Malpractice Claims Patient Safety Violations

Describe how your proposal aligns with the Foundation’s stated purpose. Malpractice lawsuits occur because of a breakdown in patient safety, resulting in injury to the patient, a loss of trust between the patient and provider, diminished professional reputation for the facility and billion-dollar payments charged to hospital systems and their insurance providers. Our proposal, sponsored by the Network Performance Group within Montefiore Medical Center, aims to addresses the significant challenges of patient safety within a large academic urban hospital. It will investigate the relationship between patient experience and the risk of malpractice suits for high risk specialties using a mixed methods approach (quantitative and qualitative research).

Our analysis will also investigate how marginal changes in patient experience impact the likelihood of having a malpractice suit.

There is evidence of a positive association between patient experience and patient safety indicators, health/clinical outcomes, adherence to recommended clinical practice and medication, preventive care, resource use, measures of the technical quality of care and adverse events, capacity to deal with the disease (clinical effectiveness).

According to CRICO, 30% of malpractice suits attribute failures in communication as a major reason for patient harm. Our proposal supports the Foundation’s purpose in supporting patient safety education for healthcare professionals because our research strives to address patient -provider communication factors that promote failure in patient safety standards, such as diagnostic errors and lack of informed consent. Our analysis will examine the probability of facing a malpractice suit when communication failures are identified in the patient experience and qualitative research methods, such as focus groups, will provide in depth detail about

Describe what makes your project innovative or what differentiates it and makes it better than the models or methods currently in use to improve patient safety.

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Patient experience will be measured using the Hospital Consumer Assessment of Healthcare Providers and Systems (HCAHPS) survey, which is the first national standardized and publicly reported survey of patients’ perspectives of hospital care. This survey collects information about patients’ perceptions of their hospital experience post-discharge. HCAHPS survey results are reported to the Center for Medicare and Medicaid Services (CMS) solely for quality improvement purposes, but we plan to use this survey to establish an association with patient safety and medical malpractice. Previous research, Fullam et al, conducted a similar analysis that used patient satisfaction scores to predict malpractice risk among selected providers.

The limitations of this research are that poor patience was associated with the specific providers included in the analysis and this lacks generalizability and external validity. Also, the authors recommended a qualitative analysis to fully explain the relationship between patient experience and patient safety and malpractice. Our analysis plans to fill this gap by focusing on high risk specialties rather than individual providers, in conjunction with Montefiore practice of Just Culture, which creates an environment that encourages system level accountability and de-emphasizes individual blame. This approach is more generalizable because patient safety failures are more prevalent in high risk specialties (medicine, surgery and obstetrics/gynecology). We will also use a mixed methods approach to provide a higher potential for robust insights into factors affecting patient safety from the patient perspective.

Describe how your dissemination plan will result in widespread use to improve patient safety across the healthcare community. This proposal will yield results that summarize the relationship between patient experience (measured by HCAHPS responses) with malpractice claims and suits. HCAHPS is mandated for every hospital and the results of this analysis will likely be similar in other institutions. The recommendations we generate from the results will be shared during local and national conferences and through peer-reviewed publication. Explain specifically how the cost of this project is justified by the improvement in patient safety that will result from implementation, and comment on whether the project can be implemented in other care settings where the associated costs also will be justified by the overall benefits.

The results from this research will highlight recommendations for addressing the breakdown in patient experience and patient safety. Strengthening this relationship could eventually result in a decreased rate of medical malpractice cases. Purpose of the study is to identify communication specific patient experience factors which contribute towards malpractice lawsuits. “Fifty-seven percent of the communication failures identified occurred between providers and 55 percent occurred between providers and patients, meaning 12 percent involved both provider-provider and provider-patient communication errors. ​ The total incurred losses related to these cases were estimated to be about $1.7 billion.”

This will have system-wide policy implications for hospitals in terms of how to improve patient experiences by focusing on activities (such as care coordination and patient engagement) found to be associated with both outcomes and malpractice claims, evaluate the effects of new care-delivery models on patients’ experiences and outcomes, develop robust measurement approaches that provide timely and actionable information to facilitate organizational change, and improve data-collection methods and procedures to provide fair and accurate assessments of individual providers.​​

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Malpractice Claims Patient Safety Violations. (2021, Dec 27). Retrieved from

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