Some practitioners and hospital officials fear that admitting a medical error might be tantamount to "handing over a 'blank check' and invite lawsuits and disputes about compensation amounts" while others might worry about damage to the institution's or individual provider's reputations.
What they discovered, however, was a dramatic decline in legal action taken on the part of patients and their families. "The monthly rate of new claims decreased from 7.03 per 100,000 patient encounters before initial program implementation to 4.52 after," the researchers wrote. They decrease was statistically significant for claims resulting in lawsuits, 232 of which were filed per year before the program and 106 of which were filed after.
Median time to claim resolution before the program was 1.36 years, but after the program, it went to .95 of a year.
J. James Rohack, MD, immediate past president of the American Medical Association, says the AMA supports funding "to further test the effectiveness of early disclosure programs and other innovative proposals, including health courts and safe harbors for the practice of evidence-based medicine."
However, he emphasized that the AMA strongly supports liability reform at state and federal levels to implement policies with malpractice payment caps on non-economic damages, such as the $250,000 pain and suffering limit in California and another program in Texas.
Nancy Foster, vice president for quality and patient safety policy for the American Hospital Association, says that such programs are growing throughout hospitals in the country, with the support of the AHA. "It's about changing the culture of the institutions," she says.
Questions remain, however, about how the hospital selects the right person to talk with the patient and his or her family, and at what point in the discovery process of exactly what happened should disclosure be made.
"As we see with other errors, you don't know very much in the first few minutes or hours. How early do you share the information with the patient especially when there is still a good deal of uncertainty?"