How Reporting Harm Events Early Brings Faster Resolution, Lowers Cost and Promotes Healing

Candello was happy to contribute our data to the HEAL program, launched by one of our member organizations, Constellation. In alignment with a partnership representing our mutual dedication to promoting safety, we share this post describing the benefits of HEAL authored by Constellation's CMO, Laurie Drill-Mellum, MD, MPH.

It’s often said that if a business entity does the right thing then success will follow. We believe that our decision at Constellation to address harm events as soon as they occur, or are realized by an organization, will make us more successful at fulfilling our purpose: To champion all those who devote their lives to health care … to the essential work of enhancing health and life. We help them attain their dream to help, heal and serve.

The HEAL program

Constellation launched our early intervention program, HEAL, in January of 2020. For Constellation customers, the interest in, support of, and engagement in the program have gone beyond our greatest hopes. HEAL includes:

  • Early reporting
  • Communication and peer support services
  • Early expert evaluation of the harm event
  • Risk team consultations for preparing and responding to harm events
  • Support for fair and reasonable offers of compensation when it’s determined there is liability

Early intervention research

Because we are just one medical professional liability (MPL) insurance company, and we want to spread the practice and benefits of early intervention to others, we approached one of our partners in the industry, Candello, formerly CRICO Strategies' Comparative Benchmarking System (CBS) of which Constellation is a data-contributing member with the idea of leveraging their large claim data set to study whether there are measurable benefits to reporting harm events to MPL carriers early.

It was a simple and straightforward research question. We were interested in whether harm events which were reported to MPL companies within 90 days of occurrence showed any measurable difference in expenses for managing the case, the length the case was open, and the indemnity paid on it. Our goal with our early intervention program, HEAL, was to decrease the expenses and life cycle of these cases, and to pay similar (i.e., fair and reasonable dollars) amounts on them to people who were harmed due to malpractice.

Here’s what we found:

data

When a harm event that became a claim or suit was reported early, the research found a statistically significant reduction in both expenses and the life cycle of a case. Recognizing and accounting for the variability of region, analysis year, case type and clinical severity of the patient’s injuries, a 25% decrease in average expenses and a 3.4% decrease in average time to closure was observed when a case was reported early.

There was no statistically significant difference in indemnity payments between cases that were resolved early and those that were not. In other words, early reporting was not found to consistently affect the payments made to a patient/resident/family member to compensate fairly for the harm incurred.

Early reporting has many benefits

This new research shows that with early reporting after a harm event, expenses are lower and the life cycle of the case how long it remains open and unresolved is shortened significantly.

What if the process of healing could begin right away?

What could early reporting and early resolution do to help lessen the impact of the harm for patients and residents and their families, for care teams involved, and for the health care organization?

While this research demonstrates benefits in both expense and life-cycle reduction, we at Constellation know from our experience that early reporting also has the potential to limit suffering and promote healing for all people impacted by harm events. Additionally, Constellation has witnessed how harm events can significantly affect an organizations bottom line and threaten their business viability, which can then affect thousands of patients seeking care. Poor and slow handling of harm events can affect productivity, and can lead to physician or clinician burnout, as they roil in the emotional impacts inevitable after being a part of, or the cause of something, when their patient/resident was harmed. This can occur even if the potential of harm was known and disclosed, and even if the standard of care was met.

In this era of clinician shortage and transactional care leading to burnout, poor experience for all involved, as well as increasing costs the practice of early reporting and prompt event investigation is critical to the future of care itself.

Constellation has observed that reducing the life cycle of a cases which was found to occur with early reporting can have profound effects on everyone involved, reducing the emotional impact and duration as well as the number of claims and suits, especially those that proceed to litigation. At each step of the way, the HEAL program is a collaborative effort between the health care organizations we serve and Constellation.

This research demonstrates that early reporting shortens the life cycle of an event and reduces expenses, which benefits patients and senior living residents, their families, and the clinicians who care for them. Reporting harm events early is not only the right thing to do, but it also helps everyone involved, including health care organizations and their care teams.

At Constellation, we believe that what’s good for care teams is good for business. Supporting physicians and their patients and senior living residents through early reporting of harm events is just one of the many ways that we deliver on our purpose. Learn more about Constellation at ConstellationMutual.com.

Constellation and HEAL are trademarks of Constellation, Inc.

Written By
LDMcmoConstellation
Laurie Drill-Mellum, MD, MPH
Laurie is the Chief Medical Officer at Constellation. Dr. Drill-Mellum’s passion for, and background in, the studies of culture, behavior, leadership and integrative medicine fuel her commitment and drive in serving the mission of Constellation. She reminds us of, and provides insights to, health practitioners’ perspectives, challenges, and lives; she is a fierce advocate for the wellbeing of those practicing medicine on the front lines of care and the critical importance of supporting them when they’ve been involved in a patient-harm event. Preventing these events and mitigating harm once they occur is the core of her dedication to her work.
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