.

A study published earlier this summer found that hospital staff and physicians who explained, apologized and resolved adverse medical events saw a drop in legal defense and liability costs.

Twitter: @JELagasse

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