The power of an apology post-medical error: 5 key points

Many hospitals are doing away with the "deny and defend" model when it comes to medical errors and instead are opting for disclosing, apologizing and compensating for mistakes, according to a Kaiser Health News report.

Here are five key points on the increasingly popular approach to the aftermath of medical errors.

1. An established framework exists. The federal Agency for Healthcare Research and Quality has a framework called CANDOR, which stands for Communication and Optimal Resolution. Fourteen hospitals across the country tested the framework, which was pioneered by the University of Michigan Health System in Ann Arbor. Programs based on the CANDOR framework typically involve investigation into the errors, sharing the results of said investigations with patients, as well as an apology and financial compensation.

2. It doesn't lead to more litigation. According to Kaiser Health News, the number of malpractice lawsuits at University of Michigan Health System was nearly cut in half after implementing the CANDOR system, and the system saved roughly $2 million in the first year from saved litigation costs.

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3. It can make care safer. "The whole point of this isn't to drop malpractice costs, it's to drive patient safety," Richard Boothman, the University of Michigan Health System's executive director of clinical safety and chief risk officer, told Kaiser Health News. For instance, in hospitals without such a model, "patient safety experts do not routinely talk to risk managers who handle malpractice claims," according to the article. "As a result, valuable information about preventing errors is lost."

4. Not everyone is a fan. Several groups of stakeholders push back against this approach to mollifying patients after a medical error. For instance, physicians worry an apology would make a patient more likely to file a malpractice suit, studies have shown. Some lawyers fear hospitals will take advantage of patients who aren't represented legally. "The hospitals are in control of it, and it's still in their interest to try and limit compensation to patients," Joanne Doroshow, a lawyer and director of the Center for Justice & Democracy, told Kaiser Health News.

5. One success story. MedStar Union Memorial Hospital in Baltimore uses a form of the CANDOR model, and when a medical error left Jack Gentry a quadriplegic, the hospital set the framework into motion — Mr. Gentry and his wife were immediately told about the surgical error, received an apology and were eventually financially supported by the hospital for Mr. Gentry's rehabilitation and other major expenses. "I was skeptical in the beginning of this whole process," Ms. Gentry told Kaiser Health News, but she now believes it works.

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