The "Seven Pillars" Response to Patient Safety Incidents: Effects on Medical Liability Processes and Outcomes.

Autor: Lambert BL; Department of Communication Studies and Center for Communication and Health, Northwestern University, Chicago, IL., Centomani NM; Office of Patient Safety Loyola University Health System, Maywood, IL., Smith KM; MedStar Institute for Quality & Safety, MedStar Health Research Institute, Columbia, MD., Helmchen LA; Department of Health Policy and Management, Milken Institute School of Public Health, The George Washington University, Washington, DC., Bhaumik DK; Department of Psychiatry, University of Illinois at Chicago, Chicago, IL., Jalundhwala YJ; Department of Pharmacy Systems, Outcomes and Policy, University of Illinois at Chicago, Chicago, IL., McDonald TB; MedStar Institute for Quality & Safety, MedStar Health Research Institute, Columbia, MD.; Beazley Institute for Health Law and Policy, Loyola University Chicago, Chicago, IL.
Jazyk: angličtina
Zdroj: Health services research [Health Serv Res] 2016 Dec; Vol. 51 Suppl 3, pp. 2491-2515. Date of Electronic Publication: 2016 Aug 24.
DOI: 10.1111/1475-6773.12548
Abstrakt: Objective: To determine whether a communication and resolution approach to patient harm is associated with changes in medical liability processes and outcomes.
Data Sources/study Setting: Administrative, safety, and risk management data from the University of Illinois Hospital and Health Sciences System, from 2002 to 2014.
Study Design: Single health system, interrupted time series design. Using Mann-Whitney U tests and segmented regression models, we compared means and trends in incident reports, claims, event analyses, patient communication consults, legal fees, costs per claim, settlements, and self-insurance expenses before and after the implementation of the "Seven Pillars" communication and resolution intervention.
Data Collection Methods: Queried databases maintained by Department of Safety and Risk Management and the Department of Administrative Services at UIH. Extracted data from risk module of the Midas incident reporting system.
Principal Findings: The intervention nearly doubled the number of incident reports, halved the number of claims, and reduced legal fees and costs as well as total costs per claim, settlement amounts, and self-insurance costs.
Conclusions: A communication and optimal resolution (CANDOR) approach to adverse events was associated with long-lasting, clinically and financially significant changes in a large set of core medical liability process and outcome measures.
(© Health Research and Educational Trust.)
Databáze: MEDLINE
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