Disclosure and compensation programs are a leading alternative to traditional medical liability. Patients want to know about medical errors, especially errors that directly harm them. Although disclosing an error and its consequences to a patient is difficult, the benefits of disclosing errors to patients are multiple. Our overall goal is to determine how to make disclosure and compensation a process that will not only serve the needs of individual patients, but take more advantage of the patient's experience to help hospitals change their systems and improve safety for subsequent patients. To meet this goal we will: 1) conduct a 3-year study of disclosure and compensation in the University of Texas System with measures of disclosure, malpractice, and impact on safety at three points in time (baseline, after initial disclosure training/before implementation of best practices for using disclosure to improve safety, and after implementation of these best practices);2) host a conference of national experts during year two to identify best practices for using disclosure to improve hospital safety;and 3) implement, evaluate, and disseminate these best practices (with a focus on incorporating patients and families into efforts to understand why errors occur). The products of this study will include: best practices for using disclosure and patients'perspectives to improve patient safety;a new survey to measure both safety culture and error disclosure culture;and an assessment of how disclosure and compensation influences traditional tort outcomes such as claims, suits, time to resolution, payments, and overall expense.

Public Health Relevance

Our overall goal is to determine how to make disclosure and compensation a process that will not only serve the needs of individual patients, but take more advantage of the patient's experience to help hospitals change their systems and improve safety for subsequent patients. To meet this goal we will: 1) conduct a 3-year study of disclosure and compensation in the University of Texas System with measures of disclosure, malpractice, and impact on safety at three points in time (baseline, after initial disclosure training/before implementation of best practices for using disclosure to improve safety, and after implementation of these best practices);2) host a conference of national experts during year two to identify best practices for using disclosure to improve hospital safety;and 3) implement, evaluate, and disseminate these best practices (with a focus on incorporating patients and families into efforts to understand why errors occur). The products of this study will include: best practices for using disclosure and patients'perspectives to improve patient safety;a new survey to measure both safety culture and error disclosure culture;and an assessment of how disclosure and compensation influences traditional tort outcomes such as claims, suits, time to resolution, payments, and overall expense.

Agency
National Institute of Health (NIH)
Institute
Agency for Healthcare Research and Quality (AHRQ)
Type
Research Demonstration and Dissemination Projects (R18)
Project #
1R18HS019561-01
Application #
8015920
Study Section
Special Emphasis Panel (ZHS1-HSR-F (02))
Program Officer
Battles, James
Project Start
2010-07-01
Project End
2014-06-30
Budget Start
2010-07-01
Budget End
2014-06-30
Support Year
1
Fiscal Year
2010
Total Cost
Indirect Cost
Name
University of Texas Health Science Center Houston
Department
Internal Medicine/Medicine
Type
Schools of Medicine
DUNS #
800771594
City
Houston
State
TX
Country
United States
Zip Code
77225
Ottosen, Madelene J; Sedlock, Emily W; Aigbe, Aitebureme O et al. (2018) Long-Term Impacts Faced by Patients and Families After Harmful Healthcare Events. J Patient Saf :
Sage, William M; Jablonski, Joseph S; Thomas, Eric J (2015) Use of Nondisclosure Agreements in Medical Malpractice Settlements by a Large Academic Health Care System. JAMA Intern Med 175:1130-5
Etchegaray, Jason M; Ottosen, Madelene J; Burress, Landrus et al. (2014) Structuring patient and family involvement in medical error event disclosure and analysis. Health Aff (Millwood) 33:46-52
Sage, William M; Gallagher, Thomas H; Armstrong, Sarah et al. (2014) How policy makers can smooth the way for communication-and- resolution programs. Health Aff (Millwood) 33:11-9
Etchegaray, Jason M; Gallagher, Thomas H; Bell, Sigall K et al. (2012) Error disclosure: a new domain for safety culture assessment. BMJ Qual Saf 21:594-9