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Truth or Consequences: Does Disclosure Reduce Risk Exposure?

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Dec. 20, 1999 (Boston) -- Accidents will happen, but doctors or hospital staff members who admit from the outset that they've made a mistake and pledge to work with patients and families to set things right can help restore balance and sanity to the process of risk management. That's from a report in the Dec. 21 issue of the journal Annals of Internal Medicine.

Hospitals that take a "humanistic" approach to risk management -- a process that involves early and active investigation of errors, keeping lines of communication open, full disclosure of fault to patients who have been injured due to hospital-related accidents or medical negligence, and fair compensation -- may be at lower risk for liability than hospitals that throw up defenses at the first sign of trouble, write Steve S. Kraman, MD, and Ginny Hamm, MD. Kraman and Hamm authored the study and are from the University of Kentucky and Veterans Affairs Medical Center in Lexington.

Although telling patients that they have been injured due to a preventable care-related error would seem to be a call for ambulance chasers to come crawling out of the woodwork, just such a policy has been in place at the Lexington VA Medical Center for 12 years, and it seems to be working for the benefit of providers and patients alike, says Kraman.

"We didn't start doing this to try to limit payments; we did it because we decided we weren't going to sit on or hide evidence that we had harmed a patient just because the patient didn't know it," he tells WebMD. "We started doing it because it was the right thing to do, and after a decade of doing it decided to look back to see what the experience had been. The indication that it's costing us less money was really unexpected."

Although it's difficult to make meaningful comparisons about litigation between different institutions, the authors found that "despite following a policy that seems to be designed to maximize malpractice claims, the Lexington facility's liability payments have been moderate and are comparable to those of similar facilities," the authors write. They attribute the lack of a negative financial impact to the institutional policy of notifying patients of substandard care and helping them with filing comprehensive claims.

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