Insurance companies and the medical community have been scapegoating lawyers and lawsuits for years, blaming them for rising health care costs. And so for decades they have been lobbying for legislation to weaken the civil justice system and deprive individuals of their right to a full and fair jury trial. Not surprisingly, the lobbying efforts have done little to improve patient safety. A recent article published in the American Journal of Obstetrics & Gynecology shows that patient safety is actually improved when health care providers and insurance companies work together to, well, improve patient safety.
In 2002, the obstetric department at the Yale-New Haven Hospital collaborated with their liability insurance company to implement a comprehensive obstetric safety program. The core elements included team training (so the physicians, midwives, nurses, administrators, and assistants would communicate and cooperate better), an anonymous reporting system (which allowed team members to report medical errors that might have harmed a patient), a patient safety committee (to review the reports), and measures to standardize care. The program also required an obstetrician be present at the hospital 24 hours a day, and not just reachable by phone.
The results were remarkable. In the 5 years before the program started, the department paid $50.7 million for medical negligence claims. In the 5 years after the program started the total payouts dropped more than 90%. The actual number of negligence claims also dropped by about 50%.
Medical negligence lawsuits are a good indicator of healthcare quality. And so the precipitous drop in negligence claims is a sign that this comprehensive safety program has reduced the number and magnitude of preventable medical errors.
It’s a sobering and reassuring lesson about what happens when we stop blaming the legal system and start focusing on improving the healthcare system.