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Massachusetts health care — wonky, with a healthy dose of reality

Improving Patient Safety Goal of New Malpractice Law

Improving Patient Safety Goal of New Malpractice Law

October 24, 2012
Alan Woodward and Jeff Catalano at HCFA --  10-24-12 Left: Alan Woodward of Mass Medical Society; Right: Jeffrey Catalano of Mass Bar Association

Health Care For All and Health Law Advocates cosponsored a talk earlier today (see the slides (pdf)) featuring attorney Jeff Catalano and Dr. Alan Woodward talking about the new medical malpractice laws in Massachusetts and the on-going efforts to move hospitals and other healthcare providers toward a culture of openness and transparency. The ultimate goal is to make care more patient- and family-centered and improve patient safety by learning from errors so that they can be prevented.

Dr. Woodward talked about a collaborative effort among a number of Massachusetts organizations, starting before the new laws were enacted, to move the state’s hospitals towards a system of “DA&O” or “Disclosure, Apology and Offer.” (Read this Business West article to learn more.) The system encourages disclosure of medical errors or adverse medical events to patients and families and an apology and offer of financial compensation when appropriate. The purpose is to be completely open with patients and families, who so often have found that there is no acknowledgement of what happened following a medical error, and to allow the process of healing on both sides (patient and provider) to begin during a period of communication about what happened and what will be done to prevent it from happening again. The University of Michigan’s health care system has been using DA&O since 2001 and has seen a large drop in the number of lawsuits filed, quicker resolution of cases, and, therefore, a decrease in cost, freeing up money that could be put toward patient safety initiatives. They have also seen a culture change with more reporting of incidents because of decreased fear by staff of what would happen if they reported an error or a near-miss. A number of MA hospitals are in a pilot program to implement similar systems and the goal is for all hospitals to implement, especially now that they are required to develop such programs under Chapter 224.

Mr. Catalano described the historic and unique collaboration between attorneys and doctors that allowed for the DA&O legislation to become law. As he said, for years the doctors and the lawyers would argue against one another at the State House and nothing would happen, so they decided to come together and forge a compromise, keeping in mind their shared goal of preventing patient harm and improving patient safety.

This partnership led to the provision in Chapter 224, something that has been a priority of the Consumer Health Quality Council and Health Care For All for 6 years. Many members of the Council had experienced medical errors, directly or through loved ones, and found that, in addition to trying to heal physically, they could not heal emotionally because they often never received an apology or acknowledgement of what had occurred. This law, we believe, will help patients and families in that healing process, and hopefully will reduce harm and change the culture of health care as it is implemented in hospitals across the state.