Objectives: Assess relative importance of market, professional, regulatory, and legal incentives in improving patient safety so as to make recommendations for public policy.
Study Design: Literature review, case studies of large, often heavily capitated physician groups with reputations for advanced management, legal policy analysis
Principal Findings: Liability experience can help promote improvements, at least in well organized groups predisposed to change. Liability fears can also deter constructive action, particularly through reluctance to share detailed information about patient dissatisfaction or medical error, lest it become discoverable in lawsuits. Clear signals from buyers and regulators also help drive behavior.
Implications: Organized buyers of medical care need to demand injury-reduction but also to pay for it and shield innovators from potentially excessive discovery at the start of litigation and large punitive awards at the end. Regulators need to promote systems change more than punishment of individuals. Balancing external accountability with internal openness to data sharing and process change is a major policy challenge. Liability law may even penalize groups that uncover their own problems, relative to unorganized practice that lacks systems management and hence accountability. Liability could theoretically attach to insurers and be passed down to participating providers, but not without practical problems. Absent other constructive outside oversight, liability law may become the main instrument of accountability for medical management, a role it is not well suited to play.
Learning Objectives: At the conclusion of the session, participants will be able to: the types of patient injury at issue in current policy discussions about patient protection, patient safety, and medical error, particularly in the outpatient setting. understand some of what is known about the factors underlying injry and promoting or inhibiting efforts at prevention articulate the policy options available -- public and private, legal and other -- to ameliorate medical injuries understand the emerging state of evidence about errors, injury and prevention. identify the relative strengths and weaknesses of differing approaches consider whether their career or their research can make a contribution to improving such outcomes
Keywords: Health Law, Injury Prevention
Presenting author's disclosure statement:
Organization/institution whose products or services will be discussed: None
I do not have any significant financial interest/arrangement or affiliation with any organization/institution whose products or services are being discussed in this session.