Each year the Joint Commission gathers information about emerging patient safety issues from different stakeholder groups. From this information, it releases patient safety goals for the following year.
Addressing issues like those put forth by the Joint Commission is integral to improving patient safety. We applaud this scrutiny of patient safety vulnerabilities and recognize it as a good starting point for organizations to evaluate their patient safety and quality performance. While important to monitor, understanding the drivers behind these issues is key to an organization mitigating them.
An organization that is aware of its own medical malpractice claims data (case rates, trends, injuries, contributing factors, etc.) and able to compare its own experience to national peers, can make data-informed decisions about its patient safety program. This expanded lens provides health care leaders clarity about their organization’s risks and the drivers—or contributing factors—behind those risks.
HOW HOSPITALS USE MEDICAL MALPRACTICE DATA
UMass Memorial Healthcare, Inc. in Worcester, Massachusetts partners with Candello to code and analyze its medical malpractice data. Through the dedicated and collaborative work by its claims leadership and risk management leadership, UMass Memorial has embedded medical malpractice data into its culture.
As a result, department chairs often request a one-time or annual presentation on the unit’s malpractice risk and possible solutions for improvement. Claims and risk management staff typically analyze the data for insights about vulnerabilities and trends in that service. They review 10 years’ worth of internal data—from lawsuits, adverse events, observations—along with national data from Candello Comparative Benchmarking System. They meet with the department’s leadership to discuss findings and how best to convey them to their clinicians. UMass Memorial recognizes that identifying the specific contributing factors behind patient safety risks and vulnerabilities is key to developing interventions to mitigate them.
Even without the risk management and clinical coding resources of an academic medical center like UMass Memorial, astute organizations can still use malpractice claims data as a signal or learning tool. A small hospital may have only a handful of claims each year, but even a single claim turned into a compelling story becomes a potent teaching tool for addressing malpractice vulnerabilities elsewhere in the institution.
Read more examples of how UMass Memorial leverages medical malpractice data to improve patient care.
HOW INSURANCE CARRIERS USE MALPRACTICE DATA
For more than 40 years, CRICO, the medical liability insurer of the Harvard medical institutions and their affiliates, has been analyzing medical malpractice data to identify risk exposure and work with its insured hospitals and clinicians to reduce those risks.
This strategy has helped improve patient safety and lessen the loss exposure of the CRICO insurance program. A recent article published in Anesthesia & Analgesia discussed the patient safety standards in anesthesia and how they have evolved, citing a program put in place by CRICO1. In the 1980s, anesthesia departments within the CRICO-insurance program were faced with mounting medical malpractice costs. CRICO spearheaded an effort to reduce these costs and ultimately found a way to decrease the clinical risks associated with anesthesia. This program has proven effective and remains in place.
CRICO continues to look at claims data for the Harvard medical institutions and compare it to national peers in CBS for signals of emerging patient safety issues. From this insight, patient safety initiatives are determined, including focus areas for the CRICO grant program which is offered to CRICO-member health care organizations.
WHAT ARE YOUR PATIENT SAFETY GOALS FOR 2021?
Analysis of medical malpractice data—individual by organization and national comparative data—can be an integral data point in setting patient safety initiatives. It can be used by hospitals like UMass Memorial and by insurance programs like CRICO to gain insights and clarity into clinical and financial risks.
How do you develop your patient safety goals? Leave a comment below,
References
Pandya AN, Majid SZ; Desai MS. “The origins, evolution, and spread of anesthesia monitoring standards.” Anesthesia & Analgesia: July 8, 2020 - Volume Publish Ahead of Print - Issue - doi: 10.1213/ANE.0000000000005021