In an article which was published in the online version of the American Journal of Obstetrics and Gynecology, the authors make the pretty common sense discovery that when patient safety was made a priority at their hospital, malpractice claims and payments dropped significantly. You can find the article here.
The program at the large teaching hospital, Yale-New Haven Hospital, was begun in 2003. The comprehensive safety program intended to standardize care, improve teamwork and communication, and optimize oversight and quality review. The program was undertaken by the hospital in partnership with its malpractice insurance carrier. Almost immediately, the hospital noticed an improvement in patient safety and a reduction in adverse outcomes. These improvements have persisted. What was unclear to the authors at first was whether these improvements in patient safety and outcomes would result in a reduction in malpractice claims and payments. The hospital and its insurer compared claims and payments for the five years preceding the program with the five years following the program and found what the authors referred to as “dramatic” reductions in the number of claims made and the size of the payments made to claimants. At the same time in Connecticut as a whole, malpractice claims and payments remained steady. The authors quite appropriately concluded that the safety program not only made things better for their obstetric and gynecologic patients, it saved the hospital substantial money by reducing claims and payouts.
The outcome of this study should come as a surprise to no one. One of the goals of the tort system in the United States is to encourage safety by discouraging negligence and requiring those whose negligence injures another to compensate the injured person. Many health care professionals refuse to accept this or to learn from their mistakes. Instead of working to improve care and reduce negligence, they petition the legislature to enact laws to protect them from their mistakes. What they ought to be doing is what the Yale-New Haven Hospital did: make patient safety a major goal and create a program to reach that goal. However, as the authors note, the creation of programs such as theirs is almost always resisted by doctors and nurses who see them as an attack on their ability to make independent decisions for their patients.
The next time you hear someone talk about the “malpractice insurance crisis”, tell them about this study. Write your state and federal legislators and tell them about this study. Rather than making special laws to protect health care providers from having to pay for their mistakes, don’t you think we should be encouraging providers to put patient safety first? Not surprisingly, putting patient safety first is not only good for patients, it is good business and avoids pesky malpractice claims too: A win-win for everyone.
