By Greg Freeman
Executive Summary
A hospital’s patient advocacy reporting system has been tied to lower malpractice costs. The system collects patient and family reports regarding physician behavior.
- The data are used to identify clinicians in need of intervention.
- There was an 83% reduction in malpractice claims cost per high-risk clinician.
- A similar system could be implemented by other hospitals.
A patient advocacy reporting program at Vanderbilt University Medical Center was associated with a significant decrease in malpractice claim costs for high-risk clinicians in an orthopedic practice network, suggesting a strategy that other hospitals can employ.
The Patient Advocacy Reporting System (PARS) was designed by the Vanderbilt Center for Patient and Professional Advocacy. Prompted by research showing that a small subset of physicians were associated with a disproportionate share of claims and payouts, PARS was developed to facilitate the reporting of patient and family observations and experiences, which can be used to identify high-risk clinicians and support intervention.
Recent research suggests the program has a beneficial effect on reducing malpractice claims, says William Cooper, MD, MPH, Cornelius Vanderbilt Professor of Pediatrics and Health Policy and President of the Vanderbilt Health Center for Patient and Professional Advocacy at Vanderbilt University Medical Center in Nashville, TN. (The study is available online at https://bit.ly/3V1MGfZ.)
Cooper and his colleagues performed a retrospective cohort study analyzing the impact of PARS on patient complaints and the cost of malpractice claims in an orthopedic practice network from 2004 to 2020. They found that 42 clinicians from the practice had high PARS index scores, meaning they had a higher risk of complaints and claims. “Overall, implementation of PARS was associated with an 83% reduction in malpractice claims cost per high-risk clinician and an 87% reduction in mean annual claims cost per clinician for the entire practice,” the study found. “Clinicians who identified as high risk accounted for $95,592 in malpractice claims per clinician before the implementation of PARS and $16,368 per clinician after the implementation of PARS.”
The three-year mean malpractice claims cost per insured clinician was $12,088 before the implementation of PARS and $1,586 after 12 years of PARS, the study found.
“One reason why it was so successful is because this group said, ‘We’re going to give you every chance to self-correct, but if you don’t, we’re going to hold you accountable.’ One of the reasons why we believe this group had such success is they applied the tiered intervention that we developed at Vanderbilt in a really robust way,” Cooper says. “But they were also willing to hold those who didn’t respond to the early intervention with a more measured approach to help them improve. This is all about helping people be the best version of themselves.”
Cooper says the lesson for other hospitals is about the value of giving physicians feedback as soon as possible about their malpractice risk.
“Giving them a chance to self-correct can be extraordinarily helpful,” he says.
Source
- William Cooper, MD, MPH, Cornelius Vanderbilt Professor of Pediatrics and Health Policy and President of the Vanderbilt Health Center for Patient and Professional Advocacy, Vanderbilt University Medical Center, Nashville, TN. Email: [email protected].
A patient advocacy reporting program at Vanderbilt University Medical Center was associated with a significant decrease in malpractice claim costs for high-risk clinicians in an orthopedic practice network, suggesting a strategy that other hospitals can employ.
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