The Agency for Healthcare Research and Quality (AHRQ) is the lead Federal agency charged with improving the safety and quality of America’s health care system. AHRQ develops the knowledge, tools, and data needed to improve the health care system and help Americans, health care professionals, and policymakers make informed health decisions.

Read how the AMA pursues medical liability laws on the state level to reshape the current medical liability system to better serve both physicians and patients.

39 states have apology laws, with over a third applying to healthcare or other contexts. After over a decade of experience with apology laws, the authors explore whether apology laws reduce malpractice liability risk and why, and whether there is a reason to have them.

WEBINAR DATE: May 1, 2020

The COVID-19 pandemic is posing a host of potential medicolegal risks for healthcare providers, institutions, and liability insurers. How should one respond to the patient with behavioral challenges who refuses to comply with social distancing? How do COVID requirements affect consent and surrogate decision-making? What new legal issues are arising with rapid expanding telehealth programs or deploying providers to new care environments such as nursing homes? In what situations should healthcare providers or organizations be provided with immunity for potential adverse events associated with COVID-19 care?

PRESENTERS:

Moderator
Thomas H. Gallagher, University of Washington
Panelists
Marcia Rhodes, University of Washington
Leilani Schweitzer, Stanford Health
Michael Severyn, ProAssurance
Kyle Sweet, Sweet Law Firm

OBJECTIVES:

1. Identify current medicolegal issues associated with COVID-19
2. Consider how medicolegal issues associated with COVID-19 may evolve in the future
3. Discuss possible ways to address these issues

WEBINAR DATE: July 16, 2020

This webinar outlines the concerns and questions about the collision between the judicial system and its pathway to addressing medical error and CRP programs.

PRESENTERS: Cindy Jacobs, RN, JD

OBJECTIVES:

1. Describe the basics of how the tort system operates in a medical error/adverse outcome situations
2. Describe the basics and how, when, and why CRP “apology laws,” “mandatory disclosure” laws/requirements, and healthcare licensing systems intersect and/or collide with the tort system
3. Identify key points to assist healthcare professionals in navigating intersections and collisions

The Communication and Resolution Program (CRP) Certification program is a promising example of collaboration among institutions, insurers, and regulators to promote patient‐centered accountability and learning following adverse events in the healthcare setting. These programs are successful, because they promote transparency among patients after an adverse health incident, and increase overall health quality.

Colorado Candor Act: ARTICLE 51 Communication and Resolution After an Adverse Health Care Incident (2019)

The Sweet Law Firm in Oklahoma City, one of the Collaborative for Accountability and Improvement’s partners in promoting the spread of CRPs, has developed a COVID-19 Consent for Treatment/Procedure/Surgery form.

2020-04-24 Proposed COVID-19 Consent Form (Final)

Doctors and Litigation is a website produced by Dr. Gita Pensa, an Emergency Medicine physician at Brown was a defendant for 12 years, and regularly speaks on the topic at conferences and has a podcast “Doctors in Litigation: the ‘L’ word.”

Communication-and-resolution programs (CRPs) in health care organizations seek to identify medical injuries promptly; ensure that they are disclosed to patients compassionately; pursue timely resolution through patient engagement, explanation, and, where appropriate, apology and compensation; and use lessons learned to improve patient safety. To make these programs more successful, legal entities should support them. State and federal policy makers should try to allay potential defendants’ fears of litigation, facilitate patient participation, and address the economic concerns of health care providers.

The Institute for Healthcare Improvement (IHI) and the National Patient Safety Foundation (NPSF) started collaborating together to utilize its combined resources and knowledge to further  patient safety efforts and create safety systems in various healthcare settings.

Iowa’s Candor Statute – Iowa Code §135P (2017)

Publish Date: January 28, 2020

A systematic review of 37 studies of malpractice deterrence  published between January 1, 1990, and November 25, 2019 was conducted to examine the association between malpractice liability risk and health care quality and safety. This review found that most studies suggest that higher risk of malpractice liability is not significantly associated with improved health care quality. The findings also suggested that greater tort liability was not associated with the improvement of quality of care.

Publish Date: January 28, 2020

This issue presents a thorough and rigorous analysis of recent research and draws findings from 37 studies.  It conclude that increased liability exposure, such as numbers of malpractice claims or changes to state malpractice laws, was not associated with improvement in the quality of patient care.

MA 2012 Payment Reform Legislation (Ch 224) – Key Liability Provisions

Oregon Resolution of Adverse Health Care Incidents Act (2013)

The authors of this study analyzed the importance of healthcare professionals being transparent in medical malpractices with their patients in the Texas healthcare system. The authors found that medical mishap litigation helped significantly reduce suing and other damages. The authors also emphasized the importance for healthcare systems to work with attorneys, policy makers, and patients to help develop methods to be more transparent about medical mishaps and enforce proactive mediation.

Data from case studies support the fact that apologies from physicians to patients promote reconciliation and forgiveness. To promote a culture that supports apologizing and disclosure, 39 states, including Washington, D.C., are enacting apology policies to decrease the litigation problems surrounding medical malpractice. This article is delves into the implications surrounding the enactment of these laws. The article is divided into four parts. The first part of the article explains why states are passing apology laws and how they can help reduce lawsuits associated with medical malpractice. The second part presents data that supports the effectiveness of apology laws. The third part illustrates how apology laws affect various legal outcomes, especially the probability that medical providers will be presented with litigation fees. The fourth part of the article delves into the legal significance of their results. It is important to note that apology laws do not replace communication-and-resolution programs (CRPs), nor do they mitigate the existing data that these programs are effective in lowering the incidence rates of medical error claims.

Healthcare professionals are reluctant to apologize for medical errors, because they fear it could be used against them in lawsuits. In response to this issue, some states are developing policies that legally protect physicians, so they feel more comfortable apologizing to patients involved in medical errors. Even though these policies seem beneficial in theory, researchers found that these laws could discourage apologies and honest communication between patients and physicians following adverse medical events. Thus, researchers emphasize the importance for states to develop policies with modified legal protections and implications to not only promote disclosure between patients and physicians following adverse medical incidents, but also do not weaken the legal influence on lawsuits involving malpractice.

The Medstar’s Patient Safety and Quality Program included this video in their patient safety and care program. This video illustrates the story of Michael Skolnik, who lost his life due to medical malpractice. The error involved the surgeon not being completely transparent with the patient or his family about the surgical procedure. This video emphasizes the importance of shared decision making between patients, families, and physicians to avoid future adverse medical outcomes, especially ones in which lives are lost.