COHN NEW YORK STATE MEDICAL LIABILITY REFORM AND PATIENT SAFETY MODEL

FUNDED BY AHRQ

THE ROLE OF THE STATETHE ROLE OF THE STATE:

CAN GOVERNMENT HELP HOSPITALS TO EMBRACE PATIENT SAFETY MEASURES AND REDUCE MEDICAL LIABILITY COSTS?

October 5, 2011

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COHN NEW YORK STATE MEDICAL LIABILITY REFORM AND PATIENT SAFETY MODEL

FUNDED BY AHRQ

THE NEW YORK SITUATIONTHE NEW YORK SITUATION

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COHN NEW YORK STATE MEDICAL LIABILITY REFORM AND PATIENT SAFETY MODEL

FUNDED BY AHRQ

AGENCY FOR HEALTHCARE RESEARCH & AGENCY FOR HEALTHCARE RESEARCH & QUALITY (AHRQ) SOLICITED PROPOSALS QUALITY (AHRQ) SOLICITED PROPOSALS THAT:THAT:

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COHN NEW YORK STATE MEDICAL LIABILITY REFORM AND PATIENT SAFETY MODEL

FUNDED BY AHRQ

New York State Unified Court SystemNew York State Department of Health

5 Academic Medical Centers in New York City_____________

Judge Douglas E. McKeon, NYS Supreme CourtRichard C. Boothman, UMHC

Michelle Mello, HSPH

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PROJECT TEAMPROJECT TEAM

COHN NEW YORK STATE MEDICAL LIABILITY REFORM AND PATIENT SAFETY MODEL

FUNDED BY AHRQ

1. Develop & Enhance A Culture Of Patient Safety

2. Create And Implement A Communication & Resolution Program (CRP)

3. Expand and Enhance Judge-directed Negotiation Program

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THE NY MODEL: 3 PROJECT THE NY MODEL: 3 PROJECT COMPONENTSCOMPONENTS

COHN NEW YORK STATE MEDICAL LIABILITY REFORM AND PATIENT SAFETY MODEL

FUNDED BY AHRQ

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COHN NEW YORK STATE MEDICAL LIABILITY REFORM AND PATIENT SAFETY MODEL

FUNDED BY AHRQ

Developing an action plan based on the results of culture of safety survey

Just Culture TeamSTEPPS

Creating patient safety initiatives identified through adverse events

Sign outs and handoffs WHO Surgical Checklist

and Creating a Communication and Resolution Program.

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ASSUMPTIONASSUMPTION

COHN NEW YORK STATE MEDICAL LIABILITY REFORM AND PATIENT SAFETY MODEL

FUNDED BY AHRQ

Develop policies and procedures for adverse event response and settlement

Provide training for disclosure and communication

Implement the program and gather and analyze data

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ASSUMPTIONASSUMPTION

COHN NEW YORK STATE MEDICAL LIABILITY REFORM AND PATIENT SAFETY MODEL

FUNDED BY AHRQ

Identify judges to participate in judge-directed negotiations

Train judges in targeted medical knowledge

Train judges in enhanced negotiation and mediation techniques

Provide neutral RN/JD for medical expertise

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ASSUMPTIONASSUMPTION

COHN NEW YORK STATE MEDICAL LIABILITY REFORM AND PATIENT SAFETY MODEL

FUNDED BY AHRQ

Patient Safety Teams Administer Survey of Safety Culture, analyze

results, develop an action plan. Establish a system to increase adverse event

reporting. Look in the mirror. Identify weaknesses. Identify and shepherd interventions.

Communication and Resolution Teams Develop a comprehensive policy and process for

disclosure, discussion and where appropriate, compensation.

Obtain staff buy-in and provide training.

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IN THE HOSPITALSIN THE HOSPITALS

COHN NEW YORK STATE MEDICAL LIABILITY REFORM AND PATIENT SAFETY MODEL

FUNDED BY AHRQ

BARRIERS AND FEARSBARRIERS AND FEARS

This will make costs go up, not down We already do this Systems and checklists stifle

excellence [New York] is different It’s just a few bad apples Mandatory reporting (NPDB, etc.) What we need is tort reform

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COHN NEW YORK STATE MEDICAL LIABILITY REFORM AND PATIENT SAFETY MODEL

FUNDED BY AHRQ

HOSPITALS DO NOT TRUST THE DEPARTMENT OF HEALTH And why should they?

THEY DON’T LIKE TO BE TOLD THEY SHOULD CHANGE. Who does?

THEY WANT TO DO THE RIGHT THING. BUT THEY’RE SCARED OF THE BOTTOM LINE. You’ve got to make the financial case.

Use a carrot, not a stick. You can be the pilot light.

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THE STATE: CAN IT GET THE HORSE TO THE STATE: CAN IT GET THE HORSE TO DRINK?DRINK?