Commentary: Medical Malpractice and Patient Safety: Tear Down That Wall!

Department of Medicine, UMass Memorial Medical Center/University of Massachusetts Medical School, Worcester, Massachusetts 01655, USA.
Academic medicine: journal of the Association of American Medical Colleges (Impact Factor: 2.93). 03/2011; 86(3):282-4. DOI: 10.1097/ACM.0b013e3182086f14
Source: PubMed


Although medical malpractice influences the way that physicians learn to practice medicine, information related to malpractice cases is among the most closely guarded data in the hospital and is rarely available to training programs. In this issue, Hochberg and colleagues describe an intervention in which they used data from their hospital's closed malpractice cases as part of a training seminar for surgical residents on malpractice. The authors of this commentary believe that there is very low risk and great potential value to more openly sharing this type of information. They point to potential conflicts between the goals of the risk management discipline (as it has been practiced in some settings in the past) and those of the patient safety discipline as one reason such data are not disseminated widely, and they highlight what they believe to be hopeful trends toward greater transparency. They call on patient safety professionals and educators to use their hospitals' malpractice data to better prepare learners and improve patient care.

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  • Academic medicine: journal of the Association of American Medical Colleges 10/2011; 86(10):1193; author reply 1193-4. DOI:10.1097/ACM.0b013e31822bbc8e · 2.93 Impact Factor
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    ABSTRACT: Every year, medical error kills and injures hundreds of thousands of people and costs billions of dollars in lost income, lost household production, disability, and healthcare expenses. In recent years, hospitals have implemented multiple systems to gather information about medical errors, understand the causes of these errors, and change policies and practices to improve patient safety. The effect of malpractice lawsuits on these patient safety efforts is hotly contested. Some believe that the fear of malpractice liability inhibits the kind of openness and transparency needed to identify and address the root causes of medical error. Others believe that malpractice litigation brings crucial information about medical error to the surface and creates financial, political, and institutional pressures to improve. Yet neither side in this debate offers much evidence to support its claims. Drawing on a national survey of healthcare professionals and thirty-five in-depth interviews of those responsible for managing risk and improving patient safety in hospitals across the country, I find reason to believe that malpractice litigation is not significantly compromising the patient safety movement's call for transparency. In fact, the opposite appears to be occurring: The openness and transparency promoted by patient safety advocates appear to be influencing hospitals' responses to litigation risk. Hospitals, once afraid of disclosing and discussing error for fear of liability, increasingly encourage transparency with patients and medical staff. Moreover, lawsuits play a productive role in hospital patient safety efforts by revealing valuable information about weaknesses in hospital policies, practices, providers, and administration. These findings should inform open and pressing questions about medical malpractice reform and the best ways to continue improving patient safety.